Examining the relation between usual-brand nicotine yield, blood cotinine concentration and the nicotine-“compensation” hypothesis

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Abstract
Eight data sets relating usual-brand nicotine yield (FTC method or equivalent) to blood cotinine concentration are reviewed with respect to the so-called nicotine-“compensation” hypothesis, i.e., that all smokers achieve a specific level of nicotine in their blood, regardless of the FTC nicotine yield of the cigarette smoked. The data from the studies reviewed here indicate wide variability in blood cotinine concentrations over the range of FTC nicotine yields and that the nicotine-compensation hypothesis is not supported. On average, blood cotinine concentrations are found to be roughly midway between complete compensation (all smokers absorb equal amounts of nicotine regardless of FTC nicotine yield) and the value expected if there was no compensation (i.e., smokers absorb an amount of nicotine exactly equal to the FTC yield). As a result of individual smoking-behavior differences (number of cigarettes smoked, puff volume, puff frequency inhalation volume and depth, etc.), the data indicate that, on average, smokers achieve roughly 50% lower blood cotinine concentrations than predicted by the nicotine-compensation hypothesis.