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Impact of Factors Related to Loose and Pouched Moist Smokeless Tobacco Product Use Behavior on Biomarkers of Exposure to Nicotine and N-Nitrosonornicotine Cover

Impact of Factors Related to Loose and Pouched Moist Smokeless Tobacco Product Use Behavior on Biomarkers of Exposure to Nicotine and N-Nitrosonornicotine

Open Access
|Jun 2025

Figures & Tables

Figure 1.

Relationship between nicotine equivalents (mg/24 h) and total duration of use (min). Each symbol represents the individual daily urinary nicotine equivalent levels (mg/24 h) and daily total duration of use loose (A) or pouched (B) MST products. Total duration of loose or pouched MST product use was calculated as the sum of the measured time duration for each use occasion by each participant. Each symbol represents the individual daily urinary nicotine equivalent levels (mg/24 h) and number of loose or pouched MST product use occasions. A significant linear relationship (p < 0.05) was observed based on the linear regression analysis.

Figure 2.

Relationship between nicotine equivalents (mg/24 h) and total weight of loose MST product / Total number of pouches used per day. Each symbol represents the individual daily urinary nicotine equivalent levels (mg/24 h) and number of loose (A) or pouched (B) MST product use occasions. A significant linear relationship (p < 0.05) was observed based on the linear regression analysis.

Table 1.

Demographics.

CharacteristicsLoose MST n = 168Pouched MST n = 61Overall N = 229
Mean age (SD), years37.6 (11.61)36.9 (10.75)37.4 (11.37)
Sex, n (%)
  Male160 (95.2)54 (88.5)214 (93.4)
  Female8 (4.8)7 (11.5)15 (6.6)
Race, n (%)
  American Indian / Alaska native4 (2.4)1 (1.6)5 (2.2)
  Asian1 (0.6)1 (0.4)
  Black16 (9.5)9 (14.8)25 (10.9)
  White145 (86.3)50 (82.0)195 (85.2)
  Multiple2 (1.2)1 (1.6)3 (1.3)
Ethnicity, n (%)
  Hispanic or Latino3 (1.8)3 (4.9)6 (2.6)
  Not Hispanic or Latino165 (98.2)58 (95.1)223 (97.4)
Mean BMI (SD), kg/m229.3 (5.21)29.4 (4.97)29.3 (5.14)

[i] BMI: body mass index; MST: moist smokeless tobacco; SD: standard deviation.

Table 2.

Summary statistics for product use behavior. Data reflect a product use period of 16 h.

Product use behaviorNMeanSDMinMedianMax
Loose MST
Average duration of use (min)16873.9533.88415.670.48188.00
Average pinch mass (g)1684.342.1940.63.9114.70
Total number of use occasions/day1686.502.2402.06.0014.00
Total duration of use (min/day)168451.6203.040103.0434.501108.00
Total weight used (g/day)16828.1418.2223.524.47132.70
Pouched MST
Average duration of use (min)6169.0732.49321.061.00172.30
Average number of pouches per use612.230.9661.02.007.20
Total number of use occasions/day616.002.6401.05.0015.00
Total duration use (min/day)61395.84186.9321.0400.00809.00
Total number used/day6113.37.3802.012.0036.00

[i] MST: moist smokeless tobacco; SD: standard deviation.

Table 3.

Summary statistics for biomarkers of exposure.

Biomarker of exposureMST product formatNMeanSDMinMedianMaxGeometric mean95% CI of Geomean
Nicotine equivalents (mg/24 h)Loose16826.2718.1114.322.29144.9021.6219.65–23.78
Pouch6120.4011.8073.517.1952.6017.4615.08–20.23
NNN (ng/24 h)Loose16878.0091.7127.353.56908.8053.3246.80–60.76
Pouch6161.9943.7141.944.17183.9346.4437.62–57.33

[i] CI: confidence interval; MST: moist smokeless tobacco; NNN: N-nitrosonornicotine; SD: standard deviation.

DOI: https://doi.org/10.2478/cttr-2025-0008 | Journal eISSN: 2719-9509 (formerly 1612-9237)
Language: English, French, German
Page range: 84 - 93
Submitted on: Aug 9, 2024
Accepted on: Dec 19, 2024
Published on: Jun 14, 2025
Published by: Beiträge zur Tabakforschung GmbH
In partnership with: Paradigm Publishing Services

© 2025 Katy M. Webb, J. Scott Rensch, Jingzhu Wang, Xiaohong Jin, Jeffery S. Edmiston, Mohamadi Sarkar, published by Beiträge zur Tabakforschung GmbH
This work is licensed under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License.