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Neal L. Benowitz - One of the best experts on this subject based on the ideXlab platform.
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evaluation of nicotine patch adherence measurement using self report and saliva Cotinine among abstainers in a smoking cessation trial
Drug and Alcohol Dependence, 2020Co-Authors: Robert A Schnoll, Neal L. Benowitz, Paul E Wileyto, Robert E Gross, Brian Hitsman, Larry W Hawk, Paul M Cinciripini, Tony P George, Su Fen Lubitz, Rebecca L AshareAbstract:Abstract Background Adherence to nicotine patches relates to cessation. This is the first study to examine the validity of self-reported nicotine patch adherence relative to saliva Cotinine. Methods We used data from 198 clinical trial participants who received 11 weeks of nicotine patches, self-reported patch use, had saliva Cotinine 1-week after the start of treatment assessed, and were not smoking when saliva was collected (CO Results Self-reported 7-day (r = 0.13) and 3-week (r = 0.13) patch use marginally correlated with week 1 Cotinine (p’s = 0.08) but not 3-day or 11-week. Significant area under the curve (AUC) values of 0.67 (95 %CI: 0.55−0.79) and 0.72 (95 %CI: 0.57−0.88) were found using 7-day self-report for the overall sample and for slow metabolizers (p’s Conclusions Among CO-confirmed abstainers, self-reported patch use and saliva Cotinine assessed 1-week into treatment, were modestly correlated and optimal Cotinine cut-point differed by rate of nicotine metabolism. Seven-day patch use may be a more valid self-report measure of patch adherence based on Cotinine than 3-day, 3-week, or 11-week. Rate of nicotine metabolism may affect this relationship.
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the ability of plasma Cotinine to predict nicotine and carcinogen exposure is altered by differences in cyp2a6 the influence of genetics race and sex
Cancer Epidemiology Biomarkers & Prevention, 2013Co-Authors: Andy Z X Zhu, Neal L. Benowitz, Caroline C Renner, Dorothy K Hatsukami, Gary E Swan, Caryn Lerman, Rachel F TyndaleAbstract:Background: Cotinine, a nicotine metabolite, is a biomarker of tobacco, nicotine, and carcinogen exposure. However, a given Cotinine level may not represent the same tobacco exposure; for example, African-Americans have higher Cotinine levels than Caucasians after controlling for exposure. Methods: Cotinine levels are determined by the amount of Cotinine formation and the rate of Cotinine removal, which are both mediated by the enzyme CYP2A6. Because CYP2A6 activity differs by sex (estrogen induces CYP2A6) and genotype, their effect on Cotinine formation and removal was measured in nonsmoking Caucasians (Study 1, n = 181) infused with labeled nicotine and Cotinine. The findings were then extended to ad libitum smokers (Study 2, n = 163). Results: Study 1: Reduced CYP2A6 activity altered Cotinine formation less than Cotinine removal resulting in ratios of formation to removal of 1.31 and 1.12 in CYP2A6 reduced and normal metabolizers ( P = 0.01), or 1.39 and 1.12 in males and females ( P = 0.001), suggesting an overestimation of tobacco exposure in slower metabolizers. Study 2: Cotinine again overestimated tobacco and carcinogen exposure by 25% or more in CYP2A6 reduced metabolizers (≈2-fold between some genotypes) and in males. Conclusions: In people with slower relative to faster CYP2A6 activity, Cotinine accumulates resulting in substantial differences in Cotinine levels for a given tobacco exposure. Impact: Cotinine levels may be misleading when comparing those with differing CYP2A6 genotypes within a race, between races with differing frequencies of CYP2A6 gene variants (i.e., African-Americans have higher frequencies of reduced function variants contributing to their higher Cotinine levels), or between the sexes. Cancer Epidemiol Biomarkers Prev; 22(4); 708–18. ©2013 AACR .
