, 1987) does not appear to be as much of a problem today; this decrease in analytical bias should facilitate the comparison of results from different studies and laboratories. The data from this investigation Vandetanib have also enabled us to assign consensus cotinine concentrations to the unfortified serum pools that we examined; these consensus concentrations will be of value in future method development and evaluations. Funding This work was supported by the Centers for Disease Control and Prevention (JTB, DBH, and CSS; 5U59EH223392-05 to KMA) and by the Flight Attendant Medical Research Institute and the National Institutes of Health (DA12393 to PJ and NLB). Declaration of Interests All authors state that they have no competing interests in this work. Supplementary Material Article Summary: Click here to view.

Acknowledgments We gratefully acknowledge the valuable assistance with statistical analyses provided by Jiantong Wang of RTI International. We also thank Tia Harmon, James R. Akins, LaQuasha Gaddis, and Ricky Alexander (Centers for Disease Control and Prevention); Lisa Yu and Minjiang Duan (University of California, San Francisco); James Daly (New York State Department of Health Wadsworth Center); Emma Tzioumis (Children��s Hospital Boston); and Amy Adler, Mary Dallman, and the Laboratory Staff, Toxicology and Drug Monitoring Laboratory, Mayo Clinic, for conducting measurements of serum cotinine as part of this study. The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.

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A new generation of smokeless, low-nitrosamine tobacco products is being actively marketed in the United States. Although smokeless tobacco use has historically occurred at low rates in the United States, sales of moist snuff are on the rise (Alpert, Koh, & Connolly, 2008) and financial market watchers have described smokeless tobacco as ��the next big thing�� as smokers search for ways to cope with an environment that is increasingly hostile to cigarettes (Goldman Sachs Global Investment Research, 2006).

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