Serum cotinine levels and nicotine addiction potential of e-cigarettes: an NhaNES analysis.

Introduction:
This text provides an analysis of the potential chronic nicotine addiction risk that e-cigarettes pose, as compared to combustible cigarettes. The study utilizes data from the National health and Nutrition Examination Survey (NhaNES) to compare serum cotinine levels in e-cigarette and combustible cigarette smokers.

Key Points:

* The study analyzed 428 participants in the 2015-2016 NhaNES, including 379 combustible cigarette smokers and 49 e-cigarette smokers.
* Serum cotinine levels were measured by isotope-dilution high-performance liquid chromatography/atmospheric pressure chemical ionization tandem mass spectrometric method.
* Electronic cigarette smokers were younger, more likely to be male, and significantly less likely to live with other smokers than combustible cigarette smokers.
* Serum cotinine levels increased linearly with self-reported days of smoking in both electronic cigarette and combustible cigarette smokers.
* In a subgroup who reported daily use, electronic cigarette smokers had non-statistically significantly higher serum cotinine levels versus combustible cigarette smokers (β adj = 52.50, P = 0.10).
* The study demonstrates that electronic cigarettes expose users to nicotine levels proportionate to, and potentially higher than combustible cigarettes.
* The potential risk of chronic nicotine addiction, as well as the future risk of tobacco-related dependence, addiction, and cancers in these subjects needs to be investigated.

Main Message:
The study highlights the serious risk of chronic nicotine addiction that electronic cigarettes pose, with users potentially exposed to nicotine levels equivalent to or even higher than combustible cigarettes. This could be particularly relevant in otherwise tobacco naive individuals, and further research is needed to investigate the potential long-term health risks associated with e-cigarette use.

Rapp JL, alpert N, Flores RM, Taioli E. Serum cotinine levels and nicotine addiction potential of e-cigarettes: an NhaNES analysis. Carcinogenesis. 2020;41(10):1454-1459. doi:10.1093/carcin/bgaa015