Population characteristics and cigarette yield as determinants of smoke exposure

Relationships of population characteristics, smoking history, and cigarette yield with smoke exposure as measured by peripheral blood concentrations of thiocyanate, carboxyhemoglobin, nicotine and cotinine were sought in 170 male smokers. This population of smokers had significant elevations of serum thiocyanate, blood carboxyhemoglobin and plasma nicotine and cotinine concentrations as compared with an equal number of age- and sex-matched nonsmokers and these concentrations correlated significantly with past 24-hour cigarette consumption. Although the nicotine yield of the cigarette correlated significantly with plasma cotinine and marginally with plasma nicotine, the reduction in plasma nicotine and cotinine was not proportionate to the reduced yield of the cigarettes, suggesting that smokers partially compensate for the lower yields of their cigarettes. Blood levels of carboxyhemoglobin, nicotine and cotinine were also significantly associated with the weight of the subjects, presumably due to the relationship between weight and the volume of distribution. Univariate and multiple regression analyses provided evidence that coffee and alcohol consumption and years smoked also may be important determinants of smoke exposure.     

Effect of cigarette design on biomarkers of exposure,puffing topography and respiratory parameters

Abstract

Despite the lack of evidence, many reports exist which have implied that smokers inhale low-yield cigarette smoke more deeply than that of high-yield cigarettes. The objective of this study was to investigate the effect of short-term switching between smoker’s own brand and test cigarettes with different smoke yields on puffing topography, respiratory parameters and biomarkers of exposure. Participants were randomly assigned to smoke either a Test Cigarette-High Tar (TCH), for two days, and then switched to a Test Cigarette-Low Tar (TCL), for two days or the reverse order (n?=?10 each sequence). Puffing topography (CReSS microdevice), respiratory parameters (inductive plethysmography) and biomarkers of exposure (BOE, urinary nicotine equivalents – NE and blood carboxyhemoglobin – COHb) were measured at baseline and on days 2 and 4. The average puffs per cigarette, puff volume and puff durations were statistically significantly lower, and inter-puff interval was significantly longer for the TCH compared to the TCL groups. Respiratory parameters were not statistically significantly different between the TCH and TCL groups. Post-baseline NE and COHb were statistically significantly lower in the TCL compared to the TCH groups. Under the conditions of this study, we found no indication of changes in respiratory parameters, particularly inhalation time and volume, between study participants smoking lower versus higher yield cigarettes. Likewise, the BOE provides no indication of deeper inhalation when smoking low- versus high-yield cigarettes. These findings are consistent with the published literature indicating smoking low-yield cigarettes does not increase the depth of inhalation.     

Determinants of puff duration in cigarette smokers: II

Studies were conducted to provide information about variables that might account for decreases in puff duration that consistently occur as a whole cigarette is smoked. In two experiments, cigarette smoking was investigated under conditions in which subjects smoked cigarettes which they could not see. Puff duration was shown to covary with manipulations of resistance to draw--increasing tobacco rod length or adding filters proximal or distal to the smoke stream increased puff duration. Filtration of the smoke stream did not influence puff duration when resistance to draw was controlled. Comparison of changes in smoke temperature with changes in puff duration across a whole cigarette, and manipulation of smoke temperature by use of different length cigarette holders suggested that temperature did not appreciably control puff duration. A final experiment with nonhuman stimulated puffing of constant puff volume showed that both tobacco rod length and cigarette brand affected puff duration and suggests the possibility that the physics of smoke passing through the cigarette may be fundamental determinant of changes in puff duration during human smoking.     

Cigarette smoking in alcohol and cocaine abusers

This study compared the cigarette smoking of substance abusers whose primary substance of abuse was cocaine (cocaine group: n = 18) or alcohol (alcohol group: n = 23). Cigarette smoking and smoking topography was assessed daily (via self-report and single cigarette topography assessments) at baseline and following a switch to a cigarette brand with 30% lower nicotine. The alcohol and cocaine groups did not differ at baseline on cigarettes smoked per day, cigarette nicotine, smoking topography, or the Fagerstrom Tolerance Questionnaire. However, the cocaine group exhibited marked increases in compensatory smoking relative to the alcohol group following the 30% reduction in cigarette nicotine, as evidenced by decreases in the average time interval between each puff, p < .05, increases in the total amount of time spent puffing, p < .05, and increases in estimated total amount of time spent puffing per day, p < .05. These findings provide initial data that cocaine and alcohol abusers may titrate nicotine d differently and suggest that cocaine abusers may require additional or modified smoking cessation treatments.     

