This report demonstrates higher levels of urine Cd in current and
former cigarette smokers in the U.S. adult population without CKD,
and it is the first to examine the prevalence in U.S. adults of urine
Cd above levels associated with risks for renal effects. The ARRs
for having urine Cd above levels associated with increased microproteinuria
and reduced GFR were higher in current and former
cigarette smoking adults. This report confirms that cigarette smoking
continues to be a major source for adult Cd exposure in the U.S.
population and complements a recent NHANES analysis showing an
increased risk for CKD associated with CdUs above 1 g Cd/g creatinine
(Ferraro et al., 2010). Because Cd cannot be easily cleared from
the body after exposure, as demonstrated by the retained RRs in former
smokers, and elimination of Cd from tobacco seems unfeasible,
the only way to prevent or minimize smoking-related Cd exposure
is to never start smoking or to quit early in life.