Racial and Ethnic Differences in Serum Cotinine Levels of Cigarette Smokers

Abstract

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 (PϽ.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.

Can Urinary Cotinine Predict Nicotine Dependence Level in Smokers?

“…In the correlation analysis, urinary cotinine levels were associated with both the number of cigarettes smoked per day and the FTND scores, which was consistent with previous studies (Heatherton et al, 1991;Payne et al, 1994;Law et al, 1997;Caraballo et al, 1998;Park et al, 2004;Blackford et al, 2006). In contrast to previous reports that showed that the duration of smoking was not associated with the FTND scores (John et al, 2003;Park et al, 2004), the degree of nicotine dependence increased according to the total smoking period in our study.…”

“…All information pertaining to smoking status was acquired by self-administered smoking questionnaires; therefore, the potential recall bias should be considered. Finally, because serum cotinine levels in cigarette smokers have been shown to be dependent on race and ethnicity (Caraballo et al, 1998), the application of the cut-off value for the urinary cotinine level in this study should be restricted to Asians. Accordingly, determination of an optimal cut-off value to detect high nicotine dependence for other races should only follow sufficient consideration of results from additional inter-racial comparative studies.…”

Stuttering, alcohol consumption and smoking

“…They found that heavy drinkers were likely to under-report, but the binary alcohol consumption variables used in the present study revealed equal proportions of heavy drinkers among those who did and did not stutter, so there should be no discrepancy between the two groups on this basis. Caraballo, Giovino, Pechacek & Mowery (2001) concluded that self-reported smoking among adults is generally accurate, and even though younger smokers were more likely to under-report smoking, participants in both groups in the present study were matched for age; of the other factors that were associated with under-reporting, none were relevant to the comparison in the present study.…”

Gene-Centric Analysis of Serum Cotinine Levels in African and European American Populations

“…After controlling for number and yield of cigarettes, Wagenknecht et al (1990) observed that African American smokers have significantly higher serum cotinine levels in comparison with European American smokersFa finding that has since been independently replicated (Caraballo et al, 1998). To date, there are no published reports of serum cotinine genetic association analyses evaluating and comparing the genome in these two racial groups.…”