Wastewater-based epidemiology as a surveillance tool to assess human consumption of psychotropic substances: Alcohol, nicotine and caffeine as case studies

Wastewater-based epidemiology (WBE) is used as a surveillance tool to provide data on public health, drug use, exposure to chemicals and lifestyle habits. This approach can be used to monitor the achievement of the United Nations Sustainable Development Goals, such as reducing alcohol consumption and reducing the use of tobacco. In addition, it can be applied to monitor total caffeine consumption and assess levels according to the recommended daily safety limit as suggested by the European Food Safety Authority. The purpose of this review was to summarize and discuss analytical protocols for the determination of alcohol, nicotine, and caffeine WBE biomarkers in wastewater. The WBE requirements for these biomarkers were thoroughly investigated. Furthermore, back-calculated levels of alcohol, nicotine, and caffeine in the population were reviewed. Finally, challenges were identified, and future directions were proposed to fill knowledge gaps and improve the quality of information obtained from the WBE approach.