A Cross-Sectional Analysis of the Nicotine Metabolite Ratio and Its Association with Sociodemographic and Smoking Characteristics among People with HIV Who Smoke in South Africa

Chukwudi Keke, Zane Wilson, Limakatso Lebina, Katlego Motlhaoleng, David Abrams, Ebrahim Variava, Nikhil Gupte, Raymond Niaura, Neil Martinson, Jonathan E. Golub and Jessica L. Elf ()
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Chukwudi Keke: Department of Environmental and Radiological Health Science, Colorado State University, Fort Collins, CO 80523, USA
Zane Wilson: Department of Environmental and Radiological Health Science, Colorado State University, Fort Collins, CO 80523, USA
Limakatso Lebina: Africa Health Research Institute, Somkhele, Myeki 3935, South Africa
Katlego Motlhaoleng: Perinatal HIV Research Unit, Soweto 1862, South Africa
David Abrams: School of Global Public Health, New York University, New York, NY 10003, USA
Ebrahim Variava: Klerksdorp Tshepong Hospital Complex, Matlosana 2574, South Africa
Nikhil Gupte: Department of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
Raymond Niaura: School of Global Public Health, New York University, New York, NY 10003, USA
Neil Martinson: Perinatal HIV Research Unit, Soweto 1862, South Africa
Jonathan E. Golub: Department of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
Jessica L. Elf: Department of Environmental and Radiological Health Science, Colorado State University, Fort Collins, CO 80523, USA

IJERPH, 2023, vol. 20, issue 6, 1-8

Abstract: The nicotine metabolite ratio (NMR) is associated with race/ethnicity but has not been evaluated among smokers in the African region. We conducted a cross-sectional analysis of baseline data from a large randomized, controlled trial for smoking cessation among people with HIV (PWH) in South Africa. Urine samples were analyzed for the NMR and evaluated as a binary variable using a cutoff value of the fourth quartile to determine the fastest metabolizers. The median NMR was 0.31 (IQR: 0.31, 0.32; range: 0.29, 0.57); the cut-point for fast metabolizers was ≥0.3174 ng/mL. A high NMR was not associated with the number of cigarettes per day (OR = 1.10, 95% CI: 0.71, 1.70, p = 0.66) but was associated with 40% lower odds of a quit attempt in the past year (OR = 0.69; 95% CI: 0.44, 1.07, p = 0.09) and alcohol use (OR = 0.59, 95% CI: 0.32, 1.06, p = 0.07). No association was seen with marijuana or HIV clinical characteristics. As we found only minimal variability in the NMR and minimal associations with intensity of smoking, NMR may be of limited clinical value in this population, although it may inform which individuals are less likely to make a quit attempt.

Keywords: HIV; smoking; nicotine metabolite ratio; NMR; South Africa (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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