{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T18:53:26Z","timestamp":1782327206895,"version":"3.54.5"},"reference-count":20,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T00:00:00Z","timestamp":1780963200000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"National Institute on Drug Abuse and the Food and Drug Administration\u2019s Center for Tobacco Products","award":["U54DA031659"],"award-info":[{"award-number":["U54DA031659"]}]},{"name":"the US National Cancer Institute","award":["P01CA217806"],"award-info":[{"award-number":["P01CA217806"]}]},{"name":"the US National Cancer Institute","award":["R01CA260831"],"award-info":[{"award-number":["R01CA260831"]}]},{"name":"Biostatistics Shared Resource of the Masonic Cancer Center"},{"name":"National Cancer Institute Cancer Center Support","award":["P30CA077598"],"award-info":[{"award-number":["P30CA077598"]}]},{"name":"National Institutes of Health\u2019s National Center for Advancing Translational Sciences","award":["UM1TR004405"],"award-info":[{"award-number":["UM1TR004405"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Some people who relight cigarettes (extinguishing then relighting later) believe they are reducing health harm from smoking, although studies suggest an increase in health risk compared to those who do not relight. Few studies have evaluated differences in biomarkers of exposures to toxicants among those who relight compared to those who do not.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Secondary analyses were conducted on baseline data from 2 clinical trials. Both studies assessed relighting frequency and collected urine samples. Measures included total nicotine equivalents (TNE), 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol and its glucuronides (total NNAL; lung carcinogen metabolites for 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone[NNK]), 2-cyanoethyl mercapturic acid (CEMA; acrylonitrile metabolite), 3-hydroxy-1-methylpropyl mercapturic acid (HMPMA; crotonaldehyde metabolite), 3-hydroxypropyl mercapturic acid (3-HPMA; acrolein metabolite), and S-phenyl mercapturic acid (SPMA; benzene metabolite). Biomarkers were adjusted for creatinine and calculated per cigarette. Wilcoxon rank-sum tests (unadjusted) and multivariable linear regression (adjusting for variables differing between groups) compared participants who reported relighting cigarettes at least half the time and those who did not report relighting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Relighting participants (n\u2009=\u200994) smoked fewer cigarettes\/day than non-relighting participants (n\u2009=\u2009181) (13.1 vs 14.9; P\u2009=\u2009.045) but had higher TNE (P\u2009=\u2009.047). Other biomarkers did not differ (Ps\u2009&amp;gt;\u2009.05). In unadjusted analysis, most biomarkers per cigarette were higher for relighting participants (Ps\u2009&amp;lt;\u2009.021), except total NNAL (P\u2009=\u2009.159). After covariate adjustment, total NNAL was lower for relighting participants (P\u2009=\u2009.019), while no per-cigarette biomarkers were significantly different (Ps\u2009&amp;gt;\u2009.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>People who relight smoke fewer cigarettes but do not reduce exposure to smoke toxicants, possibly due to more intense smoking. However, differences in levels per cigarette observed may primarily reflect individual characteristics, such as age, income, etc, distinguishing relighting from non-relighting participants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications<\/jats:title>\n                    <jats:p>People who relight do not reduce their exposure to key cigarette smoke toxicants and carcinogens even if on average they smoke fewer cigarettes per day. Whether the greater intensity of smoking each cigarette is a result of relighting or the characteristics of the person who relights requires further study. Tobacco surveillance efforts may be enhanced by including assessment of relighting.