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comparison of urine Cotinine and the tobacco specific nitrosamine metabolite 4 methylnitrosamino 1 3 pyridyl 1 butanol nnal and their ratio to discriminate active from passive smoking
Nicotine & Tobacco Research, 2011Co-Authors: Maciej L Goniewicz, Peyton Jacob, Mark D Eisner, Eduardo Lazcanoponce, Wioleta Zielinskadanch, Bartosz Koszowski, Andrzej Sobczak, Christopher Havel, Neal L. BenowitzAbstract:Objectives: Cotinine is the most widely used biomarker to distinguish active versus passive smoking. However, there is an overlap in Cotinine levels when comparing light or occasional smokers versus heavily exposed passive smokers. 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) is a tobacco-specific nitrosamine measurable in urine with a much longer half-life than Cotinine. The aim of the study was to determine optimal cutoff points to discriminate active versus passive smokers and to compare sensitivity and specificity for the use of Cotinine, NNAL, and the ratio of the NNAL/Cotinine in urine.
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Urine Cotinine Underestimates Exposure to the Tobacco-Derived Lung Carcinogen 4-(Methylnitrosamino)-1-(3-Pyridyl)-1-Butanone in Passive Compared with Active Smokers
Cancer epidemiology biomarkers & prevention : a publication of the American Association for Cancer Research cosponsored by the American Society of Pre, 2010Co-Authors: Neal L. Benowitz, Maciej L Goniewicz, Mark D Eisner, Bartosz Koszowski, Andrzej Sobczak, Christopher Havel, Eduardo Lazcano-ponce, Wioleta Zielińska-danch, Peyton JacobAbstract:Objectives: Cotinine and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) are widely used biomarkers for tobacco-derived nicotine and the lung carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK), respectively. The discrepancy between Cotinine levels in relation to disease risk comparing active versus passive smoking suggests a nonlinear tobacco smoke dose-response and/or that Cotinine is not providing an accurate measure of exposure to the toxic constituents of secondhand tobacco smoke. Methods: Cotinine and NNAL were measured in the urine of 373 active smokers and 228 passive smokers. Results: Average Cotinine levels were 1,155 (interquartile range, 703-2,715) for active smokers and 1.82 (0.45-7.33) ng/mg creatinine for passive smokers. Average NNAL levels were 183 (103-393) and 5.19 (2.04-11.6) pg/mg creatinine, respectively. NNAL/Cotinine ratio in urine was significantly higher for passive smokers when compared with active smokers (2.85 × 103 versus 0.16 × 103, P < 0.0001). Conclusions: Passive smoking is associated with a much higher ratio of NNAL/Cotinine in the urine compared with active smoking. Impact: Cotinine measurement leads to an underestimation of exposure to the carcinogen NNK from secondhand smoke when compared with active smoking. Cancer Epidemiol Biomarkers Prev; 19(11); 2795–800. ©2010 AACR.
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interlaboratory comparability of serum Cotinine measurements at smoker and nonsmoker concentration levels a round robin study
Nicotine & Tobacco Research, 2009Co-Authors: John T. Bernert, Neal L. Benowitz, Peyton Jacob, Connie S. Sosnoff, C Feyerabend, David Holiday, Mira Doig, Kenneth M Aldous, Mehran Sharifi, Mark D. KelloggAbstract:Introduction Cotinine, the primary proximate metabolite of nicotine, is commonly measured as an index of exposure to tobacco in both active users of tobacco and nonsmokers with possible exposure to secondhand smoke (SHS). A number of laboratories have implemented analyses for measuring serum Cotinine in recent years, but there have been few interlaboratory comparisons of the results. Among nonsmokers exposed to SHS, the concentration of Cotinine in blood can be quite low, and extensive variability in these measurements has been reported in the past. Methods In this study, a group of seven laboratories, all experienced in serum Cotinine analysis, measured eight coded serum pools with concentrations ranging from background levels of about 0.05 ng/ml to relatively high concentrations in the active smokers range. All laboratories used either gas-liquid chromatography with nitrogen-phosphorus detection or liquid chromatography with mass spectrometric detection. Results All seven laboratories reliably measured the Cotinine concentrations in samples that were within the range of their methods. In each case, the results for the pools were correctly ranked in order, and no significant interlaboratory bias was observed at the 5% level of significance for results from any of the pools. Discussion We conclude that present methods of chromatographic analysis of serum Cotinine, as used by these experienced laboratories, are capable of providing accurate and precise results in both the smoker and the nonsmoker concentration range.