The relationship between chronic ethanol exposure and cigarette smoking in the laboratory and the natural environment

Few studies have examined the association between ethanol use and cigarette smoking topography. In particular, no study has objectively investigated the relationship between chronic ethanol exposure and cigarette smoking. The aim of this study was to quantify the relationship between cigarette smoking and past and current ethanol use. Male and female cigarette smokers (n=77) between the ages of 30 and 65 years were recruited and grouped as a function of their past and current ethanol use. Group 1 (n=18) included subjects who were ethanol abstinent for the 3 months prior to the study and had no history of alcohol abuse (as defined by DSM-III criteria). Group 2 (n=19) included subjects who were current regular ethanol users and had no history of alcohol abuse. Group 3 (n=20) included subjects who were ethanol abstinent and had a history of alcohol abuse. Group 4 (n=20) included current regular ethanol users with a history of alcohol abuse. A history of alcohol abuse was associated with an intensified pattern of cigarette smoking. Significant differences were observed for total daily smoke exposure, cigarette number, puff number, total puff and inhalation volume, and the nicotine, tar and carbon monoxide yields of the cigarettes smoked. Increased expired-air carbon monoxide and serum cotinine levels were also observed. Current ethanol use was not associated with an increased cigarette smoking pattern. These data suggest that alcohol abusers are at greater risk of contracting cigarette-related pathology.Supported by National Institute on Drug Abuse Research Grant No. DA 05013 and DA 02988     

Nicotine yield as determinant of smoke exposure indicators and puffing behavior.

Relationships between machine smoking nicotine yield and different smoke exposure indicators were investigated in a cross-sectional study. For each of the four yield classes H (1.0-1.2 mg), M (0.7-0.9 mg), L (0.4-0.6 mg) and U (0.1-0.3 mg) 18 male and 18 female subjects were recruited. The experimental design (2 x 2) included smoking with lip contact or with a flowmeter holder, natural smoking of one cigarette or forced smoking (30 puffs). The analysis of presmoking measures revealed for plasma nicotine H greater than L, U; M greater than U, for plasma cotinine H, M greater than U, and no differences for respiratory CO. Pre- to postsmoking boosts of CO and nicotine increased with yield, but the differences were smaller than those in yield. This partial compensation can be attributed to puffing behavior as revealed by the differences between yield classes with respect to flowmeter measures (puff volume, flow parameters, number of puffs). Contact condition hardly influenced the results. Forced puffing revealed down regulation mechanisms in smoke absorption and, less pronounced, in puffing behavior. Cardiovascular and subjective effects were widely independent of yield. Plasma cotinine appeared as the best smoke exposure indicator, due both to its high retest reliability and its relationship to nicotine yield.     

Effects of cigarette rod length on puff volume and carbon monoxide delivery in cigarette smokers

As part of a continuing series of studies to investigate the variables controlling various topographical aspects of cigarette smoking, the present study examined the extent to which cigarette rod length influenced smoking. Cigarette smoking was examined under conditions in which subjects smoked cigarettes they could not see. Both puff volume and puff duration varied as a direct function of rod length, although they were not highly correlated. Peak flow rate was not affected by rod length. Other results suggest that visual stimulus control and satiation did not affect puff volume. Comparison of puffing whole cigarettes versus short cigarette rods suggests that puff volume, but not puff duration, may be decreased in response to increased pharmacological delivery as a result of particulate build-up during smoking of a whole cigarette. Carbon monoxide (CO) exposure was substantially greater after puffing full length cigarette rods than after short cigarette rods. Comparison of these human CO data with CO delivery from syringe-simulated puffing of full length and short cigarette rods indicates that knowledge of puff volume and duration during human smoking is insufficient for accurately predicting biological (CO) exposure.     

