Table 4.

Unadjusted and adjusted geometric mean ratios for biomarkers of exposure by tobacco use status, NHANES 1999–2012

Biomarkers of exposureTobacco use categoryUnadjusted geometric mean ratio (95% Cl)Adjusted geometric mean ratio (95% Cl)
Serum cotininePrimary cigar smokers137.3 (93.1–202.6)92.2 (64.6–131.8)
Secondary cigar smokers535.4 (331.4–864.8)485.7 (297.8–792.2)
Cigarette only smokers2,910.5 (2,694.4–3,143.9)2,341.3 (2,146.7–2,553.5)
Dual cigar/cigarette smokers2,278.2 (1,716.9–3,023.1)1,515.1 (1,143.5–2,007.5)
Nontobacco users (Ref)1.01.0
Urinary NNALPrimary cigar smokers26.6 (16.1–44.0)19.0 (11.3–32.0)
Secondary cigar smokers92.8 (49.6–173.4)82.3 (44.1–153.6)
Cigarette only smokers220.5 (198.5–244.9)182.2 (164.5–201.8)
Dual cigar/cigarette smokers273.1 (196.0–380.3)191.0 (139.0–262.4)
Nontobacco users (Ref)1.01.0
Blood cadmiumPrimary cigar smokers1.03 (0.91–1.16)1.21 (1.08–1.36)
Secondary cigar smokers1.62 (1.41–1.87)1.81 (1.58–2.08)
Cigarette only smokers3.51 (3.40–3.62)3.68 (3.57–3.80)
Dual cigar/cigarette smokers2.76 (2.36–3.22)3.20 (2.73–3.74)
Nontobacco users (Ref)1.01.0
Blood leadPrimary cigar smokers1.20 (1.09–1.33)1.13 (1.04–1.23)
Secondary cigar smokers1.61 (1.44–1.81)1.31 (1.17–1.45)
Cigarette only smokers1.48 (1.44–1.52)1.45 (1.42–1.48)
Dual cigar/cigarette smokers1.60 (1.40–1.83)1.45 (1.30–1.62)
Nontobacco users (Ref)1.01.0
Urinary arsenicPrimary cigar smokers1.18 (0.70–1.98)0.85 (0.55–1.30)
Secondary cigar smokers1.45 (1.01–2.09)1.33 (0.96–1.83)
Cigarette only smokers0.83 (0.75–0.92)0.87 (0.80–0.95)
Dual cigar/cigarette smokers1.38 (1.02–1.85)1.16 (0.79–1.69)
Nontobacco users (Ref)1.01.0

NOTE: NNAL data were available for 2007–2012 NHANES participants. Arsenic data were available for 2003–2012 NHANES participants. The adjusted geometric mean ratios were controlled for age, sex, race/ethnicity, educational attainment, and body mass index. For urinary NNAL and urinary arsenic, the adjusted ratios were further adjusted for creatinine. The unadjusted geometric mean ratios for urinary NNAL and urinary arsenic were not controlled for creatinine.