MSACL 2023 Abstract

U.S. Population Exposure to Anabasine and Anatabine from Cigarette Smoking: National Health and Nutrition Examination Survey (NHANES) 2013-2014

Patrick B. Bendik, Connie S. Sosnoff, Benjamin C. Blount, Wanzhe Zhu, June Feng, and Lanqing Wang
Tobacco and Volatiles Branch, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA

Patrick Bendik (Presenter) CDC

Relevant Financial Disclosures (within past 24 months) No relevant financial relationship(s) to disclose. Conflict mitigation NOT REQUIRED.

Introduction:
Anabasine and anatabine are minor alkaloids in tobacco products and are precursors of tobacco-specific nitrosamines (TSNAs). The levels of these two compounds have been used to differentiate between exposure to different tobacco products, monitor compliance with smoking cessation programs, and for biomonitoring in TSNA-related studies. Urinary anabasine and anatabine are also useful for identifying exposure to products containing nicotine from different sources (tobacco-derived vs. synthetic). There is a lack of information on urinary anabasine and anatabine levels in a representative sample of the U.S. population.

Methods:
The concentrations of anabasine and anatabine were measured in urine collected from a representative sample of U.S. adults who currently smoked cigarettes (N = 770) during the 2013-2014 National Health and Nutrition Examination Survey (NHANES) study cycle. Smoking status was confirmed by urinary cotinine concentrations ≥20 ng/mL while smoking frequency was self-reported. Urinary anabasine and anatabine concentrations were measured using an isotope-dilution high-performance liquid chromatography/electrospray ionization tandem mass spectrometric (HPLC-ESI-MS/MS) method. Weighted geometric means (GM) and geometric least squares means (LSM) with 95% confidence intervals were calculated for urinary anabasine and anatabine categorized by tobacco-use status [cigarettes per day (CPD) and smoking frequency] and demographic characteristics. All statistical analyses were performed using SAS 9.4 and JMP 13.2. We included strata and primary sampling unit (PSU) variables, and sample weights from the special sample set in all analyses to adjust for unequal probabilities of selection.

Results:
Urinary anabasine and anatabine are strongly, positively correlated with each other (R = 0.97) and are moderately, positively correlated with serum cotinine (R = 0.66 and 0.68, respectively). Smoking ≥20 CPD was associated with 3.6 times higher anabasine GM and 4.8 times higher anatabine GM compared with smoking <10 CPD. Compared with non-daily smoking, daily smoking was associated with higher GMs for urinary anabasine (1.41 ng/mL vs. 6.28 ng/mL) and anatabine (1.62 ng/mL vs. 9.24 ng/mL). Urinary anabasine and anatabine concentrations exceeded the established cut point of 2 ng/mL in 86% and 91% of urine samples from people who smoke (PWS) daily, respectively; in comparison, 100% of PWS daily had serum cotinine concentrations greater than the established 10 ng/mL cut point. We compared these minor tobacco alkaloid levels to those of serum cotinine to assess their suitability as indicators of recent tobacco use at established cut points and found that their optimal cut point values are lower than the established values.

Discussion:
This is the first time that anabasine and anatabine are reported for urine collected from a U.S. population-representative sample of NHANES study participants, providing a snapshot of exposure levels for U.S. adults who smoked during 2013-2014. The results of this study serve as an initial reference point for future analysis of NHANES cycles, where changes in the national level of urinary anabasine and anatabine can be monitored among people who smoke to show the effect of changes in tobacco policy.

Disclaimer:
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention (CDC). Use of trade names is for identification only and does not imply endorsement by the Centers for Disease Control and Prevention.