Cigarette filter vent blocking: effects on smoking topography and carbon monoxide exposure

Two studies were conducted using smokers of unventilated cigarettes to determine the effects of filter vent blocking on smoke exposure (Experiment 1) and smoking topography (Experiment 2). In both studies, subjects were exposed to ultra low yield cigarettes that had 0%, 50%, and 100% of their filter vents blocked with tape. In Experiment 1, carbon monoxide (CO) exposure from eight 60 ml puffs increased in an orderly fashion as a function of filter vent blocking. By blocking filter vents, smoke was no longer diluted with air as it passed through the filter, and hence, exposure to smoke constituents was increased. In Experiment 2, when puff and inhalation parameters were allowed to vary, subjects took significantly more puffs, and larger puffs from unblocked cigarettes than from completely blocked cigarettes, but CO exposure from the completely blocked cigarette was double that from the unblocked cigarette (8.96 ppm vs. 4.32 ppm). The increased number and volume of puffs taken from ultra low yield cigarettes with unblocked filter vents may be due to changes in physical characteristics of the cigarette, and not to smokers actively compensating for reduced smoke constituent yields.     

Topography of sham and real puffing examined using a paced smoking regimen

Topographical patterns of normal puffing on a cigarette may be reflected in the topographical patterns of sham puffing (Morris & Gale, 1994). To test further the possibility of measuring behavior associated with cigarette smoke self-administration without actual smoke intake, we compared sham and real puffing using a paced smoking regimen under different levels of smoke deprivation. Cigarette smokers were instructed to draw and inhale six times on their unlit and then subsequently on their lit cigarette. Intensity, maximum, area and duration of puffs were lower for sham as opposed to real puffing; however, sham and real puffing showed parallel changes in response to deprivation, and significant positive correlations were found between the two puffing conditions for puff intensity, maximum and area. Therefore, we confirmed a similarity of real puffing with puffing under placebo conditions. Discussed was smoking as an automatic motor behavior.     

Effects of single doses of alcohol and caffeine on cigarette smoke puffing behavior

Puffing behavior (number of puffs, puff duration, puff volume, peak pressure, peak flow, peak latency, and puff interval) and pre- to postsmoking delta tidal CO difference were measured in female subjects in order to assess separate and combined effects of ethanol and caffeine. The subjects smoked two cigarettes of their habitual brand in a preliminary familiarizing session and in each of the subsequent four test sessions. The treatments administered after smoking the first cigarette in the test sessions were: alcohol placebo and caffeine placebo; alcohol placebo and caffeine; alcohol and caffeine placebo; alcohol and caffeine. Test-retest reliability across the first cigarette of each session (which was not smoked under the influence of the treatments) was remarkably high for all the puffing parameters. Ethanol in the dose of 0.7 g/kg intensified cigarette smoking of the second cigarette by increasing delta tidal CO, average puff volume, and total puff volume per cigarette, whereas 0.5 g/kg ethanol and 5 mg/kg caffeine given alone or combined with ethanol failed to influence puffing behavior consistently.     

Smoking Topography in a Nonlaboratory Environment

The relationships between the number of cigarettes smoked/day and the number of puffs/cigarette, puff duration, and total puff time/cigarette were studied. Data were collected on 12 regular smokers for all cigarettes smoked over a 3-day period in a nonlaboratory environment. Between-subject variability was substantial on each of the topographical measures. Neither the number of cigarettes smoked per day nor the classification of Heavy (> 25 cigarettes/day) vs Moderate (< 25 cigarettes/day) smoking levels was related to the intensity with which cigarettes were smoked. Within-subject consistency on the topography measures indicates that smokers may have relatively unique smoking patterns.

Most studies of smoking in the natural environment employ number of cigarettes/day as their estimate of smoke exposure. However, total smoke exposure is determined by an interaction of various topographical features, including frequency (number of cigarettes/day, number of puffs/cigarette), durational (puff duration, interpuff interval, intercigarette interval), and volumetric (puff volume, inhalation volume) components. Employing cigarettes/day to estimate smoke exposure assumes a consistent relationship between cigarettes/day and other topographical features which contribute to total smoke exposure, but it is not clear that such a relationship exists. Laboratory studies of smoking behavior have found that cigarette frequency may vary independently of these other topographic components of smoking, lichtenstein and Antonuccio (1981) examined smoking topography in 24 male smokers while they smoked a cigarette during two 45-minute sessions. They found that cigarette rate was significantly related to intercigarette interval, but not to puff frequency, puff duration, cigarette duration, and amount of tobacco burned.

