Preliminary evidence from adult smokers suggests that nicotine metabolism might bear a relationship to select parameters of smoking topography among adult smokers. CYP2A6 genotype, thought to be the primary determinant of rate of nicotine metabolism [2], was significantly associated with mean puff volume and total puff volume, but not number of puffs, such that slow metabolizers exhibited reduced intake compared to others [9]. Similarly to the number of cigarettes per day (CPD), smoking topography influences negative health outcomes. For example, greater maximum puff velocity has been linked to higher alveolar carbon monoxide concentrations [10], risk of lung damage [11], and mortality from lung cancer in women [12]. Because most smokers initiate tobacco use during childhood and adolescence, studying smoking topography among adolescents will likely provide insights on early stages of the tobacco addiction cycle and thus merits further investigation [13].
