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Cited by 348Smoking Behavior and CessationPrenatal Substance Exposure EffectsCarcinogens and Genotoxicity Assessment

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

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Florescu, Ana, Ferrence, Roberta, Einarson, Tom, Selby, Peter, Soldin, Offie, Koren, Gideon·2009·Therapeutic Drug Monitoring
DOI 10.1097/ftd.0b013e3181957a3bPMC PMC3644554
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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.

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  • Serum cotinine is directly proportional to the extent of tobacco smoke exposure.

    “Serum cotinine, a primary metabolite of nicotine, is directly proportional to the extent of tobacco smoke exposure and can serve as a reliable indicator of smoking intensity and tobacco smoke exposure18,19.”

    From Association between serum cotinine and total testosterone in adult males based on NHANES 2011–2016 (2024) · cites this paper as [18]

    The Biomarkers section (page not provided) says blood cotinine approximates absorbed nicotine dose and that cotinine levels reflect tobacco-smoke exposure. It also describes variation in the relationship between cotinine levels and nicotine intake, so it does not establish that serum cotinine is directly proportional to the extent of exposure. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Serum cotinine can serve as a reliable indicator of smoking intensity and tobacco smoke exposure.

    “Serum cotinine, a primary metabolite of nicotine, is directly proportional to the extent of tobacco smoke exposure and can serve as a reliable indicator of smoking intensity and tobacco smoke exposure18,19.”

    From Association between serum cotinine and total testosterone in adult males based on NHANES 2011–2016 (2024) · cites this paper as [18]

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Authors
Florescu, A., Ferrence, R., Einarson, T., Selby, P., Soldin, O., & Koren, G.
Affiliations
  • Centre for Addiction and Mental Health (CA)
  • Hospital for Sick Children (CA)
  • Georgetown University Medical Center (US)
  • University of Toronto (CA)
Corresponding author
  • Florescu, Ana
  • Ferrence, Roberta
  • Selby, Peter
ORCID
Venue
Therapeutic Drug Monitoring
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2009-02
Volume
31
Issue
1
Pages
14-30
ISSN
0163-4356 (ISSN-L)
DOI
10.1097/ftd.0b013e3181957a3b
PMC
PMC3644554
OpenAlex
W2036179026
Cited by
348
References
3
Citations by year
2026: 8 · 2025: 18 · 2024: 15 · 2023: 18 · 2022: 19 · 2021: 25 · 2020: 23 · 2019: 25 · 2018: 29 · 2017: 23 · 2016: 31 · 2015: 25 · 2014: 20 · 2013: 22 · 2012: 16
FWCI
1.70
Type
journal article
Language
en
Open access
Locations
  • Therapeutic Drug Monitoring (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Center for Research Resources (M01RR020359)
Topics
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Carcinogens and Genotoxicity Assessment
Keywords
cigarette smoking, environmental tobacco smoke, passive smoking, cotinine, hair analysis, exposure measurement, developmental toxicology, pregnant women, children's exposure, self-report bias, nicotine metabolism, sensitivity and specificity
MeSH terms
Adult, Body Fluids, Child, Child Development, Developmental Disabilities, Child, Preschool, Cotinine, Female, Hair, Humans, Infant, Infant, Newborn, Nicotine, Pregnancy, Reproduction, Smoking, Tobacco Smoke Pollution, Biomarkers, Nicotinic Agonists, Young Adult

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