Results found in laboratory settings, however, have been found not to necessarily generalize to nonlaboratory environments. For example, OssipKlein, Martin, Lomax, Prue, and Davis (1983) examined six subjects smoking adlib in three settings: natural, clinical, and laboratory. They found that cigarette durations were shorter and that subjects took significantly longer and more puffs in a clinical or laboratory setting compared to a naturalistic setting. Thus, examination of the relationship between topographical features in naturalistic smoking would appear to require direct study outside the laboratory.

The present study is to our knowledge the first to examine topographical features of smoking and the relationship between number of cigarettes smoked/ day and other measures of smoking topography while the subject smoked ad-lib in a nonlaboratory environment. This information would potentially be important in examining the extent of individual differences in smoking topography, in assessing the extent to which cigarettes/day is related to other aspects of smoking behavior, and in determining whether categorizing smokers into smoking groups (e.g., moderate and heavy) on the basis of number of cigarettes/day accurately reflects the amount of total smoke exposure/day.     

A closed-loop control "playback" smoking machine for generating mainstream smoke aerosols.

A first generation smoking machine capable of reading and replicating detailed puffing behavior from recorded smoking topography data is presented. Unlike standard smoking machines, which model human puffing behavior as a steady periodic waveform with a fixed puff frequency, volume, and duration, this novel machine generates a mainstream smoke aerosol by automatically "playing-back" puff topography recordings. Because combustion chemistry is highly non-linear, representing real smoking behavior with a smoothed periodic waveform may result in a tobacco smoke aerosol with a significantly different chemical composition and physical properties than that generated by a smoker. The machine presented here utilizes a rapid closed-loop control algorithm coded in Labview to generate smoke aerosols for toxicological assessment and inhalation studies. To illustrate its use, dry particulate matter and carbon monoxide yields generated using the playback and equivalent periodic puffing regimens are compared for a single smoking session by a 26-year-old male narghile water-pipe smoker. It was found that the periodic puffing regimen yielded 20% less carbon monoxide (CO) than the played-back smoking session, indicating that steady periodic smoking regimens, which are widely used in tobacco smoke research, may not produce realistic smoke aerosols.     

Factors affecting exposure to nicotine and carbon monoxide in adult cigarette smokers

Exposure to cigarette smoke among smokers is highly variable. This variability has been attributed to differences in smoking behavior as measured by smoking topography, as well as other behavioral and subjective aspects of smoking. The objective of this study was to determine the factors affecting smoke exposure as estimated by biomarkers of exposure to nicotine and carbon monoxide (CO). In a multi-center cross-sectional study of 3585 adult smokers and 1077 adult nonsmokers, exposure to nicotine and CO was estimated by 24 h urinary excretion of nicotine and five of its metabolites and by blood carboxyhemoglobin, respectively. Number of cigarettes smoked per day (CPD) was determined from cigarette butts returned. Puffing parameters were determined through a CreSS® micro device and a 182-item adult smoker questionnaire (ASQ) was administered. The relationship between exposure and demographic factors, smoking machine measured tar yield and CPD was examined in a statistical model (Model A). Topography parameters were added to this model (Model B) which was further expanded (Model C) by adding selected questions from the ASQ identified by a data reduction process. In all the models, CPD was the most important and highest ranking factor determining daily exposure. Other statistically significant factors were number of years smoked, questions related to morning smoking, topography and tar yield categories. In conclusion, the models investigated in this analysis, explain about 30-40% of variability in exposure to nicotine and CO.     

