Variation in Nicotine Intake in U.S. Cigarette Smokers Over the Past 25 Years: Evidence From NHANES Surveys
Menée aux Etats-Unis à partir des données d'une enquête nationale portant au total sur 11 399 fumeurs âgés de 20 ans ou plus, cette étude évalue l'évolution de la consommation de nicotine au cours des 25 dernières années
Objective : To estimate changes in nicotine intakes in cigarette smokers in the United States from 1988 to 2012 using the National Health and Nutrition Examination Survey (NHANES).
Methods : NHANES provides data on nationally representative samples of cigarette smokers from the civilian noninstitutionalized U.S. population. A total of 4,304 smokers aged 20 and above were studied in NHANES III 1988–1994 and 7,095 in the continuous NHANES 1999–2012. We examined serum cotinine concentrations, daily cigarette consumption, and estimated nicotine intake per cigarette, with adjustment for sex, age, racial/ethnic background, education level, and body mass index.
Results : There was little overall change in nicotine intake from smoking cigarettes either in the U.S. population as a whole or in major racial/ethnic subgroups over the 25-year period from 1988. Serum cotinine averaged 223.7ng/mL (95% confidence interval [CI] = 216.1–231.3) in 1988–1994, which was not significantly different from the adjusted mean of 219.2ng/mL (95% CI = 214.1–224.4) in 1999–2012. Over the same period, average daily cigarette consumption declined substantially, from 17.3 (95% CI = 16.5–18.0) in 1988–1994 to 12.3 (95% CI = 11.0–13.6) by 2012. Cotinine per cigarette smoked increased by some 42% between 1988–1994 and 2011–2012, from a geometric mean of 12.4 (95% CI = 11.7–13.1) to 17.6 (95% CI = 16.1–19.2).
Conclusions : Reductions in cigarette smoking prevalence since the late 1980s, changes in cigarette product design, and the widespread introduction of smoke-free policies have not impacted significantly on nicotine intakes in U.S. smokers. Reductions in cigarette consumption have been offset by increased nicotine intake per cigarette smoked.
Nicotine & Tobacco Research , résumé, 2014