Methods for Quantification of Exposure to Cigarette Smoking and Environmental Tobacco Smoke: Focus on Developmental Toxicology

Abstract

Active and passive smoking have been associated with an array of adverse effects on health. The development of valid and accurate scales of measurement for exposures associated with health risks constitutes an active area of research. Tobacco smoke exposure still lacks an ideal method of measurement. A valid estimation of the risks associated with tobacco exposure depends on accurate measurement. However, some groups of people are more reluctant than others to disclose their smoking status and exposure to tobacco. This is particularly true for pregnant women and parents of young children, whose smoking is often regarded as socially unacceptable. For others, recall of tobacco exposure may also prove difficult. Because relying on self-report and the various biases it introduces may lead to inaccurate measures of nicotine exposure, more objective solutions have been suggested. Biomarkers constitute the most commonly used objective method of ascertaining nicotine exposure. Of those available, cotinine has gained supremacy as the biomarker of choice. Traditionally, cotinine has been measured in blood, saliva, and urine. Cotinine collection and analysis from these sources has posed some difficulties, which have motivated the search for a more consistent and reliable source of this biomarker. Hair analysis is a novel, noninvasive technique used to detect the presence of drugs and metabolites in the hair shaft. Because cotinine accumulates in hair during hair growth, it is a unique measure of long-term, cumulative exposure to tobacco smoke. Although hair analysis of cotinine holds great promise, a detailed evaluation of its potential as a biomarker of nicotine exposure, is needed. No studies have been published that address this issue. Because the levels of cotinine in the body are dependent on nicotine metabolism, which in turn is affected by factors such as age and pregnancy, the characterization of hair cotinine should be population specific. This review aims at defining the sensitivity, specificity, and clinical utilization of different methods used to estimate exposure to cigarette smoking and environmental tobacco smoke.

Increased oxidative stress in preschool children exposed to passive smoking

“…Um indicador de exposição à fumaça de cigarro deve ser mensurável e representar a magnitude, a duração e a frequência da exposição 20 . A cotinina urinária é um bom indicador, pois varia de acordo com a potência da fonte de exposição, pode ser determinada de forma simples e acurada por um custo acessível, e é detectável em amostras de urina em baixas concentrações 13 .…”

“…A exposição ao fumo passivo é muito comum e tem sido implicada como um fator de risco significativo para a saúde e como um hábito que traz consequências adversas para o estabelecimento e a progressão de várias doenças. As crianças são especialmente vulneráveis ao risco de tal exposição para a saúde, incluindo-se infecções respiratórias superiores e inferiores, infecções agudas e crônicas de ouvido, exacerbação da asma, alterações no neurodesenvolvimento, problemas comportamentais e diminuição no rendimento escolar 20,21 . Embora os mecanismos subjacentes envolvidos nas patologias associadas ao tabagismo ativo ou passivo sejam indiscutivelmente ainda um assunto a ser debatido, supõe-se que os danos oxidativos induzidos pelos radicais livres exerçam um papel fundamental na patogênese de numerosas doenças relacionadas ao tabagismo 6,22,23 .…”

Smoking Cessation Care for People with a Mental Illness: Family Carer Expectations of Health and Community Services

“…Third, the study used carer reported smoking status of the person they care for as a measure of smoking status. The accuracy of such a measure is unknown; however, proxy measures of smoking behaviour generally have been found to be accurate (Amos, Hastings, Angus, Bostock, & Fidler, 2009;Florescu et al, 2009). Fourth, the current study employed a 'general' focus of the items regarding expectations of smoking cessation care provision, regardless of service usage by the person being cared for; future research could explore potential differences between expectations focussing on service usage of the person with a mental illness.…”

Self‐Reported Smoking, Urine Cotinine, and Risk of Cardiovascular Disease: Findings From the PREVEND (Prevention of Renal and Vascular End‐Stage Disease) Prospective Cohort Study

“…Cotinine is the major metabolite of nicotine and has a long biological half‐life of between 19 and 40 hours in the body compared with nicotine, which has a short half‐life of about 30 minutes to 2 hours 11. Cotinine is considered a highly sensitive and specific biomarker of cigarette smoking and is considered to be the gold standard measure of smoking exposure 11, 12. Cotinine concentrations can be accurately determined in serum or urine 13…”