Peyton Jacob - One of the best experts on this subject based on the ideXlab platform.
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comparison of urine Cotinine and the tobacco specific nitrosamine metabolite 4 methylnitrosamino 1 3 pyridyl 1 butanol nnal and their ratio to discriminate active from passive smoking
Nicotine & Tobacco Research, 2011Co-Authors: Maciej L Goniewicz, Peyton Jacob, Mark D Eisner, Eduardo Lazcanoponce, Wioleta Zielinskadanch, Bartosz Koszowski, Andrzej Sobczak, Christopher Havel, Neal L. BenowitzAbstract:Objectives: Cotinine is the most widely used biomarker to distinguish active versus passive smoking. However, there is an overlap in Cotinine levels when comparing light or occasional smokers versus heavily exposed passive smokers. 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) is a tobacco-specific nitrosamine measurable in urine with a much longer half-life than Cotinine. The aim of the study was to determine optimal cutoff points to discriminate active versus passive smokers and to compare sensitivity and specificity for the use of Cotinine, NNAL, and the ratio of the NNAL/Cotinine in urine.
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Urine Cotinine Underestimates Exposure to the Tobacco-Derived Lung Carcinogen 4-(Methylnitrosamino)-1-(3-Pyridyl)-1-Butanone in Passive Compared with Active Smokers
Cancer epidemiology biomarkers & prevention : a publication of the American Association for Cancer Research cosponsored by the American Society of Pre, 2010Co-Authors: Neal L. Benowitz, Maciej L Goniewicz, Mark D Eisner, Bartosz Koszowski, Andrzej Sobczak, Christopher Havel, Eduardo Lazcano-ponce, Wioleta Zielińska-danch, Peyton JacobAbstract:Objectives: Cotinine and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) are widely used biomarkers for tobacco-derived nicotine and the lung carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK), respectively. The discrepancy between Cotinine levels in relation to disease risk comparing active versus passive smoking suggests a nonlinear tobacco smoke dose-response and/or that Cotinine is not providing an accurate measure of exposure to the toxic constituents of secondhand tobacco smoke. Methods: Cotinine and NNAL were measured in the urine of 373 active smokers and 228 passive smokers. Results: Average Cotinine levels were 1,155 (interquartile range, 703-2,715) for active smokers and 1.82 (0.45-7.33) ng/mg creatinine for passive smokers. Average NNAL levels were 183 (103-393) and 5.19 (2.04-11.6) pg/mg creatinine, respectively. NNAL/Cotinine ratio in urine was significantly higher for passive smokers when compared with active smokers (2.85 × 103 versus 0.16 × 103, P < 0.0001). Conclusions: Passive smoking is associated with a much higher ratio of NNAL/Cotinine in the urine compared with active smoking. Impact: Cotinine measurement leads to an underestimation of exposure to the carcinogen NNK from secondhand smoke when compared with active smoking. Cancer Epidemiol Biomarkers Prev; 19(11); 2795–800. ©2010 AACR.
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interlaboratory comparability of serum Cotinine measurements at smoker and nonsmoker concentration levels a round robin study
Nicotine & Tobacco Research, 2009Co-Authors: John T. Bernert, Neal L. Benowitz, Peyton Jacob, Connie S. Sosnoff, C Feyerabend, David Holiday, Mira Doig, Kenneth M Aldous, Mehran Sharifi, Mark D. KelloggAbstract:Introduction Cotinine, the primary proximate metabolite of nicotine, is commonly measured as an index of exposure to tobacco in both active users of tobacco and nonsmokers with possible exposure to secondhand smoke (SHS). A number of laboratories have implemented analyses for measuring serum Cotinine in recent years, but there have been few interlaboratory comparisons of the results. Among nonsmokers exposed to SHS, the concentration of Cotinine in blood can be quite low, and extensive variability in these measurements has been reported in the past. Methods In this study, a group of seven laboratories, all experienced in serum Cotinine analysis, measured eight coded serum pools with concentrations ranging from background levels of about 0.05 ng/ml to relatively high concentrations in the active smokers range. All laboratories used either gas-liquid chromatography with nitrogen-phosphorus detection or liquid chromatography with mass spectrometric detection. Results All seven laboratories reliably measured the Cotinine concentrations in samples that were within the range of their methods. In each case, the results for the pools were correctly ranked in order, and no significant interlaboratory bias was observed at the 5% level of significance for results from any of the pools. Discussion We conclude that present methods of chromatographic analysis of serum Cotinine, as used by these experienced laboratories, are capable of providing accurate and precise results in both the smoker and the nonsmoker concentration range.
