Uses and abuses of cotinine as a marker of tobacco smoke exposure

P, Lee

doi:10.1016/b978-044450095-3/50017-6

Cited by 23 publications

(5 citation statements)

References 167 publications

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“…While there is abundant evidence that asking whether the spouse smokes is associated with clearly elevated cotinine levels (e.g. Lee, 1999 ), such objective validation of exposure is not available for more complex measures.…”

Section: Discussionmentioning

confidence: 99%

Environmental tobacco smoke exposure and risk of breast cancer in nonsmoking women. An updated review and meta-analysis

Hamling

2016

Inhalation Toxicology

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Context: In 2006, we reviewed the evidence on environmental tobacco smoke (ETS) and breast cancer in nonsmoking women. Since then various studies and reviews have been published but opinion remains divided. Objective: To provide an updated review. Methods: We extracted study details, derived relative risk (RR) estimates with confidence intervals (CIs) for various ETS exposure indices, and conducted meta-analyses. Results: The update increased the number of studies from 22 to 47. Using an index for each study most closely equivalent to “spouse ever smoked”, a weak but significant association was seen (random-effects RR = 1.15, 95% CI = 1.07–1.23). However, the estimates were heterogeneous: higher for Asian studies than for North American or European studies, higher for studies adjusting for fewer potential confounding variables, and close to 1.0 for prospective studies, regardless of whether or not they asked detailed questions on ETS exposure. The RR for eight prospective studies asking detailed questions was 1.003, 95% CI = 0.96–1.05. Risk was increased in premenopausal women (RR = 1.36, 95% CI = 1.15–1.60), but not postmenopausal women. Dose–response findings were similarly heterogeneous. No significant increase was seen for childhood or workplace exposure, but an increase was seen for total exposure (RR = 1.22, 95% CI = 1.09–1.37). Conclusions: Increases mainly derived from case-control studies are prone to recall bias. Study weaknesses and possible publication bias limit interpretation. Considering also the weak association of smoking with breast cancer, and the much lower exposures from ETS than from smoking, our analyses do not clearly demonstrate that ETS exposure increases risk of breast cancer in nonsmokers. More research is needed.

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Section: Discussionmentioning

confidence: 99%

Environmental tobacco smoke exposure and risk of breast cancer in nonsmoking women. An updated review and meta-analysis

Hamling

2016

Inhalation Toxicology

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“…The distinction between heavily exposed passive smokers and light active smokers is important and has given rise to some uncertainty in previous studies (Lee, 1999). The study reported here involved individuals smoking, on average, 10–30 cigarettes per day, so further data from light active smokers (less than 10 cigarettes per day) would be needed.…”

Section: Discussionmentioning

confidence: 99%

“…This is a potentially important observation because it indicates that total NNAL may be a better biomarker of passive smoking than cotinine. Furthermore, the ratio possibly could be used to correctly classify light active smokers versus heavily exposed passive smokers (Lee, 1999). The Benowitz et al study, based on 373 active smokers and 228 passive smokers, had some limitations.…”

Section: Introductionmentioning

confidence: 99%

The ratio of a urinary tobacco-specific lung carcinogen metabolite to cotinine is significantly higher in passive than in active smokers

Carmella¹,

Stepanov²,

Hatsukami³

et al. 2011

Biomarkers

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4-(Methylnitrosamino)-1-(3-pyridyl)-1-butanol plus its glucuronides (total NNAL), metabolites of the lung carcinogen NNK, and total cotinine, metabolites of nicotine, are biomarkers of active and passive cigarette smoking. We calculated the total NNAL: total cotinine (× 103) ratio in 408 passive (infants, children, adults) and 1088 active smokers. The weighted averages were 0.73 (95% CI 0.71, 0.76) for passive smokers and 0.07 (0.06, 0.08) for active smokers (p<0.0001). These results demonstrate that cotinine measurements may underestimate exposure of passive smokers to the lung carcinogen NNK in secondhand cigarette smoke. The total NNAL:total cotinine (× 103) ratio may provide an improved biomarker for evaluating the health effects of passive smoking.

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“…Anti-tobacco legislation, such as clean air statutes that make indoor public places and worksites completely smoke-free are now law in 21 states of the U.S. and the District of Columbia . These positive developments, which are still in progress, would have been unimaginable in the 1980s when the first studies demonstrating the presence of cotinine in the serum and urine of nonsmokers exposed to SHS were published − . According to the National Health and Nutrition Examination Survey (NHANES) study, the percentage of nonsmokers aged >4 years in the U.S. with detectable serum cotinine declined from 83.9% in 1988 to 46.4% in 1999−2004 , .…”

Section: Application Of Biomarkers In Cancer Preventionmentioning

confidence: 99%

Applying Tobacco Carcinogen and Toxicant Biomarkers in Product Regulation and Cancer Prevention

Hecht

Yuan

Hatsukami

2010

Chem. Res. Toxicol.

115

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Tobacco carcinogen and toxicant biomarkers are metabolites or protein or DNA adducts of specific compounds in tobacco products. Highly reliable analytical methods, based mainly on mass spectrometry, have been developed and applied in large studies of many of these biomarkers. A panel of tobacco carcinogen and toxicant biomarkers is suggested here, and typical values for smokers and non-smokers are summarized. This panel of biomarkers has potential applications in the new and challenging area of tobacco product regulation and in development of rational approaches to cancer prevention by establishing carcinogen and toxicant uptake and excretion in people exposed to tobacco products.

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Uses and abuses of cotinine as a marker of tobacco smoke exposure

Cited by 23 publications

References 167 publications

Environmental tobacco smoke exposure and risk of breast cancer in nonsmoking women. An updated review and meta-analysis

Environmental tobacco smoke exposure and risk of breast cancer in nonsmoking women. An updated review and meta-analysis

The ratio of a urinary tobacco-specific lung carcinogen metabolite to cotinine is significantly higher in passive than in active smokers

Applying Tobacco Carcinogen and Toxicant Biomarkers in Product Regulation and Cancer Prevention

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