Table 2.

Biomarker concentrations by CPD category and tobacco user group among PATH Wave 1 adult daily cigarette smokers selected for biomarker analysis (geometric mean, 95% confidence interval)

Exclusive cigarette smokersDual cigarette and e-cigarette usersDual cigarette and smokeless tobacco users
Biomarker CPDnGM (95% CI)nGM (95% CI)nGM (95% CI)
TNE-2 (μmol/g creatinine)
 Never tobacco users1,6330.01 (0.01–0.01)1,6330.01 (0.01–0.01)1,6330.01 (0.01–0.01)
 0–4 CPD1109.88 (5.82–16.78)2416.91 (11.01–25.96)65.30 (0.59–47.78)a
 5–930526.43 (23.23–30.07)8335.62 (30.23–41.97)b1048.47 (20.72–113.38)
 10–1447447.98 (44.14–52.16)17246.46 (41.85–51.57)2756.22 (46.37–68.18)
 15–1927653.56 (47.95–59.83)11257.52 (50.12–66.02)1269.89 (48.43–100.88)
 20–2456062.54 (57.12–68.48)19770.23 (61.05–80.80)3852.13 (43.67–62.23)
 25–6022678.11 (69.12–88.26)6087.70 (77.53–99.22)1768.40 (46.40–100.82)
 All daily smokers1,95146.42 (43.22–49.85)64855.43 (51.52–59.63)b,c11051.20 (42.72–61.36)
P trend<0.0001<0.00010.0557
NNAL (ng/g creatinine)
 Never tobacco users1,6530.92 (0.82–1.04)a,d1,6530.92 (0.82–1.04)a,d1,6530.92 (0.82–1.04)a,d
 0–4 CPD11167.24 (45.76–98.80)2475.73 (46.22–124.07)6202.84 (65.72–626.09)
 5–9304155.26 (133.54–180.50)83204.14 (160.74–259.25)10481.67 (165.73–1399.95)b
 10–14474295.76 (267.15–327.43)172276.26 (239.83–318.24)27399.45 (311.63–512.03)b
 15–19276343.03 (309.39–380.33)111397.63 (325.43–485.84)12602.12 (321.04–1129.29)
 20–24560405.17 (372.37–440.85)196435.39 (380.30–498.47)38431.48 (330.57–563.20)
 25–60226582.55 (492.78–688.68)60622.59 (534.86–724.70)17631.52 (429.53–928.49)
 All daily smokers1,951298.01 (275.37–322.50)646345.24 (318.60–374.11)b,c110453.88 (383.26–537.51)b,c
P trend<0.0001<0.00010.0131
NNN (ng/g creatinine)
 Never tobacco users1,6471.92 (1.81–2.04)d1,6471.92 (1.81–2.04)d 1,6471.92 (1.81–2.04)d
 0–4 CPD1084.58 (3.36–6.26)243.20 (2.04–5.02)d 63.81 (1.25–11.66)a,d
 5–92928.43 (7.07–10.07)819.21 (6.41–13.23)1012.40 (5.24–29.31)
 10–1445914.84 (12.95–17.01)16710.98 (9.00–13.39)b2617.24 (13.68–21.74)
 15–1926618.75 (14.49–24.26)11016.25 (13.46–19.61)1226.22 (11.99–57.36)
 20–2452318.58 (16.90–20.41)19017.58 (14.14–21.86)3821.46 (13.62–33.83)
 25–6021424.23 (20.90–28.10)5923.94 (20.14–28.45)1722.70 (12.50–41.22)
 All daily smokers1,86214.89 (13.81–16.06)63114.05 (12.66–15.59)c10918.60 (14.57–23.74)b
P trend<0.0001<0.00010.0026
1-Hydroxypyrene (ng/g)
 Never tobacco users1,655128.13 (120.68–136.04)1,655128.13 (120.68–136.04)1,655128.13 (120.68–136.04)
