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Nicotine Levels in Smokers Differ Based on Race, CDC Study Shows

By Sarah Yang
Los Angeles Times

Black smokers have higher levels of the metabolized form of nicotine in their bodies than do white smokers, providing potential clues about why blacks are less likely to quit smoking and more likely to develop lung cancer than whites, according to a study of more than 2,000 people by federal researchers published Wednesday in the Journal of the American Medical Association.

After controlling for variables such as body weight, age, and exposure to second-hand smoke, researchers at the federal Centers for Disease Control and Prevention found that black smokers had 12 percent to 50 percent higher levels of cotinine - a nicotine metabolite - than white smokers, and 32 percent to 56 percent higher cotinine levels than Mexican Americans.

A separate University of California San Francisco study of black and white smokers in the same journal also found that black smokers absorb more nicotine per cigarette and retain more cotinine in their bodies, than white smokers.

Together, the studies suggest that prevention and treatment strategies may need to be adapted to suit variances in ethnic and racial groups, researchers said.

"To me these studies emphasize the importance that future research does a better job in including the diverse nature of the population in the U.S.," said Jack Henningfield, associate professor of psychiatry at Johns Hopkins University Medical School and editor of the 1988 surgeon general report on nicotine addiction.

In the CDC study, researchers analyzed blood samples from 2,136 subjects aged 17 year or older who had participated in the Third National Health and Nutrition Examination Survey between 1988 and 1991. All subjects had reported smoking at least one cigarette in the five days prior to the time blood samples were taken.

The study by CDC researchers puts the weight of a large, population-based survey behind those earlier findings.

Lead investigator Ralph Caraballo, an epidemiologist at the CDC Office on Smoking and Health, said more research is necessary, but the findings may indicate differences in the way blacks smoke, or biological differences in the way they metabolize cotinine.