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prevalence of smoking assessed biochemically in an urban public hospital a rationale for routine Cotinine screening
American Journal of Epidemiology, 2009Co-Authors: Neal L. Benowitz, Katherine E Schultz, Christine A Haller, Katherine M Dains, Peyton JacobAbstract:Cotinine, a metabolite of nicotine, has been used to study tobacco smoke exposure in population studies, but the authors are unaware of its use to screen hospitalized patients. The authors measured serum Cotinine levels in 948 patients admitted to an urban public hospital in San Francisco, California, between September 2005 and July 2006. On the basis of Cotinine levels, they classified patients as active smokers (Cotinine > or = 14 ng/mL), recent smokers or significantly exposed to secondhand smoke (SHS) (0.5-13.9 ng/mL), lightly exposed to SHS (0.05-0.49 ng/mL), or unexposed (<0.05 ng/mL). In contrast to the 13% prevalence of smoking in the general population of San Francisco, 40% of patients were active smokers; 15% were recent smokers or heavily exposed to SHS; 25% had low-level exposure to SHS; and 20% were unexposed. Active smoking or heavy SHS exposure was particularly high among African Americans (77%), the uninsured (65%), self-reported alcohol drinkers (77%), and illicit drug users (90%). Of people who denied smoking, 32% were found to have had significant exposure. If serum Cotinine measurement became part of routine screening at urban public hospitals, Cotinine levels would be abnormal in many patients and would provide objective evidence of tobacco smoke exposure, probably resulting in more intensive intervention to encourage patients to stop smoking and avoid SHS.
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female sex and oral contraceptive use accelerate nicotine metabolism
Clinical Pharmacology & Therapeutics, 2006Co-Authors: Neal L. Benowitz, Peyton Jacob, Gary E Swan, Christina N LessovschlaggarAbstract:Several studies have reported that female smokers have a higher risk of lung cancer than male smokers. This could be related to sex differences in nicotine metabolism and related smoking behavior. This study tested the hypothesis that women metabolize nicotine more rapidly than men and that among women oral contraceptive users metabolize nicotine more rapidly than nonusers of oral contraceptives. Two hundred seventy-eight healthy volunteers who were twins and 16 who were siblings of twins recruited from the Northern California Twin Registry received an infusion of deuterium-labeled nicotine and Cotinine with frequent blood sampling. The plasma clearances of nicotine and Cotinine the clearance of nicotine to Cotinine (an index of cytochrome P450 [CYP] 2A6 activity) and the ratio of trans-3-hydroxyCotinine to Cotinine (another indicator of CYP2A6 activity) were measured. The clearances of nicotine and Cotinine the clearance of nicotine to Cotinine and the trans-3-hydroxyCotinine/Cotinine ratio were significantly higher in women than in men (nicotine clearance 15.6 ± 4.3 mL - min/-1 - kg/-1 in men versus 18.8 ± 6.6 mL -- min/-1 - kg/-1 in women; P < .001); they were also higher among women taking oral contraceptives than in those who were not taking oral contraceptives (nicotine clearance 22.5 ± 6.6 mL -- min/-1 -- kg/-1 in women taking oral contraceptives versus 17.6 ± 6.1 mL - min/-1 -- kg/-1 in those who were not; P < .05). Women who were menopausal or postmenopausal were not different from men. Among oral contraceptive users nicotine metabolism was accelerated among those taking combined and estrogen-only contraceptives but not progesterone-only contraceptives. Conclusions: Sex hormones influence nicotine metabolism. Nicotine and Cotinine metabolism is faster in women than in men and is faster in women taking oral contraceptives compared with those who are not. Accelerated nicotine metabolism appears to be a result of estrogen. Sex-related differences in nicotine clearance could affect smoking behaviors as well as response to nicotine medications and could be a marker for altered metabolism of nicotine-derived carcinogens. (authors)
John T. Bernert - One of the best experts on this subject based on the ideXlab platform.
