Which cut-off level of urine cotinine:creatinine ratio (CCR) should be used to determine passive smoking prevalence in children in community based studies?

Keskįnoğlu, Pembe; Çımrın, Dilek; Aksakoğlu, Gazanfer

doi:10.1136/tc.2007.021998

Cited by 8 publications

(5 citation statements)

References 10 publications

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“…Cotinine also used as biomarker to verify secondhand smoke. The cut-off point for secondhand smoke exposure is roughly 2.0ng/ml cotinine in saliva, with a 30ng/ml of cotinine:creatinine ratio (Keskinoglu et al, 2007;Jarvis et al, 2012). The Centers for Disease Control and Prevention (CDC) in the U.S. uses a serum cotinine cut-off of 0.5ng/ml.…”

Section: Discussionmentioning

confidence: 99%

Biochemically-verified Smoking Rate Trends and Factors Associated with Inaccurate Self-reporting of Smoking Habits in Korean Women

Kang¹,

Kwon²,

Lee³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Background: Lung cancer is a major cause of Korean female mortality and is clearly associated with smoking. The Korean National Health and Nutrition Examination Survey (KNHANES IV-2,3), which included both self-reports of smoking and urinary cotinine data, revealed a significant discrepancy between the prevalence of self-reported and biochemically-verified female smokers. The factors associated with accurate self-reporting of current smoking status remain poorly understood, however. Materials and Methods: We assessed the prevalence of smoking in KNHANES using both self-report and urinary cotinine data. Subsequently, using univariate and multivariate tests, we assessed whether age, intensity of smoking, marital status, relationship with cohabitants, education, occupation, residential area, or annual household income were associated with inaccurate selfreporting in Korean females. We also investigated whether the prevalence of inaccurate self-reports changed over the survey period

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Section: Discussionmentioning

confidence: 99%

Biochemically-verified Smoking Rate Trends and Factors Associated with Inaccurate Self-reporting of Smoking Habits in Korean Women

Kang¹,

Kwon²,

Lee³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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“…Seventy-four (20%) patients had urinary cotinine levels ≥30 µg/g, a threshold established to represent TSE. [24][25][26][27]34 Based on parental reporting, 138 (38%) of the cohort had passive TSE (97.1%) or the patient actively smoked cigarettes (2.9%). Twentyfour (11%) patients who had no parental report of TSE had evidence of TSE based on creatinine corrected urine cotinine levels.…”

Section: Resultsmentioning

confidence: 99%

Tobacco smoke exposure, the lower airways microbiome and outcomes of ventilated children

et al. 2023

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Background Tobacco smoke exposure increases the risk and severity of lower respiratory tract infections in children, yet the mechanisms remain unclear. We hypothesized that tobacco smoke exposure would modify the lower airway microbiome. Methods Secondary analysis of a multicenter cohort of 362 children between ages 31 days and 18 years mechanically ventilated for >72 h. Tracheal aspirates from 298 patients, collected within 24 h of intubation, were evaluated via 16 S ribosomal RNA sequencing. Smoke exposure was determined by creatinine corrected urine cotinine levels ≥30 µg/g. Results Patients had a median age of 16 (IQR 568) months. The most common admission diagnosis was lower respiratory tract infection (53%). Seventy-four (20%) patients were smoke exposed and exhibited decreased richness and Shannon diversity. Smoke exposed children had higher relative abundances of Serratia spp., Moraxella spp ., Haemophilus spp., and Staphylococcus aureus . Differences were most notable in patients with bacterial and viral respiratory infections. There were no differences in development of acute respiratory distress syndrome, days of mechanical ventilation, ventilator free days at 28 days, length of stay, or mortality. Conclusion Among critically ill children requiring prolonged mechanical ventilation, tobacco smoke exposure is associated with decreased richness and Shannon diversity and change in microbial communities. Impact Tobacco smoke exposure is associated with changes in the lower airways microbiome but is not associated with clinical outcomes among critically ill pediatric patients requiring prolonged mechanical ventilation. This study is among the first to evaluate the impact of tobacco smoke exposure on the lower airway microbiome in children. This research helps elucidate the relationship between tobacco smoke exposure and the lower airway microbiome and may provide a possible mechanism by which tobacco smoke exposure increases the risk for poor outcomes in children.

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“…We used UCCs of 20 to 100 ng to clinically detect smokers. [12][13][14][15][16] To completely exclude cases with secondhand smoke exposure, the cotinine level was set at less than 100 ng/mL. 16 When compared with official indices, the results of the present study were 1% higher in terms of total current smoking, 1.6% higher for boys, and 0.3% lower for girls.…”

Section: Discussionmentioning

confidence: 99%

“…The UCC level of 20 ng/mL was once proposed in a Korean longitudinal observations study conducted on a specific target group. 13 The level of 30 ng/mL is also commonly applied, 14,15 and Henderson suggested using this level in children. The receiver-operating characteristic (ROC) curve indicated an optimal point at 27.0 ng/mL, similar to that employed in previous studies.…”

Section: Measurement Of Smoking Prevalencementioning

confidence: 99%

The Correlation of Different Cotinine Levels With Questionnaire Results

Park

Nam

Lee

et al. 2015

Asia Pac J Public Health

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This study compares the results of the Korea National Health and Nutrition Examination Survey (Self-Reported; KNHANEs [SR]) survey with urine-cotinine concentration (UCC) and the official index issued by the Korea Youth Risk Behavior Web-based Survey (KYRBS). We established standard cutoffs of 20 ng/mL, 30 ng/mL, 50 ng/mL, and 100 ng/mL to compare the results of UCC testing with those of self-reporting methods. The KYRBS demonstrated an overall current smoking rate of 12.25%, while the KNHANEs measured an overall rate of 9.63%. The UCC20 reported the highest current smoking rate at 25.6% overall. Methods that detected a lower prevalence of current smoking, in declining order, were the UCC30, UCC50, UCC100, online survey, and the KNHANEs (SR). The results of this study show that online surveys on smoking administered to adolescents have fewer false responses compared with the KNHANEs (SR). However, compared with UCC testing, online surveys still significantly underreport adolescent smoking rates.

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Which cut-off level of urine cotinine:creatinine ratio (CCR) should be used to determine passive smoking prevalence in children in community based studies?

Cited by 8 publications

References 10 publications

Biochemically-verified Smoking Rate Trends and Factors Associated with Inaccurate Self-reporting of Smoking Habits in Korean Women

Biochemically-verified Smoking Rate Trends and Factors Associated with Inaccurate Self-reporting of Smoking Habits in Korean Women

Tobacco smoke exposure, the lower airways microbiome and outcomes of ventilated children

The Correlation of Different Cotinine Levels With Questionnaire Results

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