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Cotinine

About: Cotinine is a research topic. Over the lifetime, 4222 publications have been published within this topic receiving 159603 citations. The topic is also known as: (S)-Cotinine & (S)-(-)-Cotinine.


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Book ChapterDOI
TL;DR: The current optimal plasma cotinine cut-point to distinguish smokers from non-smokers in the general US population is 3 ng ml(-1), which is much lower than that established 20 years ago, reflecting less secondhand smoke exposure due to clear air policies and more light or occasional smoking.
Abstract: Nicotine underlies tobacco addiction, influences tobacco use patterns, and is used as a pharmacological aid to smoking cessation. The absorption, distribution and disposition characteristics of nicotine from tobacco and medicinal products are reviewed. Nicotine is metabolized primarily by the liver enzymes CYP2A6, UDPglucuronosyltransfease (UGT), and flavin-containing monooxygenase (FMO). In addition to genetic factors, nicotine metabolism is influenced by diet and meals, age, sex, use of estrogen-containing hormone preparations, pregnancy and kidney disease, other medications, and smoking itself. Substantial racial/ethnic differences are observed in nicotine metabolism, which are likely influenced by both genetic and environmental factors. The most widely used biomarker of nicotine intake is cotinine, which may be measured in blood, urine, saliva, hair, or nails. The current optimal plasma cotinine cut-point to distinguish smokers from non-smokers in the general US population is 3 ng ml−1. This cut-point is much lower than that established 20 years ago, reflecting less secondhand smoke exposure due to clear air policies and more light or occasional smoking.

1,116 citations

Journal ArticleDOI
TL;DR: It is concluded that cotinine is the measure of choice, but for most clinical applications carbon monoxide provides an acceptable degree of discrimination and is considerably cheaper and simpler to apply.
Abstract: Questionnaire and biochemical measures of smoking were studied in 211 hospital outpatients. Eleven different tests of smoke intake were compared for their ability to categorize smokers and nonsmokers correctly. The concentration of cotinine, whether measured in plasma, saliva, or urine, was the best indicator of smoking, with sensitivity of 96-97 per cent and specificity of 99-100 per cent. Thiocyanate provided the poorest discrimination. Carbon monoxide measured as blood carboxyhaemoglobin or in expired air gave sensitivity and specificity of about 90 per cent. Sensitivities of the tests were little affected by the presence among the claimed nonsmokers of a group of 21 "deceivers" who concealed their smoking. It is concluded that cotinine is the measure of choice, but for most clinical applications carbon monoxide provides an acceptable degree of discrimination and is considerably cheaper and simpler to apply.

1,009 citations

Journal ArticleDOI
TL;DR: A biomarker is desirable in quantitating systemic exposure both in smokers and nonsmokers to constituents of tobacco smoke to reflect exposure to toxic constituents of smoke that are of concern.
Abstract: A biomarker is desirable in quantitating systemic exposure both in smokers and nonsmokers to constituents of tobacco smoke. Self-report measures in smokers, such as cigarettes smoked per day, are highly imprecise owing to individual differences in how cigarettes are smoked, with ranges of nicotine intake per cigarette from 0.3 to 3.0 mg (1, 2). Self-report measures, such as hours per day exposed to environmental tobacco smoke (ETS) by nonsmokers, are also likely to be imprecise indicators of intake of tobacco smoke owing to variations in the number of cigarettes smoked, proximity of nonsmokers to smokers, room ventilation and other environmental characteristics, as well as individual differences in sensitivity to and/or concern about adverse effects of ETS. The optimal assessment of exposure to tobacco smoke would be by analysis of the concentrations of a component of smoke in the body fluids of an exposed individual— i.e., a biologic marker or biomarker. There are two broad questions that need to be considered in assessing the validity of a biomarker of tobacco smoke exposure. The first is how well does the concentration of a marker chemical in the air reflect exposure to toxic constituents of smoke that are of concern? The second is how well does a concentration of a particular chemical in a biologic fluid reflect an individual's intake of that chemical (or a related chemical) from tobacco smoke? The National Research Council (3) has proposed criteria for a valid marker of ETS in the air as follows: The marker 1) should be unique or nearly unique for ETS so that other sources are minor in comparison; 2) should be easily detectable; 3) should be emitted at similar rates for a variety of tobacco products; and 4)

942 citations

Journal ArticleDOI
TL;DR: Overall, the data show trends of underestimation when smoking prevalence is based on self-report and varying sensitivity levels for self-reported estimates depending on the population studied and the medium in which the biological sample is measured.
Abstract: INTRODUCTION Smoking is a leading cause of premature mortality and preventable morbidity. Surveillance is most often based on self-reported data, but studies have shown that self-reports tend to underestimate smoking status. METHODS This study systematically reviewed the literature to measure the concordance between self-reported smoking status and smoking status determined through measures of cotinine in biological fluids. Four electronic databases were searched to identify observational and experimental studies on adult populations over the age of 18 years. RESULTS Searching identified 67 studies that met the eligibility criteria and examined the relationship between self-reported smoking and smoking confirmed by cotinine measurement. Overall, the data show trends of underestimation when smoking prevalence is based on self-report and varying sensitivity levels for self-reported estimates depending on the population studied and the medium in which the biological sample is measured. Sensitivity values were consistently higher when cotinine was measured in saliva instead of urine or blood. Meta-analysis was not appropriate because of the substantial heterogeneity among the cutpoints used to define smokers and the poor reporting on outcomes of interest. DISCUSSION Further research in this field would benefit from the standardization of cutpoints to define current smokers and the implementation of standard reporting guidelines to enhance comparability across studies. Accurate estimation of smoking status is important as data from population studies such as those included in this review are used to generate regional and national estimates of smoking status and in turn are used to allocate resources and set health priorities.

940 citations

Journal ArticleDOI
24 Apr 1996-JAMA
TL;DR: In this article, the authors estimate the extent of exposure of the US population to environmental tobacco smoke and the contribution of the home and workplace environment to environmental Tobacco smoke exposure in the United States.
Abstract: Objective. —To estimate the extent of exposure of the US population to environmental tobacco smoke and the contribution of the home and workplace environment to environmental tobacco smoke exposure. Design. —Nationally representative cross-sectional survey including questionnaire information from persons aged 2 months and older (n=16 818) and measurements of serum cotinine (a metabolite of nicotine) from persons aged 4 years and older (n=10 642). Setting/Participants. —Participants in the Third National Health and Nutrition Examination Survey, October 25, 1988, to October 21, 1991. Results. —Of US children aged 2 months to 11 years, 43% lived in a home with at least 1 smoker, and 37% of adult non—tobacco users lived in a home with at least 1 smoker or reported environmental tobacco smoke exposure at work. Serum cotinine levels indicated more widespread exposure to nicotine. Of non—tobacco users, 87.9% had detectable levels of serum cotinine. Both the number of smokers in the household and the hours exposed at work were significantly and independently associated ( P Conclusions. —The high proportion of the population with detectable serum cotinine levels indicates widespread exposure to environmental tobacco smoke in the US population. Both the home and workplace environments significantly contribute to environmental tobacco smoke exposure in the United States. ( JAMA . 1996;275:1233-1240)

686 citations


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Performance
Metrics
No. of papers in the topic in previous years
YearPapers
2023144
2022308
2021171
2020158
2019165
2018163