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ntr\/ntag131","type":"journal-article","created":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T11:41:47Z","timestamp":1780746107000},"source":"Crossref","is-referenced-by-count":0,"title":["Effects of relighting cigarettes on biomarkers of carcinogen and toxicant exposures"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7859-3876","authenticated-orcid":false,"given":"Lori G","family":"Strayer","sequence":"first","affiliation":[{"name":"Masonic Cancer Center, University of Minnesota , Minneapolis, MN 55414 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7501-6582","authenticated-orcid":false,"given":"Xianghua","family":"Luo","sequence":"additional","affiliation":[{"name":"Masonic Cancer Center, University of Minnesota , Minneapolis, MN 55414 ,","place":["United States"]},{"name":"Division of Biostatistics & Health Data Science, University of Minnesota , Minneapolis, MN 55414 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joni","family":"Jensen","sequence":"additional","affiliation":[{"name":"Masonic Cancer Center, University of Minnesota , Minneapolis, MN 55414 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-8826-3639","authenticated-orcid":false,"given":"Aleksandra","family":"Alcheva","sequence":"additional","affiliation":[{"name":"Masonic Cancer Center, University of Minnesota , Minneapolis, MN 55414 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1523-8797","authenticated-orcid":false,"given":"Qing","family":"Cao","sequence":"additional","affiliation":[{"name":"Masonic Cancer Center, University of Minnesota , Minneapolis, MN 55414 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1016-3965","authenticated-orcid":false,"given":"Carolyn J","family":"Heckman","sequence":"additional","affiliation":[{"name":"Cancer Prevention and Control Program, Rutgers Cancer Institute, Rutgers University , New Brunswick, NJ 08901 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2661-2120","authenticated-orcid":false,"given":"Michael B","family":"Steinberg","sequence":"additional","affiliation":[{"name":"Institute for Nicotine and Tobacco Studies, Rutgers University , New Brunswick, NJ 08901 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5140-8944","authenticated-orcid":false,"given":"Irina","family":"Stepanov","sequence":"additional","affiliation":[{"name":"Masonic Cancer Center, University of Minnesota , Minneapolis, MN 55414 ,","place":["United States"]},{"name":"Division of Environmental Health Sciences, University of Minnesota , Minneapolis, MN 55454 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1108-2609","authenticated-orcid":false,"given":"Dorothy K","family":"Hatsukami","sequence":"additional","affiliation":[{"name":"Masonic Cancer Center, University of Minnesota , Minneapolis, MN 55414 ,","place":["United States"]},{"name":"Department of Psychiatry & Behavioral Sciences, University of Minnesota , Minneapolis, MN 55454 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,6,9]]},"reference":[{"key":"2026062414350627800_ref1","doi-asserted-by":"publisher","first-page":"111257","DOI":"10.1016\/j.drugalcdep.2024.111257","article-title":"Measurement of cigarette relighting: a common but understudied behavior","volume":"257","author":"Young","year":"2024","journal-title":"Drug Alcohol Depend"},{"key":"2026062414350627800_ref2","doi-asserted-by":"crossref","first-page":"1206","DOI":"10.1093\/ntr\/nty138","article-title":"Characteristics of adult cigarette smokers who \u201crelight\u201d and the effects of exposure to tobacco smoke constituents","volume":"21","author":"Allen","year":"2019","journal-title":"Nicotine Tob Res"},{"key":"2026062414350627800_ref3","doi-asserted-by":"publisher","first-page":"621","DOI":"10.1080\/14622200701239688","article-title":"Relighting cigarettes: how common is it?","volume":"9","author":"Cunningham","year":"2007","journal-title":"Nicotine Tob Res"},{"key":"2026062414350627800_ref4","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1037\/adb0000019","article-title":"Characteristics of smoking used cigarettes among an incarcerated population","volume":"29","author":"Lantini","year":"2015","journal-title":"Psychol Addict Behav"},{"key":"2026062414350627800_ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2026.108706","article-title":"Cigarette relighting disparities and potential implications: survey findings from a large US probability sample","volume":"181","author":"Heckman","year":"2026","journal-title":"Addict Behav"},{"key":"2026062414350627800_ref6","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18126494","article-title":"Cigarette relighting: a series of pilot studies investigating a common yet understudied smoking behavior","volume":"18","author":"Heckman","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"2026062414350627800_ref7","doi-asserted-by":"publisher","first-page":"1358","DOI":"10.1111\/ijcp.12477","article-title":"Relighting behaviour among cigarette smokers seeking treatment: implications for tobacco treatment and policy","volume":"68","author":"Zimmermann","year":"2014","journal-title":"Int J Clin Pract"},{"key":"2026062414350627800_ref8","doi-asserted-by":"publisher","first-page":"552","DOI":"10.1002\/cpt1976205552","article-title":"Titration of nicotine intake with