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Changes in exposure to cigarette smoke and smoking behavior were assessed in adult smokers participating in a multi-center, cross-sectional study who spontaneously switched to > 3 mg lower or higher machine measured ‘tar’ yield. Of 2,542 consenting smokers only 23 down-switchers (DWNSW) and 68 up-switchers (UPSW) met study eligibility criteria. Biomarkers of exposure (BOE) to selected smoke constituents were measured. Large variability was observed in the BOEs (e.g. CV% for nicotine equivalents (nicotine and five of its metabolites, NE) per day ranged from 59% to 78%). On average, DWNSW smoked two more cigarettes/day (+ 9%) that had ~ 5.9 mg lower ‘tar’ yield. Mean NE/day were 12.0 ± 6.2 mg/day compared to 13.9 ± 8.2 mg/day after down switching. Slightly lower levels of NE/cigarette (-8%), total NNAL/day and per cigarette were observed (-18% and -23%) in the DWNSW's. UPSW smoked two fewer cigarettes/day (-13%) with higher ‘tar’ yield (~ 8.4 mg higher ‘tar’). NE/day was 12.5 ± 9.7 vs. 12.8 ± 9.0 mg/day. Total NNAL values per day and per cigarette were lower (-24% and -17%). Due to the large variability and insufficient power to detect significant differences in exposure based on post-hoc power calculations, no definitive conclusions can be drawn from this study. These results suggest that it might not be feasible to conduct a definitive assessment of changes in exposure among spontaneous switchers

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Exposure to Cigarette Smoke Constituents in a Population of Adult Cigarette Smokers in the U.S. Who Spontaneously Switched to Cigarettes with Lower or Higher Machine Measured ‘Tar’ Yield