Smoking regular and low-nicotine cigarettes results in comparable levels of volatile organic compounds in blood and exhaled breath.

Smokers are exposed to more than 6000 toxic smoke components including volatile organic compounds (VOCs). The objective is to investigate VOCs levels in blood and exhaled breath and their relation, upon smoking three types of cigarettes of one brand with varying declared tar, nicotine and carbon monoxide (TNCO) yields according to ISO 3308. Furthermore, we aim to identify the relevance of these declared yields for human smokers exposed to VOCs. Blood and exhaled breath were sampled from twelve male volunteers directly before and 10 minutes after smoking cigarettes on 3 days (day 1 Marlboro Red (regular), day 2 Marlboro Prime (highly ventilated, low-TNCO), day 3 Marlboro Prime with blocked filter ventilation (taped)). Our results show that levels of toluene, ethylbenzene, m/p-xylene, o-xylene, and 2,5-dimethylfuran in both blood and exhaled breath increase after smoking a cigarette. Overall, no strong correlation was found between VOC levels in exhaled breath and VOC levels in blood because of variations between the individual smoking volunteers. More research is required in order to use exhaled breath sampling as a non-invasive quantitative marker for volatile toxicants from cigarette smoke exposure in risk assessment. However, we also show that the increases in concentrations in blood and exhaled breath for each smoker are within the same range for all three cigarette types smoked. The differences in declared TNCO yields, as determined with machine smoking according to ISO 3308 regime, are thus irrelevant for the assessment of human exposure of VOCs, which is important for the risk assessment of inhaling mainstream cigarette smoke. Lastly, cigarettes with lower declared TNCO levels may expose smokers to similar or even higher levels of smoke toxicants. Clinical trial registration: NCT03498053.