Detectable Cotinine Levels Research Articles

Effect of Tobacco Smoke on the Oral Health of US Women of Childbearing Age

To determine the oral health status of US women of childbearing age and to analyze the effect of tobacco smoke on their oral health. Data from the 1999-2004 National Health and Nutrition Examination Survey were evaluated for women 15-44 years of age. The association of exposure to tobacco smoke with untreated caries, mean DMFS, gingivitis, and periodontitis were examined in bivariate and regression analyses controlling for potential confounders. The prevalence of untreated caries was 25%, for gingivitis 49%, and for periodontitis 6%. After adjusting for potential confounders, self-reported current smoking was a strong independent risk indicator for untreated caries, periodontitis, and to a lesser extent for greater DMFS count. Women with detectable cotinine levels below 15 ng/mL presented with an increased risk for gingivitis. Independent factors associated with increased risk for untreated caries were being Black, having less than a high school education, Medicaid or no health insurance, previous live births, and infrequent and episodic dental visits. Characteristics associated with gingivitis were being Mexican-American, obese, pregnant, and having infrequent dental visits. Older age, no insurance, and the last dental visit for treatment were independently associated with periodontitis. Dental caries and periodontitis were prevalent among certain subgroups of women of reproductive age. Smoking was found to be a significant risk indicator for various negative oral health outcomes. Barriers to accessing to dental care that were manifested by untreated caries among Black women, mothers, and Medicaid beneficiaries must be better understood.

Accuracy of self-reported smoking and secondhand smoke exposure in the US workforce: the National Health and Nutrition Examination Surveys.

Occupational health studies often rely on self-reported secondhand smoke (SHS) exposure. This study examines the accuracy of self-reported tobacco use and SHS exposure. Data on serum cotinine, self-reported tobacco use, and SHS exposure for US workers were extracted from three National Health and Nutrition Examination Surveys (n = 17,011). Serum cotinine levels were used to classify workers into SHS exposure categories. The percent agreement between self-reported tobacco use and SHS exposure with the cotinine categories was calculated. Workers reporting tobacco use were 88% accurate whereas workers reporting work, home, or home+work exposures were 87% to 92% accurate. Workers reporting no SHS exposure were only 28% accurate. Workers accurately reported their smoking status and workplace-home SHS exposures, but substantial numbers reporting "no exposures" had detectable levels of cotinine in their blood, indicating exposure to SHS.

A longitudinal study of environmental tobacco smoke exposure in children: Parental self reports versus age dependent biomarkers

BackgroundAwareness of the negative effects of smoking on children's health prompted a decrease in the self-reporting of parental tobacco use in periodic surveys from most industrialized countries. Our aim is to assess changes between ETS exposure at the end of pregnancy and at 4 years of age determined by the parents' self-report and measurement of cotinine in age related biological matrices.MethodsThe prospective birth cohort included 487 infants from Barcelona city (Spain). Mothers were asked about maternal and household smoking habit. Cord serum and children's urinary cotinine were analyzed in duplicate using a double antibody radioimmunoassay.ResultsAt 4 years of age, the median urinary cotinine level in children increased 1.4 or 3.5 times when father or mother smoked, respectively. Cotinine levels in children's urine statistically differentiated children from smoking mothers (Geometric Mean (GM) 19.7 ng/ml; 95% CI 16.83–23.01) and exposed homes (GM 7.1 ng/ml; 95% CI 5.61–8.99) compared with non-exposed homes (GM 4.5 ng/ml; 95% CI 3.71–5.48). Maternal self-reported ETS exposure in homes declined in the four year span between the two time periods from 42.2% to 31.0% (p < 0.01). Nevertheless, most of the children considered non-exposed by their mothers had detectable levels of cotinine above 1 ng/mL in their urine.ConclusionWe concluded that cotinine levels determined in cord blood and urine, respectively, were useful for categorizing the children exposed to smoking and showed that a certain increase in ETS exposure during the 4-year follow-up period occurred.

TOBACCO CONTROL LAWS AND SERUM COTININE LEVELS IN NONSMOKING ADULTS, 1999-2000

ISEE-6 Introduction: State and local bans or restrictions on indoor smoking are implemented to reduce exposure to environmental tobacco smoke (ETS), a known human carcinogen. Cotinine, a major metabolite of nicotine, is a biomarker of exposure to ETS in nonsmokers. Data from the National Health and Nutrition Examination Survey (NHANES) show that median cotinine levels in nonsmokers have declined by 70% since the late 1980’s. The objective of this study is to determine the relationship between State or local ordinances on indoor smoking and cotinine levels in the nonsmoking adult population, taking into account racial and ethnic differences. Methods: NHANES is a cross-sectional survey designed to monitor the health and nutritional status of the US population. Household interviews, physical examinations, and cotinine level assessments were performed on 4039 adults (83% response rate), of whom 3003 were non smokers. For each of 26 study locations, laws regulating indoor smoking (in enclosed public spaces, workplaces, restaurants, and bars) were categorized into one of three groups indicating minimal, moderate, or extensive regulations. The proportion of non-smoking adults with detectable levels of serum cotinine were compared across these three groups. Results: Approximately 49% of nonsmoking adults had detectable levels of cotinine. Non-Hispanic blacks had a higher proportion of detectable levels (69%) than did non-Hispanic whites (47%) and Mexican-Americans (44%). For Mexican Americans and non-Hispanic whites, persons living in areas with extensive smoking regulations had a significantly smaller proportion with detectable cotinine levels (29%) than persons living in areas with moderate (52%) and minimal (50%) smoking regulations. The difference between the moderate and minimal groups was not statistically significant. For non-Hispanic blacks, there was no difference in the proportion with detectable levels across the three smoking regulation categories. Discussion: These preliminary results suggest that at least for non-Hispanic white and Mexican American adults, those living in areas with extensive tobacco control laws have less ETS exposure compared to those living in areas with minimal or moderate smoking regulations. Multivariate analyses including covariates (age, gender, workplace smoke exposure, and cigarette smoke exposure in the home) will be conducted to further examine the relationship between tobacco control laws and ETS exposure and the lack of variability in cotinine levels by tobacco control laws among non-Hispanic blacks.