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Representative chromatograms.
2014Co-Authors: James E. Mcguffey, Binnian Wei, John T. Bernert, John C. Morrow, Baoyun Xia, Lanqing Wang, Benjamin C. BlountAbstract:(A) Standards Analysis (Cotinine, 200 ng/mL); (B) Smoker Urine Sample (“free” Cotinine, 14.1 ng/mL); (C) Smoker Urine Sample (“free” Cotinine, 2767 ng/mL); (D) Smoker Urine Sample (“total” Cotinine, 4195 ng/mL). Abbreviations: Cotinine-oxide (COX); Nicotine-oxide NOX); Hydroxycotine (HCT); NorCotinine (NCT); Cotinine (COT); Nornicotine (NNC); Anatabine (ANT); Anabasine (ANB); Nicotine (NIC). The fourth letter “T” in the abbreviations in Figure 2(D) represents the “total” concentrations for measured analytes.
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household smoking behavior effects on indoor air quality and health of urban children with asthma
Maternal and Child Health Journal, 2011Co-Authors: Arlene M Butz, John T. Bernert, Patrick N Breysse, Cynthia S Rand, Jean Curtinbrosnan, Peyton A Eggleston, Gregory B Diette, Dann L Williams, Elizabeth C MatsuiAbstract:The goal of the study was to examine the association between biomarkers and environmental measures of second hand smoke (SHS) with caregiver, i.e. parent or legal guardian, report of household smoking behavior and morbidity measures among children with asthma. Baseline data were drawn from a longitudinal intervention for 126 inner city children with asthma, residing with a smoker. Most children met criteria for moderate to severe persistent asthma (63%) versus mild intermittent (20%) or mild persistent (17%). Household smoking behavior and asthma morbidity were compared with child urine Cotinine and indoor measures of air quality including fine particulate matter (PM2.5) and air nicotine (AN). Kruskal–Wallis, Wilcoxon rank-sum and Spearman rho correlation tests were used to determine the level of association between biomarkers of SHS exposure and household smoking behavior and asthma morbidity. Most children had uncontrolled asthma (62%). The primary household smoker was the child’s caregiver (86/126, 68%) of which 66 (77%) were the child’s mother. Significantly higher mean PM2.5, AN and Cotinine concentrations were detected in households where the caregiver was the smoker (caregiver smoker: PM2.5 μg/m3: 44.16, AN: 1.79 μg/m3, Cotinine: 27.39 ng/ml; caregiver non-smoker: PM2.5: 28.88 μg/m3, AN: 0.71 μg/m3, Cotinine:10.78 ng/ml, all P ≤ 0.01). Urine Cotinine concentrations trended higher in children who reported 5 or more symptom days within the past 2 weeks (>5 days/past 2 weeks, Cotinine: 28.1 ng/ml vs. <5 days/past 2 weeks, Cotinine: 16.2 ng/ml; P = 0.08). However, environmental measures of SHS exposures were not associated with asthma symptoms. Urban children with persistent asthma, residing with a smoker are exposed to high levels of SHS predominantly from their primary caregiver. Because Cotinine was more strongly associated with asthma symptoms than environmental measures of SHS exposure and is independent of the site of exposure, it remains the gold standard for SHS exposure assessment in children with asthma.
