Cut‐off levels for breath carbon monoxide as a marker for cigarette smoking

Abstract

BCO cut-off levels well below 8 p.p.m and as low as 2-3 p.p.m. may be more useful when it is important to maximize identification of smoking abstinence with a high degree of certainty.

Optimal Carbon Monoxide Criteria to Confirm 24-hr Smoking Abstinence

“…Sessions were scheduled between noon and 4:00 p.m. at the same time of the day for each participant. Daily expired-air CO was assessed at each session via Breathco CO monitor (Lenexa, KS) following a 20-s breath hold prior to slowly expiring air into the monitor mouthpiece (Javors et al, 2005;Raiff, Faix, Turturici, & Dallery, 2010). Subjects were not informed of their CO readings (in ppm), which were recorded away from the participants' view.…”

“…Rather, they were told they would be reinforced for "being quit." For this analysis, this manipulation enabled us to assess whether the presence or absence of reinforcement for quitting influenced the association of CO with abstinence (see Javors et al, 2005). These studies were approved by the University of Pittsburgh Institutional Review Board, and all participants provided written informed consent for participation after the nature and the consequences of the relevant study were explained.…”

“…For example, Javors, Hatch, and Lamb (2005) found that, compared with the typical criterion of ≤8 ppm, a CO cutoff for abstinence of <3 ppm increased sensitivity for accurately identifying smoking (i.e., the percentage of smoking days with CO at or above 3 ppm) from about 40% to 70%. Thus, at least half of those with a CO ≤ 8 ppm would have been incorrectly identified as abstinent, despite smoking in the prior 24 hr.…”

Voucher‐based Contingent Reinforcement of Smoking Abstinence Among Methadone‐maintained Patients: A Pilot Study

“…Although thrice-weekly monitoring may be intense relative to many smoking-cessation interventions used with other populations, MM patients often report to the methadone clinic almost daily, which provides an opportunity to monitor them more frequently. Second, the CO cutoff of 8 ppm used in prior studies may permit intermittent or low levels of smoking to go undetected (Javors, Hatch, & Lamb, 2005). Given the importance of early, sustained abstinence to longer term outcomes, these procedural matters can be important in determining the longer term success of the interven-tion.…”

Advantages of breath testing for the early diagnosis of lung cancer

“…Breath analysis is a relatively new area of research and much more needs to be done. Nevertheless, this research is establishing breath analysis as a worthy technique for physiological studies and as a valuable addition to the armamentarium of the clinician for disease diagnosis and for monitoring therapy [1][2][3][4][5][6][7].…”