Smoking is estimated to cause more than seven million premature deaths annually and yet the number of smokers continues to increase across the globe. Monitoring tobacco use in the population is of high importance to public health. Wastewater-based epidemiology (WBE) was proposed as an alternative approach for monitoring nicotine consumption. However, the increasing use of non-tobacco nicotine products, such as those used for nicotine replacement therapy (e.g., gum, patch, oral inhaler), and vaping products (e.g., e-cigarettes), can lead to an overestimation of tobacco use.
This project evaluated pooled urine samples and wastewater samples to estimate the average per capita loads of nicotine metabolites, anabasine, and anatabine. By comparing the urinary loads with wastewater loads, this project evaluates the suitability of anabasine and anatabine for estimating tobacco use by WBE and estimating their excretion factors. We subsequently utilised anabasine to estimate tobacco use from a selected catchment and compared the results with tobacco sales data for validation purposes.