American Journal of Epidemiology Advance Access originally published online on August 3, 2006
American Journal of Epidemiology 2006 164(8):750-759; doi:10.1093/aje/kwj263
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Original Contribution |
Changes in Nicotine Intake and Cigarette Use Over Time in Two Nationally Representative Cross-Sectional Samples of Smokers
1 Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY
2 Department of Biobehavioral Health, College of Health and Human Development, Pennsylvania State University, University Park, PA
3 Department of Psychology, School of Arts and Sciences, University of Pittsburgh, Pittsburgh, PA
4 Pinney Associates, Pittsburgh, PA
5 National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA
6 Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
Correspondence to Dr. Richard J. O'Connor, Department of Health Behavior, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263 (e-mail: richard.oconnor{at}roswellpark.org).
Population surveys have observed decreases in cigarette use over time among smokers. These decreases have probably been influenced by tobacco control measures implemented over the past several decades, but few data exist on whether smokers have also reduced their nicotine intake. The authors examined data from two cross-sectional National Health and Nutrition Examination Surveys (NHANES), conducted in 1988–1994 and 1999–2002. Laboratory, examination, and interview data from current smokers not reporting nicotine intake from other sources were examined. From NHANES III (1988–1994) to NHANES 1999–2002, the average number of cigarettes smoked per day (CPD) fell by nearly 15% (three cigarettes), while the mean serum cotinine level fell by 13% (30 ng/ml). Finer breakdowns of CPD data in each time period suggested that most of the change occurred in the lower (<10 CPD) and higher (
20 CPD) smoking categories. These data suggest that CPD may represent a proxy for exposure to nicotine and perhaps other tobacco smoke constituents on the population level, since the decline in serum cotinine levels observed among smokers closely paralleled the decline in self-reported CPD between 1988–1994 and 1999–2002. In addition, these data are inconsistent with the hypothesis that the remaining population of smokers is becoming more dependent on nicotine over time.
nicotine; nutrition surveys; smoking; tobacco use disorder
Abbreviations: CI, confidence interval; CPD, cigarettes per day; MEC, mobile examination center; NHANES, National Health and Nutrition Examination Survey
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