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Relative performance of common biochemical indicators in detecting cigarette smoking
Author(s) -
Marrone Gina F.,
Shakleya Diaa M.,
Scheidweiler Karl B.,
Singleton Edward G.,
Huestis Marilyn A.,
Heishman Stephen J.
Publication year - 2011
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/j.1360-0443.2011.03441.x
Subject(s) - cotinine , saliva , urine , nicotine , smoke , medicine , smoking cessation , environmental health , cigarette smoking , chemistry , pathology , organic chemistry
Aims Many cities have banned indoor smoking in public places. Thus, an updated recommendation for a breath carbon monoxide (CO) cut‐off is needed that optimally determines smoking status. We evaluated and compared the performance of breath CO and semiquantitative cotinine immunoassay test strips (urine and saliva NicAlert®) alone and in combination. Design Cross‐sectional study. Setting Urban drug addiction research and treatment facility. Participants Ninety non‐treatment‐seeking smokers and 82 non‐smokers. Measurements Participants completed smoking histories and provided breath CO, urine and saliva specimens. Urine and saliva specimens were assayed for cotinine by NicAlert® and liquid chromatography‐tandem mass spectrometry (LCMSMS). Findings An optimal breath CO cut‐off was established using self‐report and LCMSMS analysis of cotinine, an objective indicator, as reference measures. Performance of smoking indicators and combinations were compared to the reference measures. Breath CO ≥5 parts per million (p.p.m.) optimally discriminated smokers from non‐smokers. Saliva NicAlert® performance was less effective than the other indicators. Conclusions In surveys of smokers and non‐smokers in areas with strong smoke‐free laws, the breath carbon monoxide cut‐off that discriminates most effectively appears to be ≥5 p.p.m. rather than the ≥10 p.p.m. cut‐off often used. These findings may not generalize to clinical trials, regions with different carbon monoxide pollution levels or areas with less stringent smoke‐free laws.