Article

Urine cotinine as an index of smoking status in smokers during 96-hr abstinence: Comparison between gas chromatography/mass spectrometry and immunoassay test strips

Department of Psychiatry, Virginia Commonwealth University, Richmond, CA 23298-0205, USA.
Nicotine & Tobacco Research (Impact Factor: 2.81). 09/2004; 6(4):615-20. DOI: 10.1080/14622200410001727867
Source: PubMed

ABSTRACT Biomarkers such as carbon monoxide (CO) and cotinine (a nicotine metabolite) are used in tobacco cessation studies to assess smoking status. CO is easy to assess, is inexpensive, and provides immediate results. However, the short half-life of CO may limit its ability to identify smokers who have abstained for several hours. Quantitative methods (e.g., gas chromatography/mass spectrometry, or GC/MS) for measuring urine cotinine, which has a longer half-life, are valid and reliable, though costly and time consuming. Recently developed semiquantitative urine cotinine measurement techniques (i.e., urine immunoassay test strips, or ITS) address these disadvantages, though the value of ITS as a means of identifying abstaining smokers has not been evaluated. The present study examined ITS as a measure of smoking status in temporarily abstaining smokers. A total of 236 breath and urine samples were collected from smokers who participated in two separate studies involving three independent, 96-hr (i.e., Monday-Friday), Latin-square-ordered, abstinence or smoking conditions; a minimum 72-hr washout separated each condition. Each urine sample was analyzed with GC/MS and ITS. Under these study conditions, CO demonstrated moderate sensitivity (83.1%) and strong specificity (100%), whereas ITS assessment showed strong sensitivity (98.5%) and weak specificity (58.5%). In this study of short-term abstinence, ITS classified as nonabstinent nearly half of the samples collected from abstaining smokers. However, it classified nearly all nonabstinent smokers as currently smoking. Validation of ITS using GC/MS results from smokers undergoing more than 96 hr of abstinence may be valuable.

0 Bookmarks
 · 
127 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background: We investigated ATP-binding cassette transporters A1/G1 expression and function in mediating cholesterol efflux by examining the macrophages of cigarette-smoking patients with coronary artery disease (CAD) before and after smoking abstinence. Methods and Results: Peripheral blood monocyte cells were collected from non-smokers (n=17) non-CAD (NCAD) smokers (n=35), and CAD smokers (n=32) before and after 3 months smoking cessation. We found that the ABCA1 expression level was lower in macrophages from both NCAD and CAD smokers than for non-smokers at baseline. The ABCA1 function of mediating cholesterol efflux was reduced in NCAD and CAD smokers as compared with non-smokers. After 3 months smoking cessation, ABCA1 expression and function were improved in CAD smokers. However, ABCG1 expression and function did not change after smoking cessation. Furthermore, ABCA1 expressions were inhibited by tar in THP-1-derived macrophages through the inhibition of Liver X receptors. Nicotine and carbon monoxide did not inhibit ABCA1 expression. Conclusion: Our results indicate that chronic cigarette smoking impaired ABCA1-mediated cholesterol efflux in macrophages, and tobacco abstinence reversed the function and expression of ABCA1, especially in CAD patients. It was tobacco tar, rather than nicotine or carbon monoxide, that played a major role in the tobacco-induced disturbance of cellular cholesterol homeostasis. Copyright © 2015, The American Society for Biochemistry and Molecular Biology.
  • [Show abstract] [Hide abstract]
    ABSTRACT: To evaluate whether preoperative smoking cessation counseling by urologists using the Ask, Advise, and Refer approach was effective in producing abstinence in patients undergoing urologic surgery. Smokers who were scheduled for inpatient urologic surgery were prospectively enrolled. Smoking cessation counseling consisted of an Ask, Advise, Refer approach. Validated smoking questionnaires were used to evaluate smoking cessation. The expired carbon monoxide and urine cotinine levels were measured to biochemically confirm short- and long-term smoking abstinence, respectively. A total of 38 patients were enrolled in the present study. A significant majority (76%) expressed a willingness to quit smoking long-term at enrollment. On the day of surgery, 9 (28%) of 32 patients reported having quit smoking. However, only 4 (13%) of 32 patients had biochemical confirmation of smoking cessation (negative carbon monoxide and urine cotinine). Similarly, at the first postoperative visit, 8 (29%) of 28 patients reported having quit smoking. However, only 4 (14%) of the 28 patients had biochemical confirmation of smoking cessation (negative carbon monoxide and urine cotinine levels). Despite these results, 89% of the patients continued to express their interest in smoking cessation. The preliminary results of the present pilot study have indicated that the short-term perioperative smoking cessation rates are modest at best. Alternative or supplemental modalities might be necessary to achieve better results and the ultimate goal of long-term smoking abstinence.
    Urology 07/2012; 80(1):104-9. DOI:10.1016/j.urology.2012.04.024 · 2.13 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: If adolescents do not receive appropriate assistance in quitting smoking, they are highly likely to become regular smokers when they enter adulthood. Thus, an effective smoking-cessation program is required. A program was designed based on both the smoking-cessation barriers reported by students and effective strategies derived from the literature. We assigned 143 student smokers from 6 vocational high schools to intervention (n = 78) and comparison groups (n = 65). Data were collected at the baseline, the end of the program, and 1- and 4-month follow-up time points. For the intervention group, the smoking-abstinence rates confirmed using the urine cotinine test were 22.73% at the end of the program and 20.75% at the 4-month follow-up point. Days smoked in the past month, number of cigarettes smoked per day, and the Fagerström Test for Nicotine Dependence score of the intervention group decreased at all of the time points. The group differences in these variables were statistically significant; the magnitude of effect sizes ranged from 0.44 to 0.95. Multicomponent programs addressing smoking-cessation barriers that students encounter can help adolescents quit smoking.
    Addictive Behaviors 10/2014; 39(10):1491–1499. DOI:10.1016/j.addbeh.2014.05.009 · 2.44 Impact Factor