Nicotine consumption rate through wastewater-based epidemiology: a systematic review, meta-analysis and probabilistic risk assessment

Wastewater-based epidemiology (WBE) with advantages like complementary, cost-effective, comprehensive, and rapid tool is used for measuring and monitoring of illicit drugs in the population. Smoking cigarettes and tobacco use are common habits in nowadays community. This systematic review and meta-analysis are the first study to calculate the consumption amount of nicotine (NIC) by searching in WBE studies on a global scale. The related studies were retrieved within the international databases including Scopus and web of science up to February 2021 and 21 articles containing 87 measurements covering 275.3 million people with a total wastewater samples of 2250 were included. ​Results show that the maximum and minimum nicotine consumption rate (mg/1000 inh./day) was in Portugal (5860) and Viet Nam (1201), respectively. The global pooled amount of nicotine consumption rate was 2476 mg/1000 inh./day (95% CI (2289–2663). Risk assessment of nicotine consumption rate through WBE was calculated by the margin of exposure (MOE) approach. The MOE amounts were obtained by probabilistic Monte Carlo simulations for daily nicotine consumption. In total, 82% of nicotine consumption measurements located in the "risk" level (MOE