Consumption patterns and biomarkers of exposure in cigarette smokers switched to dissolvable tobacco (Camel Orbs), dual use, or tobacco abstinence.
Camel Orbs (Orbs) are comprised of finely-milled tobaccos and food-grade ingredients compressed into a small oval form intended to be ingested. This trial investigated short-term changes in product usage and biomarkers of exposure when adult smokers either continued smoking, switched to consuming Orbs exclusively or partially, or were tobacco abstinent. 114 Participants were randomized into 4 groups (n=27-29/group) and confined in clinic 6 days: usual brand cigarette (UB) continued to smoke ad lib; exclusive Orbs (EO) and dual-use (DU) self-regulated product(s) consumption (DU followed a work-place 'non-smoking' schedule); and tobacco abstinent (TA). Biomarkers quantified: (24-hr urine) total nicotine equivalents and select metabolites of TSNAs, PAHs, aromatic amines, acrylamide, acrolein, benzene and urine mutagenicity; (blood) carboxyhemoglobin; (plasma) nicotine, cotinine and thiocyanate; (expired-air) carbon-monoxide (ECO). UB daily cigarette use and nicotine intake did not change from baseline (BL). DU reduced daily cigarette use from 15 to 13/day and consumed 3-4 Orbs/day, resulting in a minimal reduction in nicotine intake from BL. DU diurnal reductions in blood/plasma/ECO biomarkers were observed due to schedule. EO consumed 10-11 Orbs/day, and both EO and TA had significantly reduced nicotine intake from BL. Substantial reductions of all biomarkers from BL were observed in EO and TA, whereas minimal reductions were generally observed in UB and DU. Results demonstrated that when smokers switch to Orbs their exposure to toxicants associated with cigarette smoke are greatly reduced, similar in magnitude to being tobacco abstinent. Dual use resulted in minimal toxicant reductions in the absence of any consistent increase in nicotine or toxicant exposure.