(HealthDay News) – Smokers who smoked within five minutes after waking have higher levels of tobacco smoke carcinogen and may be at higher risk for lung and oral cancer, according to research published online April 2 in Cancer Epidemiology, Biomarkers and Prevention.

Steven A. Branstetter and Joshua E. Muscat, PhD, MPH, of the Pennsylvania State University College of Medicine in Hershey, conducted a cross-sectional study of 1,945 participants from the 2007–2008 and 2009–2010 National Health and Nutrition and Examination Survey who had provided urinary samples for tobacco biomarkers analyses.

According to the researchers, 32% of participants smoked their first cigarette of the day within five minutes of waking. The level of 4-(Methylnitrosamino)-1-(3-Pyridyl)-1-Butanol (NNAL), a metabolite of a tobacco-specific carcinogen, was twice as high in participants who smoked within five minutes after waking than participants who refrained from smoking for ≥1 hour after waking (0.58 vs. 0.28ng/mL, P = 0.001). NNAL was significantly associated with other factors including age, age onset of regular smoking, time to first cigarette (TTFC), number of days smoked in the past 30 days, and having other smokers at home. After adjustment for these confounders, a shorter TTFC was significantly associated with increasing NNAL levels.

“The TTFC might be an important factor in the identification of high-risk smokers and in the development of interventions targeted toward early morning smokers,” the authors write.

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