Breath carbon monoxide and semiquantitative saliva cotinine as biomarkers for smoking

Abstract

Objective As a biomarker of smoking, semiquantitative analysis of cotinine (NicAlert®) offers several advantages over breath carbon monoxide (CO) and quantitative analysis of cotinine. Recent studies have used urine NicAlert® and breath CO in combination to verify abstinence. However, no studies have evaluated the performance of saliva NicAlert® against or in combination with breath CO. Method Breath CO, saliva NicAlert®, and smoking history were compared in an urban population of daily smokers (n = 24) and nonsmokers (n = 25). Results Saliva NicAlert® predicted self-reported smoking with 100% sensitivity and 96% specificity. At a cutoff of > 5 ppm, breath CO had 100% sensitivity and 100% specificity in predicting self-reported smoking. Breath CO was positively correlated with saliva NicAlert® and negatively correlated with minutes since last cigarette. Conclusion Saliva NicAlert® had high sensitivity and specificity in identifying daily smokers. Compared to saliva NicAlert®, breath CO level was more indicative of recent smoking. Future treatment studies should evaluate the performance of saliva NicAlert® as an alternative to the urine test.

Individual differences in brain responses to cigarette-related cues and pleasant stimuli in young smokers

“…To control for possible effects of abstinence on LPP magnitude, carbon-monoxide (CO)-confirmed abstinence on the day of the psychophysiological recording session was also included in the model as a between-subjects factor. To be considered abstinent, a participant had to report not smoking over the past 24 h and produce a CO level < 6 parts per million [ppm] or half of his/her baseline level (whichever was lower) (Engelmann et al, 2011; Marrone et al, 2010). Per this criterion, 1 participant who was assigned to the abstinent condition was unable to remain abstinent for 24 h prior to the psychophysiological recording session, and was thus classified as non-abstinent in the analysis.…”

Smoking Cessation Outcomes and Predictors Among Individuals With Co-occurring Substance Use and/or Psychiatric Disorders

“…From participants' charts we obtained information pertaining to their demographics (gender, age), smoking history (number of cigarettes smoked per day, age at smoking initiation), length of success in previous cessation attempts (never, less than 1 week, 1 week to 1 month, 1 to 6 months, 7 months to 1 year, greater than 1 year), type (monotherapy or combination pharmacotherapy) and duration (in weeks) of pharmacotherapy received during treatment, nicotine dependence scores measured by the Fagerström Test for Nicotine Dependence (Heatherton, Kozlowski, Frecker, & Fagerström, 1991), importance of (scale of 0 to 10) and confidence in (scale of 0 to 10) quitting smoking (Burke, Ebbert, & Hays, 2008;Kahler et al, 2007), expired carbon monoxide levels (Javors, Hatch, & Lamb, 2005;Marrone, Paulpillai, Evans, Singleton, & Heishman, 2009), primary substance use disorder (none, alcohol, cocaine, opiates, marijuana, and methamphetamine and related drugs), and psychiatric disorder (none, mood, anxiety, or psychosis) history. Self-reported diagnosis of psychiatric disorder was validated by medication review.…”

Clinical Laboratory Evaluation of Electronic Cigarettes: Methodological Challenges

“…In humans, CO has a relatively short half-life of 2–3 hours 60 and is therefore often used to verify short-term combustible tobacco abstinence. 23,61–63 In contrast, ECIGs do not burn anything when operated as intended, so these products do not produce CO and do not deliver it to users (eg, 64 ).…”