Differentiating Between Smokers and Nonsmokers Using Serum Cotinine

Abstract

Aim: Our goal is to evaluate implications of cotinine cut points in subgroups of smokers and nonsmokers. Materials & methods: Data were assessed from 13,357 adult participants and collected over a period of 6 years by the National Health and Nutrition Examination Survey (2009–2014). Receiver operating characteristic curve analysis was used to identify optimal cut points. Rao–Scott χ2 tests measured associations between group characteristics. Results: The optimal serum cotinine cut point adult cigarette smokers was 3.63 ng/ml (sensitivity of 96.7%; specificity of 93.0%). This cut point differed by gender as well as race/ethnicity. Conclusion: There are notable differences in subgroup cut points compared with previous research. Use of gender or race/ethnicity specific cut points is more appropriate when feasible and may help clinician recommendations.

Anabasine and Anatabine Exposure Attributable to Cigarette Smoking: National Health and Nutrition Examination Survey (NHANES) 2013–2014

“…Demographic characteristics are associated with differences in urinary anabasine and anatabine distributions; these differences need to be considered when refining and applying cut points, as has been done for serum cotinine [ 3 , 20 , 21 ]. Among race/Hispanic origin, we find significant differences primarily between non-Hispanic Blacks and other subgroups for urinary anatabine.…”

“…In tobacco-use biomonitoring, anabasine and anatabine are measured in the urine of people who smoke (PWS) to monitor for recent tobacco use [ 2 ]. Unlike nicotine, they have longer half-lives (~16 and ~12 h, respectively) [ 3 ]. Urinary anabasine and anatabine uniquely differentiate the use of nicotine-replacement therapy (NRT) from recent tobacco-product use [ 2 , 3 ].…”

“…Unlike nicotine, they have longer half-lives (~16 and ~12 h, respectively) [ 3 ]. Urinary anabasine and anatabine uniquely differentiate the use of nicotine-replacement therapy (NRT) from recent tobacco-product use [ 2 , 3 ]. Urinary anabasine and anatabine are also useful in identifying exposure to products containing nicotine from different sources (tobacco-derived vs. synthetic) because tobacco extracts tend to also contain anabasine and anatabine, while synthetic sources do not [ 4 , 5 ].…”

Increased serum cotinine and obesity negatively impact asthma exacerbations and hospitalizations: A cross-sectional analysis of NHANES

“…Serum cotinine levels were denoted as a categorical variable based on published cotinine cut points with higher than 95% sensitivity and 90% specificity based on race/ethnicity and sex. 14 The cut points varied based on sex, race, and ethnicity. The following cotinine cut points were used: White male (3.26ng/mL), Black male (7.18ng/mL), Hispanic male (0.91ng/mL), White female (5.13ng/mL), Black female (14.9ng/mL), and Hispanic female (0.77ng/mL).…”

Attention deficit hyperactivity disorder medications and bone mineral density of adults in the United States

“…Non-Hispanic White participants were classified as smokers if their serum cotinine concentration met or exceeded 4.1 ng/mL. Cut points for non-Hispanic Blacks, Hispanics, and other races including multiracial participants, were 12.55 ng/mL, 0.92 ng/mL, and 3.63 ng/mL, respectively ( Tompkins et al, 2019 ). Participants below these cut points but with quantifiable serum cotinine (≥0.05 ng/mL) were classified as having had ETS exposure ( Kaufmann et al, 2010 ).…”