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Comparison of tests used to distinguish smokers from nonsmokers
Abstract
Questionnaire and biochemical measures of smoking were studied in 211 hospital outpatients. Eleven different tests of smoke intake were compared for their ability to categorize smokers and nonsmokers correctly. The concentration of cotinine, whether measured in plasma, saliva, or urine, was the best indicator of smoking, with sensitivity of 96-97 per cent and specificity of 99-100 per cent. Thiocyanate provided the poorest discrimination. Carbon monoxide measured as blood carboxyhaemoglobin or in expired air gave sensitivity and specificity of about 90 per cent. Sensitivities of the tests were little affected by the presence among the claimed nonsmokers of a group of 21 "deceivers" who concealed their smoking. It is concluded that cotinine is the measure of choice, but for most clinical applications carbon monoxide provides an acceptable degree of discrimination and is considerably cheaper and simpler to apply.
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“Cotinine is a reliable biomarker for nicotine levels (sensitivity of 96–97%, specificity of 99–100%)19”
From Maternal Smoking during Pregnancy and Newborn Neurobehavior: Effects at 10 to 27 Days (2009) · cites this paper as [19]
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“biomarkers that the optimal cutpoints are little affected by the prevalence of smoking in the population sampled.(23) This is also the cutoff value recommended by Bevital AS, the laboratory where the serum analyses were performed.”
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BackgroundCigarette Smoking in Opioid‐Using Patients Presenting for Hospital‐Based Medical Services
Haas, A. L., Sorensen, J. L., Hall, S. M., Lin, C. Y., Delucchi, K., Sporer, K. A., & Chen, T. (2008) · American Journal on Addictions · doi:10.1080/10550490701756112 · Cited by 27
“Participants who selfreported no smoking in the past 7 days and produced expired CO readings of 10ppm or less were coded as abstinent.(17) Participants were also asked type of cigarette they typically smoked, including preferred brands and use of filtered or mentholated cigarettes.”
BackgroundCheang, I., Zhu, X., Lu, X., Yue, X., Tang, Y., Gao, R., Liao, S., Yao, W., Zhou, Y., Zhang, H., et al. (2022) · Journal of Inflammation Research · doi:10.2147/jir.s384977 · Cited by 26
“Individuals with cotinine levels >14 ng/mL were classified as smokers.(16) Individuals who consumed ≥12 alcoholic drinks in a single calendar year were considered alcohol users.”
BackgroundQuaak, M., van Schayck, O. C. P., Postma, D. S., Wagena, E. J., & van Schooten, F. (2011) · Addiction · doi:10.1111/j.1360-0443.2011.03534.x · Cited by 26
“Prolonged abstinence was defined as a participant’s report of zero cigarettes per day (not even a puff), confirmed by urinary cotinine values of 60 ng/ml or less [15] at weeks 4, 12, 26 and 52.”
BackgroundEngelmann, J. M., Gewirtz, J. C., & Cuthbert, B. N. (2011) · Psychophysiology · doi:10.1111/j.1469-8986.2011.01235.x · Cited by 27
Secondhand Smoke Exposure and Inflammatory Markers in Nonsmokers in the Trucking Industry
Chiu, Y.-H. M., Spiegelman, D. L., Dockery, D. W., Garshick, E., Hammond, S. K., Smith, T. J., Hart, J. E., & Laden, F. (2011) · Environmental Health Perspectives · doi:10.1289/ehp.1003199 · Cited by 26
Mbah, A. K., Salihu, H. M., Dagne, G. A., Wilson, R. E., & Bruder, K. (2013) · Archives of Women s Mental Health · doi:10.1007/s00737-013-0347-x · Cited by 26
“Cotinine, a major metabolite of nicotine, has a half-life of 10–40 h and has been shown to be more sensitive and specific than carbon monoxide monitoring for measuring smoking status (Benowitz 1999; Pojer et al. 1984; Jarvis et al. 1987).”