 0–4 CPD111203.61 (171.86–241.22)24193.08 (158.38–235.39)6137.76 (93.07–203.91)
 5–9305237.27 (215.70–261.00)83335.98 (279.59–403.74)b 10418.41 (250.83–697.98)b
 10–14474326.84 (297.15–359.50)172332.93 (301.22–367.98)27412.34 (227.26–748.15)
 15–19276376.63 (316.09–448.76)112396.3 (344.40–456.04)12280.12 (231.86–338.41)b
 20–24560370.95 (341.65–402.76)197441.09 (408.32–476.49)b 38283.10 (209.87–381.90)
 25–60226482.01 (424.41–547.43)60559.97 (464.29–675.38)17450.72 (275.64–737.00)
 All daily smokers1,952335.76 (318.11–354.40)648391.17 (370.99–412.44)b,c110332.00 (278.16–396.25)
P trend<0.0001<0.00010.4101
2-Hydroxyfluorene (ng/g)
 Never tobacco users1,655167.20 (158.05–176.88)1,655167.2 (158.05–176.88)1,655167.2 (158.05–176.88)
 0–4 CPD111536.81 (452.87–636.31)24449.24 (329.64–612.23)6231.41 (170.69–313.74)b
 5–9305834.00 (743.00–936.13)83877.41 (736.63–1,045.10)101,011.39 (534.33–1,914.39)
 10–144741,134.92 (1,047.54–1,229.59)1721,113.77 (1,009.56–1,228.73)271,252.91 (758.39–2,069.91)
 15–192761,377.47 (1,229.28–1,543.53)1121,409.11 (1,237.47–1,604.56)121,145.81 (1,028.41–1,276.62)b
 20–245601,469.89 (1,359.39–1,589.38)1971,632.8 (1,481.08–1,800.06)381,013.46 (825.23–1,244.63)b
 25–602262,008.64 (1,827.04–2,208.30)602,104.13 (1,871.03–2,366.27)171,386.77 (964.98–1,992.93)
 All daily smokers1,9521,231.23 (1,173.36–1,291.97)6481,329.39 (1,249.40–1,414.50)1101,061.43 (925.93–1,216.76)c
P value for trend<0.0001<0.00010.0789
HPMA (μg/g)
 Never tobacco users1,653261.73 (247.18–277.13)1,653261.73 (247.18–277.13)1,653261.73 (247.18–277.13)
 0–4 CPD110604.78 (509.87–717.36)24477.01 (354.06–642.66)e6246.89 (190.60–319.79)b,e
 5–9301746.81 (620.88–898.29)83953.00 (790.29–1,149.22)101,128.29 (715.74–1,778.64)e
 10–144661,357.84 (1,225.63–1,504.30)1721,231.16 (1,096.02–1,382.97)251,093.16 (891.71–1,340.14)e
 15–192731,550.18 (1,383.86–1,736.49)1111,634.81 (1,366.15–1,956.29)111,215.16 (1,047.12–1,410.17)b,e
 20–245531,727.8 (1,584.74–1,883.78)1962,096.29 (1,824.04–2,409.17) b371,163.48 (921.17–1,469.53)b,e
 25–602222,566.52 (2,234.33–2,948.10)602,880.50 (2,451.94–3,383.97)171,809.66 (1,230.85–2,660.65)e
 All daily smokers1,9251,388.98 (1,299.67–1,484.42)6461,582.81 (1,457.69–1,718.67)b,c1061,143.82 (970.45–1,348.17)b,c
Ptrend<0.0001<0.00010.0007
CYMA (μg/g)
 Never tobacco users1,6531.27 (1.19–1.36)1,6531.27 (1.19–1.36)1,6531.27 (1.19–1.36)
 0–4 CPD11146.98 (31.16–70.83)2448.31 (30.20–77.27)e66.03 (1.32–27.65)a,b,e
 5–9305103.06 (87.17–121.85)83115.83 (93.60–143.34)1094.98 (43.59–206.96)e
 10–14474179.87 (160.60–201.46)172153.58 (133.50–176.68)26139.72 (114.48–170.52)e
