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Kandel, Denise B.; Hu, Mei-Chen; Schaffran, Christine; Udry, J. Richard; & Benowitz, Neal L. (2007). Urine Nicotine Metabolites and Smoking Behavior in a Multiracial/Multiethnic National Sample of Young Adults. American Journal of Epidemiology, 165(8), 901-910.


Nicotine metabolism has been hypothesized to affect patterns of smoking. The recent development of a noninvasive measure of nicotine metabolism, the nicotine metabolite ratio (trans-3'-hydroxycotinine/cotinine), makes it possible to examine the association between rate of nicotine metabolism and smoking behavior in the general population. This US study examined group differences in the ratio measured in urine and the association between the ratio and multiple measures of smoking behavior and nicotine dependence in a large, national representative sample of young adults. The sample included 900 daily smokers aged 18–26 years from wave III (2001–2002) of the National Longitudinal Survey of Adolescent Health. Nicotine dependence was measured by using the Fagerström Test for Nicotine Dependence. Females had higher nicotine metabolite ratios than males; Whites and Hispanics had higher nicotine metabolite ratios than African Americans or Asians. This finding is consistent with those from laboratory studies of older smokers based on intravenous infusion of nicotine. No significant association was found between the nicotine metabolite ratio and number of cigarettes smoked per day or nicotine dependence. The availability of a noninvasive measure makes possible systematic testing of causal hypotheses generated by laboratory studies in the general population.


Reference Type

Journal Article

Year Published


Journal Title

American Journal of Epidemiology


Kandel, Denise B.
Hu, Mei-Chen
Schaffran, Christine
Udry, J. Richard
Benowitz, Neal L.