Smoke yield of cigarettes and puffing behavior in men and women

Puffing behavior (number of puffs, puff interval, puff duration, peak pressure, latency to peak pressure, average and total puff volume) was measured in 67 dependent male and 43 dependent female smokers when they smoked two cigarettes of their habitual brand under laboratory conditions. Test-retest reliability for the two cigarettes was high, and factor analysis showed that puff shape, puff volume, and puff frequency accounted for about 50% of variation obtained with the different puffing variables. Expiratory tidal CO levels increased with the number of cigarettes smoked before the tests and with the intensity of the smoking habit, but pre- to postsmoking tidal CO differences were similar for smokers of all types of cigarettes (0.1–1.7 mg standard machine smoking nicotine yield). Volume compensation for differences of smoke yield of the cigarettes was generally more pronouced in women than in men and, additionally, it was more pronounced for cigarettes with standard smoke nicotine yield below 0.9 mg than for cigarettes with standard smoke nicotine yield above 0.9 mg for both sexes. Only for women, partial correlation procedures suggested that nicotine might be more important in determining puffing behavior than CO and condensate yield, but there were also no women smoking the strongest cigarettes (1.3–1.7 mg nicotine yield). For both sexes, no compensation by adjusting the number of cigarettes smoked daily was obtained. Personality ratings, pulmonary functions, and cardiovascular functions were not, or only inconsistently, correlated with puffing behavior or type of cigarette.     

How does puffing behavior alter during the smoking of a single cigarette?

We examined changes in puffing behavior during the course of a single cigarette in 76 subjects seen on 6 occasions each (456 cigarettes). The puff volume fell on average by 33% during a cigarette and puff duration by 39%, the interpuff interval rose by 75%, but the pressure drop and the maximum flow and pressure achieved during puffing hardly changed. There were highly significant differences between subjects but not between sessions, or when subjects were grouped according to tar yield of the cigarette or by sex. Individual puff volumes with a single cigarette were highly correlated with puff duration (except in a few individuals with irregular puffing patterns), but not generally with maximum flow rate, suggesting that most smokers reduce volume by taking shorter puffs. This is unlikely to reflect mechanical factors or smoke temperature, and may be a response to changing smoke composition. Variation in puffing patterns between individuals may reflect differences in sensitivity to smoke components and individuals who show little fall in puff volume also show small responses on switching to cigarettes with different tar and nicotine yields. The individual response to smoke might be assessed by an analysis of puffing on a single cigarette.     

Ultralow-yield cigarettes and type of ventilation: The role of ventilation blocking

Habitual smokers of perforation-ventilated cigarettes and of channel-ventilated cigarettes (18 male and 18 female subjects each; nicotine yield 0.1–0.3 mg, 0.2 mg, respectively) were compared with respect to different smoke exposure indicators and puffing behavior. The role of ventilation blocking was assessed by comparing normal lip contact smoking with smoking through a cigarette holder. The presmoking concentrations (plasma nicotine, cotinine, respiratory CO) were higher for channel-filter than for perforation-ventilated cigarettes, as were the pre- to postsmoking boosts (nicotine, CO) with normal lip smoking. Holder smoking resulted in lower boosts than lip smoking for the channel filter cigarettes, although the puffing behavior was considerably intensified. The boosts for perforation-ventilated cigarettes remained unchanged and were reached with only moderately intensified puffing behavior. The results indicate the importance of ventilation blocking in everyday lip smoking for channel-filter cigarettes, but not for conventional, perforated cigarettes.     

Estimating the hazards of less hazardous cigarettes. II. Study of cigarette yields of nicotine, carbon monoxide, and hydrogen cyanide in relation to levels of cotinine, carboxyhemoglobin, and thiocyanate in smokers

Yields of chemical constituents such as tar, nicotine, CO, and HCN defined by smoking machines are commonly assumed to provide a reasonable indication of the relative hazard associated with smoking a given brand of cigarette. Results reported here suggest that this assumption should be carefully reexamined. A total of 240 subjects, representing a wide range of smoking and brand characteristics, were recruited for an investigation of possible relations between brand yields and exposure (levels of carboxyhemoglobin, breath CO, plasma cotinine, plasma thiocyanate, and saliva thiocyanate). Exposure was highly correlated with consumption (number of cigarettes per day), but their was no correlation between any estimate of exposure and brand yield when level of consumption was held constant. In addition, a comparison of levels of carboxyhemoglobin and plasma thiocyanate for 16 smokers of "low-hazard" and 15 smokers of "high-hazard" cigarette brands revealed little difference between the two groups, even though average cigarette yields differed as much as 2- to 3-fold. A possible explanation for the results may be that current values for average puff volume, duration, and interval differ significantly from those used in programming smoking machines, particularly in the case of brands with low nicotine delivery.     