full-length and half-length cigarettes","volume":"20","author":"Gritz","year":"1976","journal-title":"Clin Pharmacol Ther"},{"key":"2026062414350627800_ref9","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1038\/clpt.1980.33","article-title":"Smokers\u2019 response to shortened cigarettes: dose reduction without dilution of tobacco smoke","volume":"27","author":"Russell","year":"1980","journal-title":"Clin Pharmacol Ther"},{"key":"2026062414350627800_ref10","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1038\/clpt.1982.131","article-title":"Smoking behavior and tobacco smoke intake: response of smokers to shortened cigarettes","volume":"32","author":"Chait","year":"1982","journal-title":"Clin Pharmacol Ther"},{"key":"2026062414350627800_ref11","doi-asserted-by":"publisher","first-page":"1164","DOI":"10.1136\/bmj.2.5366.1164","article-title":"Relighting of cigarettes and lung cancer","volume":"2","author":"Dark","year":"1963","journal-title":"Br Med J"},{"key":"2026062414350627800_ref12","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1136\/bmj.2.5919.591","article-title":"Cigarette smoker\u2019s bronchitis: the effect of relighting","volume":"2","author":"Rimington","year":"1974","journal-title":"Br Med J"},{"key":"2026062414350627800_ref13","first-page":"S171","article-title":"Lung cancer in relation to smoking, including relighting cigarette butts: Kathmandu Valley: \u201can unmatched case control study\u201d","volume":"31","author":"Rana","year":"2017","journal-title":"J Health Res"},{"key":"2026062414350627800_ref14","doi-asserted-by":"publisher","first-page":"100796","DOI":"10.1016\/j.lana.2024.100796","article-title":"Reduced nicotine in cigarettes in a marketplace with alternative nicotine systems: randomized clinical trial","volume":"35","author":"Hatsukami","year":"2024","journal-title":"Lancet Reg Health Am"},{"key":"2026062414350627800_ref15","doi-asserted-by":"publisher","journal-title":"Tob Control.","DOI":"10.1136\/tc-2025-059771"},{"key":"2026062414350627800_ref16","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1021\/acs.chemrestox.2c00413","article-title":"Quantitation of ten urinary nicotine metabolites, including 4-hydroxy-4-(3-pyridyl) butanoic acid, a product of nicotine 2'-oxidation, and CYP2A6 activity in Japanese Americans, Native Hawaiians, and whites","volume":"36","author":"von Weymarn","year":"2023","journal-title":"Chem Res Toxicol"},{"key":"2026062414350627800_ref17","doi-asserted-by":"publisher","first-page":"1209","DOI":"10.1021\/tx400121n","article-title":"High throughput liquid and gas chromatography-tandem mass spectrometry assays for tobacco-specific nitrosamine and polycyclic aromatic hydrocarbon metabolites associated with lung cancer in smokers","volume":"26","author":"Carmella","year":"2013","journal-title":"Chem Res Toxicol"},{"key":"2026062414350627800_ref18","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1016\/j.jchromb.2013.07.004","article-title":"High throughput liquid chromatography-tandem mass spectrometry assay for mercapturic acids of acrolein and crotonaldehyde in cigarette smokers\u2019 urine","volume":"935","author":"Carmella","year":"2013","journal-title":"J Chromatogr B Analyt Technol Biomed Life Sci"},{"key":"2026062414350627800_ref19","doi-asserted-by":"publisher","first-page":"734","DOI":"10.1021\/tx800479s","article-title":"Effects of smoking cessation on eight urinary tobacco carcinogen and toxicant biomarkers","volume":"22","author":"Carmella","year":"2009","journal-title":"Chem Res Toxicol"},{"key":"2026062414350627800_ref20","doi-asserted-by":"publisher","first-page":"1119","DOI":"10.1111\/j.1360-0443.1991.tb01879.x","article-title":"The Fagerstr\u00f6m test for nicotine dependence: a revision of the Fagerstr\u00f6m tolerance questionnaire","volume":"86","author":"Heatherton","year":"1991","journal-title":"Br J Addict"}],"container-title":["Nicotine &amp; Tobacco Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ntr\/advance-article-pdf\/doi\/10.1093\/ntr\/ntag131\/68492984\/ntag131.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ntr\/advance-article-pdf\/doi\/10.1093\/ntr\/ntag131\/68492984\/ntag131.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T18:35:13Z","timestamp":1782326113000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ntr\/advance-article\/doi\/10.1093\/ntr\/ntag131\/8704291"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,9]]},"references-count":20,"URL":"https:\/\/doi.org\/10.1093\/ntr\/ntag131","relation":{},"ISSN":["1469-994X"],"issn-type":[{"value":"1469-994X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,9]]},"article-number":"ntag131"}}