Figure 3.7.3

Exposure to heavy metals among individuals reporting exclusive cigarette use, exclusive e-cigarette use, and dual use of combustible cigarettes and e-cigarettes, 2018-2019

People were exposed to similar levels of heavy metals, whether they only use e-cigarettes, only smoke cigarettes, or use both products.

Footnote

Exposure to heavy metals is measured by urinary Cadmium (UCD) and Lead (UPB). CPD = Number of cigarettes smoked per day and ECIGS = Frequency of e-cigarette use per day. The bars represent adjusted geometric means and boxes represent the 95% confidence intervals of biomarkers of exposure based on weighted multivariate regression analysis. Shared letters indicate no statistically significant difference between groups (e.g., groups sharing “a” denotes no significant difference between groups; groups with different letters, “a” and “b,” denotes a significant difference between groups). ng/mg creatinine = nanograms per milligram, normalized for creatinine.

Source

Zheng Xue, Eva Orr-Souza, Nigar Nargis, Minal Patel, Tyler Nighbor, Nicotine and Toxicant Exposure among Individuals using both Combustible Cigarettes and E-cigarettes Based on Level of Product Use, Nicotine & Tobacco Research, Volume 27, Issue 9, September 2025, Pages 1591–1599, https://doi.org/10.1093/ntr/ntaf053