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interlaboratory comparability of serum Cotinine measurements at smoker and nonsmoker concentration levels a round robin study
Nicotine & Tobacco Research, 2009Co-Authors: John T. Bernert, Neal L. Benowitz, Peyton Jacob, Connie S. Sosnoff, C Feyerabend, David Holiday, Mira Doig, Kenneth M Aldous, Mehran Sharifi, Mark D. KelloggAbstract:Introduction Cotinine, the primary proximate metabolite of nicotine, is commonly measured as an index of exposure to tobacco in both active users of tobacco and nonsmokers with possible exposure to secondhand smoke (SHS). A number of laboratories have implemented analyses for measuring serum Cotinine in recent years, but there have been few interlaboratory comparisons of the results. Among nonsmokers exposed to SHS, the concentration of Cotinine in blood can be quite low, and extensive variability in these measurements has been reported in the past. Methods In this study, a group of seven laboratories, all experienced in serum Cotinine analysis, measured eight coded serum pools with concentrations ranging from background levels of about 0.05 ng/ml to relatively high concentrations in the active smokers range. All laboratories used either gas-liquid chromatography with nitrogen-phosphorus detection or liquid chromatography with mass spectrometric detection. Results All seven laboratories reliably measured the Cotinine concentrations in samples that were within the range of their methods. In each case, the results for the pools were correctly ranked in order, and no significant interlaboratory bias was observed at the 5% level of significance for results from any of the pools. Discussion We conclude that present methods of chromatographic analysis of serum Cotinine, as used by these experienced laboratories, are capable of providing accurate and precise results in both the smoker and the nonsmoker concentration range.
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trends in the exposure of nonsmokers in the u s population to secondhand smoke 1988 2002
Environmental Health Perspectives, 2006Co-Authors: James L Pirkle, Connie S. Sosnoff, John T. Bernert, Samuel P Caudill, Terry F PechacekAbstract:The objective of this study was to describe the exposure of nonsmokers in the U.S. population to secondhand smoke (SHS) using serum Cotinine concentrations measured over a period of 14 years, from October 1988 through December 2002. This study consists of a series of National Health and Nutrition Examination Surveys (NHANES) measuring serum Cotinine as an index of SHS exposure of participants. Study participants were individuals representative of the U.S. civilian, noninstitutionalized population, ≥ 4 years of age. We analyzed serum Cotinine and interview data from NHANES obtained during surveys conducted during four distinct time periods. Our results document a substantial decline of approximately 70% in serum Cotinine concentrations in non-smokers during this period. This decrease was reflected in all groups within the population regardless of age, sex, or race/ethnicity. The large decrease that we observed in serum Cotinine concentrations suggests a substantial reduction in the exposure of the U.S. population to SHS during the 1990s. The exposure of nonsmokers to SHS represents an important public health concern. Our findings suggest that recent public health efforts to reduce such exposures have had an important effect, although children and non-Hispanic black nonsmokers show relatively higher levels of serum Cotinine.
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comparison of serum and salivary Cotinine measurements by a sensitive high performance liquid chromatography tandem mass spectrometry method as an indicator of exposure to tobacco smoke among smokers and nonsmokers
Journal of Analytical Toxicology, 2000Co-Authors: John T. Bernert, James E. Mcguffey, Melissa Morrison, James L PirkleAbstract:Exposure to tobacco smoke, both from active smoking and from passive exposure to environmental tobacco smoke, can be monitored by measuring Cotinine, a metabolite of nicotine, in a variety of biological sources including blood, urine, and saliva. Previously, a sensitive atmospheric-pressure ionization, tandem mass spectrometric (LC-API-MS-MS) method for Cotinine measurements in serum was developed in support of a large, recurrent national epidemiologic investigation. The current study examined the application of this LC-API-MS-MS method to both serum and saliva Cotinine measurements in a group of 200 healthy adults, including both smokers and nonsmokers. The primary objective of this study was to evaluate the relationship between serum and saliva Cotinine concentrations to facilitate the linking of results from epidemiologic studies using salivary Cotinine measurements to existing national data based on serum Cotinine analyses. The results indicate that a simple, linear relationship can be developed to describe serum and saliva Cotinine concentrations in an individual, and the expression describing this relationship can be used to estimate with reasonable accuracy (approximately +/- 10%) the serum Cotinine concentration in an individual given his or her salivary Cotinine result. It was further confirmed that saliva Cotinine samples are generally quite stable during storage after collection, even at ambient temperatures, and this sample matrix appears to be well-suited to the requirements of many epidemiologic investigations.
K Malik - One of the best experts on this subject based on the ideXlab platform.
