Nicotine and carbon monoxide exposure from inhalation of cigarillo smoke

•Puffing topography, biomarkers, and physiologic effects from usual brand cigarette and Black & Mild cigarillo were tested.•Time to smoke, number of puffs, and total puff volume differed for cigarette and cigarillo smoking.•Nicotine boost after cigarettes and cigarillos was similar; cigarillo smoking caused higher CO exposure.•Exposure to nicotine and other toxicants form cigarillo use are relevant to health and regulatory considerations.

BackgroundThere has been an increase in the use of cigarillos in the US. People who smoke cigarillos typically also regularly smoke cigarettes (dual users).MethodsWe compared puffing topography, biomarkers of acute exposure [exhaled carbon monoxide (COex) and plasma nicotine] and physiologic effects from usual brand cigarette and Black & Mild cigarillo smoking in dual users (N = 23) in two laboratory sessions.ResultsParticipants (21 men) smoked an average of 17.5 cigarettes/day. Cigarillo consumption varied widely from as few as 1/week to daily. Participants were highly nicotine dependent (average FTND score: 6.3). There were statistically significant differences in smoking behavior between cigarette and cigarillo smoking in time to smoke, number of puffs, and total puff volume (all P < 0.001). Average puff duration, interpuff interval average puff volume, and puff velocity did not differ between cigarettes and cigarillos. Nicotine boost was similar after both cigarettes and cigarillos. COex boost was significantly greater after cigarillo smoking compared to cigarette smoking (P < 0.001).ConclusionsThe smoking pattern and exposure profile indicate that dual users inhale cigarillo smoke just as they inhale cigarette smoke thereby exposing themselves to considerable amounts of nicotine and other components of tobacco smoke. COex exposure results imply that cigarillo smoking may be associated with higher exposure to smoke-delivered volatile components of mainstream cigarillo smoke including carcinogens when compared to cigarettes.ImpactThe findings that cigarillos and cigarettes are smoked similarly in dual users are relevant to health and regulatory considerations on cigar products.