Differences between the effects of conventional cigarettes, e-cigarettes and dual product use on urine cotinine levels

Introduction The goal of this study was to evaluate the differences in urine cotinine (UC) concentration based on the use of conventional cigarettes, e-cigarettes (ECs), and dual product use, and determine the use of ECs in the real world. Methods In total, 15099 subjects were classified into non-smokers, cigarette smokers (c-smokers), e-cigarette smokers (e-smokers), and dual users, and their UC (a classical biomarker of smoking) values were compared. Analysis of covariance (ANCOVA) was performed after adjusting for age, sex and job status to analyze the differences in UC concentration in relation to type of smoking. The reasons for using ECs and the experience of cigarette use before using ECs were analyzed. Results Of the 15099 people, 76.4% were non-smokers, 20.9% c-smokers, 2.3% dual users, and 0.4% were e-smokers. There were significant differences in UC concentration among the groups (p