Table 2.

Geometric mean biomarker concentrations by tobacco use status, NHANES 1999 to 2012

Biomarkers of exposureNontobacco usersExclusive smokeless tobacco usersExclusive cigarette smokersDual cigarette and smokeless tobacco users
Serum cotinine, ng/mL
 Number of observations15,4244766,43990
 Mean (95% CI)0.043 (0.041–0.046)179.6 (145.8–221.1)130.6 (122.3–139.6)184.1 (132.4–256.0)
Urinary NNAL, pg/mg creatinine
 Number of observations7,2432102,95243
 Mean (95% CI)0.98 (0.92–1.04)583.0 (445.2–763.5)217.6 (193.0–245.2)430.3 (284.8–650.1)
Blood cadmium, μg/L
 Number of observations15,6872546,50990
 Mean (95% CI)0.268 (0.262–0.273)0.220 (0.201–0.240)0.941 (0.916–0.968)0.644 (0.515–0.806)
Blood lead, μg/L
 Number of observations15,6874776,50990
 Mean (95% CI)1.18 (1.16–1.21)1.76 (1.62–1.91)1.76 (1.71–1.81)1.76 (1.55–2.00)
Blood mercury, μg/L
 Number of observations12,9973575,25864
 Mean (95% CI)1.02 (0.97–1.06)0.82 (0.73–0.93)0.77 (0.73–0.81)0.63 (0.49–0.80)
Urinary arsenic, ng/mg creatinine
 Number of observations3,9051191,53827
 Mean (95% CI)9.53 (8.98–10.11)6.43 (5.36–7.71)7.65 (7.05–8.30)6.73 (4.84–9.37)
Urinary CYMA, ng/mg creatinine
 Number of observations1,883411,20214
 Mean (95% CI)1.47 (1.37–1.58)2.21 (1.11–4.39)117.3 (103.1–133.4)35.4 (2.1–606.8)

NOTE: Urinary NNAL, arsenic, and CYMA concentrations were adjusted for creatinine. NNAL data were available for 2007 to 2012 NHANES participants, arsenic data were available for 2003 to 2012 NHANES participants, and CYMA data were available for 2005 to 2006 and 2011 to 2012 NHANES participants. Former cigarette smokers were excluded from smokeless tobacco users for the analysis for cadmium.