 15–19276213.27 (182.96–248.61)112219.57 (183.71–262.44)12162.34 (122.19–215.68)e
 20–24560218.83 (201.97–237.11)197246.04 (215.03–281.52)38147.85 (109.78–199.13)b,e
 25–60225306.41 (271.79–345.43)60359.21 (307.82–419.17)17224.59 (136.45–369.68)e
 All daily smokers1,951176.38 (164.66–188.94)648194.79 (178.92–212.07)109130.94 (107.27–159.84)b,c
Ptrend<0.0001<0.00010.0060
MHB3 (μg/g)
 Never tobacco users1,6534.44 (4.24–4.64)1,6534.44 (4.24–4.64)1,6534.44 (4.24–4.64)
 0–4 CPD11113.52 (11.40–16.04)2413.89 (10.40–18.53)e65.99 (4.14–8.69)b,e
 5–930521.26 (18.37–24.61)8325.23 (20.00–31.83)1033.72 (22.08–51.50)e
 10–1447435.28 (31.23–39.85)17231.05 (27.09–35.59)2629.55 (23.36–37.38)e
 15–1927637.61 (33.39–42.36)11243.02 (37.35–49.57)1231.12 (25.97–37.29)e
 20–2456043.13 (39.90–46.62)19752.09 (44.71–60.67)b3828.37 (22.48–35.80)b,e
 25–6022552.45 (47.96–57.35)6062.13 (53.80–71.75)1736.50 (23.95–55.63)e
 All daily smokers1,95134.53 (32.64–36.53)64839.82 (36.59–43.34)b,c10928.34 (24.49–32.79)b,c
Ptrend<0.0001<0.00010.0300
Cadmium (μg/g)
 Never tobacco users1,6520.15 (0.14–0.16)1,6520.15 (0.14–0.16)1,6520.15 (0.14–0.16)
 0–4 CPD1110.23 (0.18–0.29)240.13 (0.09–0.19)b60.14 (0.05–0.38)d
 5–93030.20 (0.17–0.23)830.21 (0.17–0.26)100.13 (0.06–0.29)
 10–144730.29 (0.26–0.33)1720.24 (0.21–0.28)270.14 (0.11–0.19)
 15–192750.29 (0.25–0.34)1120.30 (0.23–0.41)120.20 (0.11–0.38)
 20–245580.37 (0.33–0.42)1960.37 (0.32–0.43)380.15 (0.11–0.20)b
 25–602240.53 (0.46–0.61)600.50 (0.42–0.59)170.35 (0.21–0.59)
 All daily smokers1,9440.31 (0.29–0.33)6470.30 (0.28–0.33)1100.17 (0.14–0.22)b,c
Ptrend<0.0001<0.00010.0005
Lead (μg/g)
 Never tobacco users1,6530.35 (0.33–0.37)1,6530.35 (0.33–0.37)1,6530.35 (0.33–0.37)
 0–4 CPD1110.50 (0.40–0.63)240.39 (0.31–0.50)60.47 (0.30–0.75)a
 5–93030.39 (0.34–0.44)830.46 (0.38–0.56)100.31 (0.23–0.42)
 10–144730.47 (0.43–0.51)1720.45 (0.41–0.50)270.43 (0.33–0.56)
 15–192750.51 (0.47–0.57)1120.50 (0.42–0.59)120.56 (0.32–1.00)a
 20–245580.52 (0.49–0.56)1960.56 (0.49–0.62)380.46 (0.37–0.57)
 25–602240.62 (0.56–0.69)600.67 (0.55–0.81)170.64 (0.34–1.20)a
 All daily smokers1,9440.49 (0.47–0.52)6470.51 (0.48–0.54)1100.47 (0.41–0.54)
Ptrend0.00040.00050.1503
  • Abbreviations: CI, confidence interval; GM, geometric mean.

  • aRelative SE > 30%.

  • bP value for difference from exclusive cigarette smokers <0.05.

  • cP value for difference from exclusive cigarette smokers among all daily smokers <0.05, controlling for CPD.

  • dMore than 40% of values were below the LOD.

  • en < 50.