Cigarette smoking as a risk for cardiovascular disease V: Biochemical parameters with increased and decreased nicotine content cigarettes

Cigarette smokers were assessed for customary smoking behavior and then were assigned a cigarette which was 0.4 mg higher or lower in nicotine and after 4 weeks, were returned to their customary brand. Biochemical indices of smoking behavior including blood carboxyhemoglobin (COHb), plasma nicotine, cotinine and thiocyanate (-SCN) were measured every 2 weeks. When nicotine availability was increased, smokers received an increased nicotine bolus per puff as determined by plasma nicotine and did not alter smoking topography or cigarettes per day. Over the 4 weeks, plasma cotinine increased without corresponding increases in COHb and -SCN. The return to standard brand resulted in declining cotinine levels but increasing COHb and -SCN, suggesting altered inhalation patterns. In smokers switched to a low yield cigarette, there was a decrease in the nicotine obtained per cigarette followed by a steady rise in plasma cotinine, -SCN and blood COHb over the 4-week period. A positive correlation was observed between cotinine and the gas phase constituents during the change to lower yield and back to standard brand cigarettes. These results indicate that cigarette smokers compensate for decreased nicotine yield with concomitant increases in gas phase components. In addition, increased nicotine availability results in an increased body burden of nicotine and “tar,” but not gas phase constituents. The relative risks of cardiovascular disease under these two situations, which increase exposure to nicotine or gas phase components, deserve careful consideration.     

The influence of changing nicotine to tar ratios on human puffing behaviour and perceived sensory response

Rationale Smokers modify their smoking behaviour when switching from their usual product to higher or lower tar and nicotine-yield cigarettes.Objective The aims of the current study were to assess the influence of varying nicotine yields at constant tar yield on human puffing measures, nicotine deliveries under human smoking conditions and the sensory response to mainstream cigarette smoke. These assessments would allow an evaluation of the degree of compensation and the various possible causes of changes, if any.Methods The participants were 13 regular smokers of commercial or hand-rolled cigarettes. They were tested with four cigarettes, which exhibited a wide range of nicotine to 'tar' ratios at a relatively constant 'tar' yield. Their smoking behaviour was monitored by placing the test cigarettes into an orifice-type holder/flowmeter attached to a custom-built smoker behaviour analyser. In addition, a comprehensive sensory evaluation of the products was carried out.Results The differences in the nicotine to tar ratios of the samples did not significantly influence the puffing behaviour patterns, i.e. puff number and interval, total and average puff volume, integrated pressure and puff duration. Additionally the pre- to post-exhaled CO boosts were not significantly influenced by the experimental samples used in the study. However, the nicotine yields obtained by the smokers were significantly influenced by the machine-smoked nicotine yields or the nicotine to tar ratios of the samples. The machine-smoked nicotine yields were highly correlated with the nicotine yields obtained under human smoking conditions. For the sensory evaluation, there was only a significant difference between the samples in the intensity of the impact.Conclusion These observations imply that these puffing variables are not controlled by the nicotine yield of the cigarette.     

Smoking topography and carbon monoxide levels in smokers

Factors which effect the expired air carbon monoxide (CO) levels of smokers were examined in matched subject pairs who smoked an equal number of daytime cigarettes but had different CO levels (mean difference = 15.4 ppm). Measures of puff number, duration, and spacing, as well as the amount of CO increase per cigarette (CO boost), were assessed while subjects smoked a single cigarette in daily laboratory sessions. Subjects with relatively high CO levels had larger increases in CO after smoking a single cigarette than did individuals with low CO levels (p. less than .005) but did not differ on any other smoking topography measure. These data suggest that simple topography measures of puff number and duration may not contribute to between subject differences in tobacco smoke exposure, and that greater attention should be given to more refined measures such as puff volume and depth of inhalation. These data also suggest that the measurement of CO boost per cigarette may provide useful information regarding tobacco smoke intake.