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the validation of self reported smoking status by analysing Cotinine levels in stimulated and unstimulated saliva serum and urine
Oral Diseases, 2004Co-Authors: Vivian I Binnie, Siobhan Mchugh, L M D Macpherson, B Borland, K Moir, K MalikAbstract:OBJECTIVES: Cotinine, a nicotine metabolite, can be used to measure exposure to tobacco smoke. The aim of this study was to compare Cotinine levels in different biological fluids collected from both smokers and non-smokers and to relate the findings to self-reported smoking status. Data were also collected concerning the acceptability of the differing methods of sample collection. MATERIAL AND METHOD: Patients recruited to the study were asked to provide samples of urine, blood and saliva (both stimulated and unstimulated). Data collected from patients by questionnaire included information on smoking behaviour such as daily number of cigarettes and environmental exposure to smoke. After the sample collection, patients were asked to rate the acceptability of each sampling method. Samples were analysed using enzyme immunoassay (EIA) kits. RESULTS: In total, 80 patients participated, with 49 being smokers and 31 being non-smokers. There was clear differentiation between smokers and non-smokers (P < 0.001) for all the different samples in terms of Cotinine. A significant relationship was seen between Cotinine and daily number of cigarettes for both salivas and urine (all P < 0.001) but not for serum. Participants found serum and urine collection methodologies 'very acceptable' (67 and 66%, respectively) whereas 9% found collection of stimulated saliva 'not at all acceptable'. CONCLUSION: Cotinine, whatever the collection method and analysed by EIA kits, shows good differentiation between smokers and non-smokers. Salivary samples have the advantage of being non-invasive, although collection methodology is important, as Cotinine levels may vary.
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the validation of self reported smoking status by analysing Cotinine levels in stimulated and unstimulated saliva serum and urine
Oral Diseases, 2004Co-Authors: Vivian I Binnie, Siobhan Mchugh, L M D Macpherson, B Borland, K Moir, K MalikAbstract:Objectives: Cotinine, a nicotine metabolite, can be used to measure exposure to tobacco smoke. The aim of this study was to compare Cotinine levels in different biological fluids collected from both smokers and non-smokers and to relate the findings to self-reported smoking status. Data were also collected concerning the acceptability of the differing methods of sample collection. Material and method: Patients recruited to the study were asked to provide samples of urine, blood and saliva (both stimulated and unstimulated). Data collected from patients by questionnaire included information on smoking behaviour such as daily number of cigarettes and environmental exposure to smoke. After the sample collection, patients were asked to rate the acceptability of each sampling method. Samples were analysed using enzyme immunoassay (EIA) kits. Results: In total, 80 patients participated, with 49 being smokers and 31 being non-smokers. There was clear differentiation between smokers and non-smokers (P < 0.001) for all the different samples in terms of Cotinine. A significant relationship was seen between Cotinine and daily number of cigarettes for both salivas and urine (all P < 0.001) but not for serum. Participants found serum and urine collection methodologies ‘very acceptable’ (67 and 66%, respectively) whereas 9% found collection of stimulated saliva ‘not at all acceptable’. Conclusion: Cotinine, whatever the collection method and analysed by EIA kits, shows good differentiation between smokers and non-smokers. Salivary samples have the advantage of being non-invasive, although collection methodology is important, as Cotinine levels may vary.
James L Pirkle - One of the best experts on this subject based on the ideXlab platform.
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trends in the exposure of nonsmokers in the u s population to secondhand smoke 1988 2002
Environmental Health Perspectives, 2006Co-Authors: James L Pirkle, Connie S. Sosnoff, John T. Bernert, Samuel P Caudill, Terry F PechacekAbstract:The objective of this study was to describe the exposure of nonsmokers in the U.S. population to secondhand smoke (SHS) using serum Cotinine concentrations measured over a period of 14 years, from October 1988 through December 2002. This study consists of a series of National Health and Nutrition Examination Surveys (NHANES) measuring serum Cotinine as an index of SHS exposure of participants. Study participants were individuals representative of the U.S. civilian, noninstitutionalized population, ≥ 4 years of age. We analyzed serum Cotinine and interview data from NHANES obtained during surveys conducted during four distinct time periods. Our results document a substantial decline of approximately 70% in serum Cotinine concentrations in non-smokers during this period. This decrease was reflected in all groups within the population regardless of age, sex, or race/ethnicity. The large decrease that we observed in serum Cotinine concentrations suggests a substantial reduction in the exposure of the U.S. population to SHS during the 1990s. The exposure of nonsmokers to SHS represents an important public health concern. Our findings suggest that recent public health efforts to reduce such exposures have had an important effect, although children and non-Hispanic black nonsmokers show relatively higher levels of serum Cotinine.
