Measurement of population tobacco use via wastewater-based epidemiology (WBE) provides objective data to evaluate the efficacy of tobacco control strategies. However, current WBE tobacco-use estimates based on nicotine metabolites (cotinine and hydroxycotinine) can be masked by use of non-tobacco nicotine-containing products. To better understand nicotine and tobacco use, we analysed tobacco-specific biomarkers, anabasine and anatabine, as well as nicotine metabolites, cotinine and hydroxycotinine, in wastewater samples collected for 6 weeks per year over 6 years (2012–2017) from an Australian wastewater treatment plant serving approximately 100,000 people. Population-normalised mass loads were used to estimate tobacco and nicotine use trends and were compared with surveys and taxation statistics. Significant annual declines were observed for anabasine, anatabine, cotinine and hydroxycotinine of −3.0%, −2.7%, −2.4%, and −2.1%, respectively. The results corresponded with the annual declining trends reported from surveys (−5%) and taxation statistics (−4%). Significant annual decreases in the ratios of anabasine to cotinine (−1.2%) and anatabine to cotinine (−1.0%) suggested a relative increase in the use of non-tobacco nicotine products at the same time that tobacco use was declining. Monitoring tobacco use with anabasine and anatabine removed influence from nicotine-containing products, showing larger reductions in this Australian city than via nicotine biomarkers, whilst also demonstrating their suitability for monitoring long-term trends.

通过基于废水的流行病学 (WBE) 测量人口烟草使用情况，可以提供客观数据来评估烟草控制策略的有效性。然而，目前基于尼古丁代谢物（可替宁和羟基可替宁）的 WBE 烟草使用估计可以通过使用非烟草含尼古丁产品来掩盖。为了更好地了解尼古丁和烟草的使用情况，我们分析了 6 年来（2012-2017 年）每年 6 周从澳大利亚废水中收集的废水样本中的烟草特异性生物标志物新木碱和新烟草碱，以及尼古丁代谢物可替宁和羟基可替宁。处理厂为大约 100,000 人提供服务。人口标准化质量负荷用于估计烟草和尼古丁使用趋势，并与调查和税收统计数据进行比较。观察到新竹碱、新竹碱、可替宁和羟基可替宁的显着年度下降分别为-3.0%、-2.7%、-2.4%和-2.1%。结果与调查（-5%）和税收统计（-4%）报告的年度下降趋势相对应。新竹碱与可替宁（-1.2%）和新竹碱与可替宁（-1.0%）的比率每年显着下降，表明在烟草使用下降的同时，非烟草尼古丁产品的使用相对增加。使用新烟碱和新烟碱监测烟草使用消除了含尼古丁产品的影响，与尼古丁生物标记物相比，该澳大利亚城市的烟草使用量减少幅度更大，同时也证明了它们适合监测长期趋势。