TY - JOUR
T1 - Cigarettes, heated tobacco products and dual use
T2 - exhaled carbon monoxide, saliva cotinine and total tobacco consumed by Hong Kong tobacco users
AU - Zhang, Xiaoyu
AU - Sun, Yuying
AU - Cheung, Yee Tak Derek
AU - Wang, Man Ping
AU - Wu, Yongda Socrates
AU - Chak, Kin Yeung
AU - Chen, Jianjiu
AU - Leung, Lok Tung
AU - Lam, Tai Hing
AU - Ho, Sai Yin
N1 - Publisher Copyright:
© Author(s) (or their employer(s)) 2024.
PY - 2024/6/20
Y1 - 2024/6/20
N2 - Background Independent studies on exhaled carbon monoxide (CO) and saliva cotinine levels in regular heated tobacco product (HTP) users, and how they compare with conventional cigarette (CC) smokers, are lacking. Methods A total of 3294 current users of CCs, HTPs or electronic cigarettes (ECs) from a household survey and a smoking hotspot survey were classified into seven groups: exclusive users of CCs, HTPs, ECs; dual users of CCs and HTPs, CCs and ECs, HTPs and ECs; and triple users. We measured exhaled CO level using the piCo Smokerlyzer (n=780) and saliva cotinine using NicAlert cotinine test strips (n=620). Among the seven groups, the differences in (1) CO and cotinine levels were examined using Kruskal-Wallis test, and (2) the average daily tobacco consumption in the past 30 days was examined using multivariable linear regression. Results Both exclusive and dual users of CCs had a higher CO level than exclusive HTP or EC users (p<0.05). Exhaled CO levels were similar between HTP and EC users, as were saliva cotinine levels among the seven groups. Compared with exclusive CC users, those who also used HTPs or ECs smoked fewer CCs (CCs+HTPs: adjusted coefficient −2.79, 95% CI −3.90 to –1.69; CCs+ECs: −1.34, 95% CI −2.34 to –0.34), but consumed more tobacco sticks equivalent in total (2.79 (95% CI 1.61 to 3.96); 1.95 (95% CI 0.79 to 3.12)). Conclusions HTP or EC use showed lower exhaled CO but similar saliva cotinine levels compared with CC use. Dual users of CCs and HTPs/ECs smoked fewer CCs than exclusive CC users, but consumed more tobacco in total.
AB - Background Independent studies on exhaled carbon monoxide (CO) and saliva cotinine levels in regular heated tobacco product (HTP) users, and how they compare with conventional cigarette (CC) smokers, are lacking. Methods A total of 3294 current users of CCs, HTPs or electronic cigarettes (ECs) from a household survey and a smoking hotspot survey were classified into seven groups: exclusive users of CCs, HTPs, ECs; dual users of CCs and HTPs, CCs and ECs, HTPs and ECs; and triple users. We measured exhaled CO level using the piCo Smokerlyzer (n=780) and saliva cotinine using NicAlert cotinine test strips (n=620). Among the seven groups, the differences in (1) CO and cotinine levels were examined using Kruskal-Wallis test, and (2) the average daily tobacco consumption in the past 30 days was examined using multivariable linear regression. Results Both exclusive and dual users of CCs had a higher CO level than exclusive HTP or EC users (p<0.05). Exhaled CO levels were similar between HTP and EC users, as were saliva cotinine levels among the seven groups. Compared with exclusive CC users, those who also used HTPs or ECs smoked fewer CCs (CCs+HTPs: adjusted coefficient −2.79, 95% CI −3.90 to –1.69; CCs+ECs: −1.34, 95% CI −2.34 to –0.34), but consumed more tobacco sticks equivalent in total (2.79 (95% CI 1.61 to 3.96); 1.95 (95% CI 0.79 to 3.12)). Conclusions HTP or EC use showed lower exhaled CO but similar saliva cotinine levels compared with CC use. Dual users of CCs and HTPs/ECs smoked fewer CCs than exclusive CC users, but consumed more tobacco in total.
KW - cotinine
KW - harm reduction
KW - non-cigarette tobacco products
UR - http://www.scopus.com/inward/record.url?scp=85148669176&partnerID=8YFLogxK
U2 - 10.1136/tc-2022-057598
DO - 10.1136/tc-2022-057598
M3 - Article
C2 - 36693724
AN - SCOPUS:85148669176
SN - 0964-4563
VL - 33
SP - 457
EP - 463
JO - Tobacco Control
JF - Tobacco Control
IS - 4
ER -