Infant exposure to environmental tobacco smoke: a prevalence study in Australia.

To determine: the prevalence of exposure to environmental tobacco smoke among infants aged 0-12 months in two child health care settings; the accuracy of parent report indicators of exposure; and the factors associated with exposure to environmental tobacco smoke. Samples of consecutive parents of infants 12 months of age or younger who attended Hunter Region public child health and immunisation clinics were approached to complete a questionnaire and to allow a urine sample to be obtained from their infant during December and January 1998/99. Infant urine samples were analysed for cotinine and information obtained regarding the smoking status of household members, infant exposure to environmental tobacco smoke during the previous three days, and parent and infant characteristics and demographics. 85 (47%) [95% CI 40-54] infants in the combined sample had detectable levels of cotinine. Sensitivity of reported infant exposure of 86% was achieved through the combined measure of parent report of exposure and smoking status of households. The odds of exposure for infants of smoking parents were 14 times that of infants of nonsmokers [CI 5.26-50.0]. Almost half of the infants in this study had detectable levels of cotinine in their urine. Future interventions targeting infant exposure to environmental tobacco smoke should incorporate quit smoking strategies for both parents and other household members, as well as strategies for changing the pattern of smoking behaviour around infants. These findings suggest that existing community education strategies and passive smoking public policies are failing to protect this vulnerable population group.

Tobacco smoking and the uterine cervix: cotinine in blood, urine and cervical fluid.

Cotinine levels in blood, urine and cervical fluid of smokers and nonsmokers were analyzed by capillary-column gas chromatography. The sensitivity of this method appeared to be 100%. The specificity was lower (87.5% in blood, 25% in urine and 75% in cervical fluid). Nonsmokers exposed to smoke by others had low but detectable cotinine levels in the three body fluids. The highest cotinine levels in cervical fluid were detected during the proliferative phase of the cycle. Cotinine levels in cervical fluid and blood correlated well, but the correlation was less during the proliferation phase. Cotinine measurement in cervical fluid proves to be a reliable method to quantify exposure to tobacco smoke, even when induced by others.

Cotinine concentrations in semen, urine, and blood of smokers and nonsmokers.

Cotinine levels in the semen, urine, and blood of 88 male smokers and nonsmokers, aged 18 to 35, were analyzed via radioimmunoassay. Detectable cotinine levels were found in all three body fluids, and cotinine levels in all three fluids were highly correlated. Cotinine levels in semen and blood were of similar magnitude; cotinine levels in urine were an order of magnitude or more higher. In all three fluids, cotinine levels increased with an increase in cigarette smoke exposure.

Saliva cotinine and thiocyanate: chemical indicators of smokeless tobacco and cigarette use in adolescents.

Recent attempts to measure smoking behavior using chemical tests may have been confounded by the use of smokeless tobacco. An objective measure of smokeless tobacco use is needed, particularly among adolescents who may not provide accurate self-reports of tobacco usage. Saliva cotinine was used to distinguish self-reported tobacco users from nonusers and a combination of saliva cotinine and thiocyanate (SCN) tests was used to distinguish smokers from smokeless tobacco users. The subjects were 471 students in grades 7 through 11 who lived in a high-tobacco production area. Approximately 89% of reported nonusers had no detectable cotinine and 99% of nonusers had levels less than 25 ng/ml. Of those who had used tobacco within the last 12 hr, 95% had detectable levels of cotinine. Samples that tested positive for cotinine were also tested for SCN. Eighty-six percent of smokers and 74% of mixed users had SCN values of greater than 1000 mumol/liter, while only 14% of smokeless users had SCN values at that level. The combination of cotinine and SCN was effective in distinguishing smokers from smokeless users but was not effective in distinguishing mixed use from the other two types of use.

Validation of students' self-reported cigarette smoking status with plasma cotinine levels.

Plasma cotinine levels were measured in 137 students (ages 14 to 17 years), as an independent validation of self-reported cigarette smoking status. Ninety-five per cent of the students who reported daily cigarette smoking had detectable cotinine levels. In contract, only 2 per cent of students who reported that they never smoke cigarettes had detectable levels of plasma cotinine. Results suggest that adolescents can report accurately on their smoking status if sufficient assurance of confidentiality is stressed.