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Smoking and Tobacco

Cotinine

04/01/2008

Question:

does cotinine cause lung cancer?

Answer:

I'm not sure what prompted this question. Nicotine is transformed into cotinine in the human body. This is another way of saying that cotinine is the primary metabolite of nicotine. Cotinine is thought to have no effect on brain receptors and little metabolic effect elsewhere.

The short answer to "does cotinine (by itself) cause lung cancer?" -- probably not. But, we'll never know because to get cotinine you must start with nicotine (in the body). Thus, in humans where there's cotinine there's nicotine.

Still, there is little evidence of increased lung cancer in folks who only use spit tobacco. These people have high levels of nicotine and cotinine, yet not much lung cancer. The only fly-in-the-ointment concern is that smokers who switch to spit tobacco have a greater risk of getting lung cancer than smokers who quit altogether. Please note that both groups have much less risk of lung cancer than those who continue to smoke.

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Response by:

Rob  Crane, MD Rob Crane, MD
Clinical Associate Professor of Family Medicine
College of Medicine
The Ohio State University