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comparison of serum and salivary Cotinine measurements by a sensitive high performance liquid chromatography tandem mass spectrometry method as an indicator of exposure to tobacco smoke among smokers and nonsmokers
Journal of Analytical Toxicology, 2000Co-Authors: John T. Bernert, James E. Mcguffey, Melissa Morrison, James L PirkleAbstract:Exposure to tobacco smoke, both from active smoking and from passive exposure to environmental tobacco smoke, can be monitored by measuring Cotinine, a metabolite of nicotine, in a variety of biological sources including blood, urine, and saliva. Previously, a sensitive atmospheric-pressure ionization, tandem mass spectrometric (LC-API-MS-MS) method for Cotinine measurements in serum was developed in support of a large, recurrent national epidemiologic investigation. The current study examined the application of this LC-API-MS-MS method to both serum and saliva Cotinine measurements in a group of 200 healthy adults, including both smokers and nonsmokers. The primary objective of this study was to evaluate the relationship between serum and saliva Cotinine concentrations to facilitate the linking of results from epidemiologic studies using salivary Cotinine measurements to existing national data based on serum Cotinine analyses. The results indicate that a simple, linear relationship can be developed to describe serum and saliva Cotinine concentrations in an individual, and the expression describing this relationship can be used to estimate with reasonable accuracy (approximately +/- 10%) the serum Cotinine concentration in an individual given his or her salivary Cotinine result. It was further confirmed that saliva Cotinine samples are generally quite stable during storage after collection, even at ambient temperatures, and this sample matrix appears to be well-suited to the requirements of many epidemiologic investigations.
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racial and ethnic differences in serum Cotinine levels of cigarette smokers third national health and nutrition examination survey 1988 1991
JAMA, 1998Co-Authors: Ralph S Caraballo, James L Pirkle, Terry F Pechacek, Gary A Giovino, Paul Mowery, Patricia Richter, Warren J Strauss, Donald J Sharp, Michael P Eriksen, Kurt R MaurerAbstract:Context.—Cotinine, a metabolite of nicotine, is a marker of exposure to tobacco smoke. Previous studies suggest that non-Hispanic blacks have higher levels of serum Cotinine than non-Hispanic whites who report similar levels of cigarette smoking.Objective.—To investigate differences in levels of serum Cotinine in black, white, and Mexican American cigarette smokers in the US adult population.Design.—Third National Health and Nutrition Examination Survey, 1988-1991.Participants.—A nationally representative sample of persons aged 17 years or older who participated in the survey.Outcome Measures.—Serum Cotinine levels by reported number of cigarettes smoked per day and by race and ethnicity.Results.—A total of 7182 subjects were involved in the study; 2136 subjects reported smoking at least 1 cigarette in the last 5 days. Black smokers had Cotinine concentrations substantially higher at all levels of cigarette smoking than did white or Mexican American smokers (P<.001). Serum Cotinine levels for blacks were 125 nmol/L (22 ng/mL) (95% confidence interval [CI], 79-176 nmol/L [14-31 ng/mL]) to 539 nmol/L (95 ng/mL) (95% CI, 289-630 nmol/L [51-111 ng/mL]) higher than for whites and 136 nmol/L (24 ng/mL) (95% CI, 85-182 nmol/L [15-32 ng/mL]) to 641 nmol/L (113 ng/mL) (95% CI, 386-897 nmol/L [68-158 ng/mL]) higher than for Mexican Americans. These differences do not appear to be attributable to differences in environmental tobacco smoke exposure or in number of cigarettes smoked.Conclusions.—To our knowledge, this study provides the first evidence from a national study that serum Cotinine levels are higher among black smokers than among white or Mexican American smokers. If higher Cotinine levels among blacks indicate higher nicotine intake or differential pharmacokinetics and possibly serve as a marker of higher exposure to cigarette carcinogenic components, they may help explain why blacks find it harder to quit and are more likely to experience higher rates of lung cancer than white smokers.
