Rachel Boykan1, Catherine R Messina2, Gabriela Chateau3, Allison Eliscu4, Jonathan Tolentino4,5, Maciej L Goniewicz6. 1. Departments of Pediatrics, rachel.boykan@stonybrookmedicine.edu. 2. Family, Population, and Preventive Medicine. 3. Renaissance School of Medicine at Stony Brook University, Stony Brook, New York; and. 4. Departments of Pediatrics. 5. Internal Medicine, and. 6. Division of Cancer Prevention and Population Sciences, Department of Health Behavior, Roswell Park Comprehensive Center, Buffalo, New York.
Abstract
BACKGROUND: Surveys have been instrumental in describing adolescent use of tobacco, electronic cigarettes (e-cigarettes), and marijuana. However, objective biomarker data are lacking. We compared adolescent self-reported use to urinary biomarkers. METHODS: From April 2017 to April 2018, adolescents 12 to 21 years old completed an anonymous questionnaire regarding tobacco, e-cigarette, and marijuana use and provided a urine sample. Urine was analyzed for biomarkers cotinine, total 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol, and tetrahydrocannabinolic acid (THCA). RESULTS: Of 517 participants, 2.9% reported using tobacco, 14.3% e-cigarettes, and 11.4% marijuana in the past week. Only 2% reporting no smoking had total 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol levels above cutoff (14.5 pg/mL); 2% of non-e-cigarette users had cotinine above cutoff (10 ng/mL); 2% of those denying marijuana use had THCA above cutoff (10 ng/mL). Daily e-cigarette users showed significantly higher median cotinine than nondaily users (315.4 [interquartile range (IQR) 1375.9] vs 1.69 ng/mL [IQR 28.2]; P < .003). Overall, 40% who reported using nicotine-free products had cotinine >10 ng/mL. Pod users' median cotinine was significantly higher than in nonpod users (259.03 [IQR 1267.69] vs 1.61 ng/mL [IQR 16.3]; P < .003). Median THCA among daily marijuana users was higher than in nondaily users (560.1 [IQR 1248.3] vs 7.2 ng/mL [IQR 254.9]; P = .04). Sixty-one percent of those with cotinine >10 ng/mL vs 39% of those with cotinine<10 ng/mL had THCA >10 ng/mL (P < .001). CONCLUSIONS: Adolescents' self-report correlated with measured urinary biomarkers, but subjects were unaware of their nicotine exposure. More frequent e-cigarette and pod use correlated with elevated biomarkers. Co-use of tobacco, e-cigarettes, and marijuana was corroborated by higher THCA in those with higher cotinine.
BACKGROUND: Surveys have been instrumental in describing adolescent use of tobacco, electronic cigarettes (e-cigarettes), and marijuana. However, objective biomarker data are lacking. We compared adolescent self-reported use to urinary biomarkers. METHODS: From April 2017 to April 2018, adolescents 12 to 21 years old completed an anonymous questionnaire regarding tobacco, e-cigarette, and marijuana use and provided a urine sample. Urine was analyzed for biomarkers cotinine, total 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol, and tetrahydrocannabinolic acid (THCA). RESULTS: Of 517 participants, 2.9% reported using tobacco, 14.3% e-cigarettes, and 11.4% marijuana in the past week. Only 2% reporting no smoking had total 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol levels above cutoff (14.5 pg/mL); 2% of non-e-cigarette users had cotinine above cutoff (10 ng/mL); 2% of those denying marijuana use had THCA above cutoff (10 ng/mL). Daily e-cigarette users showed significantly higher median cotinine than nondaily users (315.4 [interquartile range (IQR) 1375.9] vs 1.69 ng/mL [IQR 28.2]; P < .003). Overall, 40% who reported using nicotine-free products had cotinine >10 ng/mL. Pod users' median cotinine was significantly higher than in nonpod users (259.03 [IQR 1267.69] vs 1.61 ng/mL [IQR 16.3]; P < .003). Median THCA among daily marijuana users was higher than in nondaily users (560.1 [IQR 1248.3] vs 7.2 ng/mL [IQR 254.9]; P = .04). Sixty-one percent of those with cotinine >10 ng/mL vs 39% of those with cotinine<10 ng/mL had THCA >10 ng/mL (P < .001). CONCLUSIONS: Adolescents' self-report correlated with measured urinary biomarkers, but subjects were unaware of their nicotine exposure. More frequent e-cigarette and pod use correlated with elevated biomarkers. Co-use of tobacco, e-cigarettes, and marijuana was corroborated by higher THCA in those with higher cotinine.
Authors: Jessica M Perkins; Bernard Kakuhikire; Charles Baguma; Meredith Meadows; Claire Q Evans; Jordan Jurinsky; Justin D Rasmussen; Emily N Satinsky; Patience Ayebare; Viola Kyokunda; Mercy Juliet; David R Bangsberg; Alexander C Tsai Journal: Int J Drug Policy Date: 2021-12-07
Authors: Elise E DeVito; Tessa Fagle; Alicia M Allen; Raina D Pang; Nicole Petersen; Philip H Smith; Andrea H Weinberger Journal: Curr Addict Rep Date: 2021-07-21
Authors: Laura E Crotty Alexander; Lorraine B Ware; Carolyn S Calfee; Sean J Callahan; Thomas Eissenberg; Carol Farver; Maciej L Goniewicz; Ilona Jaspers; Farrah Kheradmand; Talmadge E King; Nuala J Meyer; Vladimir B Mikheev; Peter G Shields; Alan Shihadeh; Robert Strongin; Robert Tarran Journal: Am J Respir Crit Care Med Date: 2020-09-15 Impact factor: 21.405
Authors: Andrea S Gentzke; Teresa W Wang; Monica Cornelius; Eunice Park-Lee; Chunfeng Ren; Michael D Sawdey; Karen A Cullen; Caitlin Loretan; Ahmed Jamal; David M Homa Journal: MMWR Surveill Summ Date: 2022-03-11
Authors: Teresa W Wang; Andrea S Gentzke; MeLisa R Creamer; Karen A Cullen; Enver Holder-Hayes; Michael D Sawdey; Gabriella M Anic; David B Portnoy; Sean Hu; David M Homa; Ahmed Jamal; Linda J Neff Journal: MMWR Surveill Summ Date: 2019-11-06
Authors: Rachel Herold; Rachel Boykan; Allison Eliscu; Héctor E Alcalá; Maciej L Goniewicz Journal: Int J Environ Res Public Health Date: 2021-01-15 Impact factor: 3.390
Authors: Danielle M Smith; Connor Miller; Richard J O'Connor; Lynn T Kozlowski; Elle Wadsworth; Brian V Fix; R Lorraine Collins; Binnian Wei; Maciej L Goniewicz; Andrew J Hyland; David Hammond Journal: Subst Abus Date: 2020-01-17 Impact factor: 3.716