BackgroundThe Role of Smoking and Gingival Crevicular Fluid Markers on Coronally Advanced Flap Outcomes
Kaval, B., Renaud, D. E., Scott, D. A., & Buduneli, N. (2013) · Journal of Periodontology · doi:10.1902/jop.2013.120685 · Cited by 26
Effectiveness of a Health Professional Training Program for Treatment of Tobacco Addiction
Olano-Espinosa, E., Pardo, B. M., Minué-Lorenzo, C., Anton, E., Gómez‐Gascón, T., & Ayesta, F. J. A. (2013) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntt040 · Cited by 26
Wong, S. L., Malaison, E., Hammond, D. G., & Leatherdale, S. T. (2012) · Nicotine & Tobacco Research · doi:10.1093/ntr/nts195 · Cited by 26
Tyrpień-Golder, K., Wielkoszyński, T., Janoszka, B., Dobosz, C., Bodzek, D., & Steplewski, Z. (2000) · Journal of Chromatography A · doi:10.1016/s0021-9673(99)01239-x · Cited by 26
Smoking Cessation Intervention Using Stepwise Exercise Incentives for Male Workers in the Workplace
Hwang, G.-S., Jung, H., Yi, Y., Yoon, C., & Choi, J.-W. (2010) · Asia Pacific Journal of Public Health · doi:10.1177/1010539510370991 · Cited by 26
Measurement of cotinine in urine by liquid chromatography tandem mass spectrometry
Chadwick, C., & Keevil, B. G. (2007) · Annals of Clinical Biochemistry International Journal of Laboratory Medicine · doi:10.1258/000456307781645996 · Cited by 26
Urinary cotinine levels of smokeless tobacco (MaraE powder) users1
Çok, İ., & Öztürk, R. (2000) · Human & Experimental Toxicology · doi:10.1191/096032700670928812 · Cited by 26
Nicotine and metabolites: analysis and levels in body fluids
Curvall, M., & Vala, E. K. (1993) · Springer eBooks · doi:10.1007/978-94-011-2110-1_8 · Cited by 26
Paper spray mass spectrometry for high-throughput quantification of nicotine and cotinine
Keating, J. E., Minges, J. T., Randell, S. H., & Glish, G. L. (2017) · Analytical Methods · doi:10.1039/c7ay02204b · Cited by 25
Assessing tobacco use in an African population: Serum and urine cotinine cut-offs from South Africa
Ware, L. J., Charlton, K. E., Kruger, R., Breet, Y., Rooyen, J. V., Huisman, H. W., Roux, S. B., Uys, L., Rennie, K. L., Naidoo, N., et al. (2018) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2018.11.022 · Cited by 25
“The authors of the SANHANES report discuss how the cotinine cut-off may change with prevalence of tobacco use and for different groups, stating that 10 ng/ml was chosen as it was between the previously suggested cut-offs of 14 ng/ml (Jarvis et al., 1987)and 3 ng/ml (Benowitz et al.”
BackgroundMethodHow accurate is in-patient smoking status data collected by hospital admissions staff?
Schofield, P. E., & Hill, D. J. (1999) · Australian and New Zealand Journal of Public Health · doi:10.1111/j.1467-842x.1999.tb01555.x · Cited by 25
The influence of smoking on success of tympanoplasty measured by serum cotinine analysis
Uğuz, M. Z., Önal, K., Kazıkdaş, K. Ç., & Önal, A. (2007) · European Archives of Oto-Rhino-Laryngology · doi:10.1007/s00405-007-0485-8 · Cited by 25
“Compared with other metabolites, it is more speciWc, and compared with nicotine, it is present in body Xuids much longer [4, 5].”
BackgroundVeracity of Smokers' Response Regarding Abstinence at Smoking Cessation Clinics
Barrueco, M., Ruiz, C. J., Palomo, L., Torrecilla, M., Romero, P., & Riesco, J. A. (2005) · Archivos de Bronconeumología · doi:10.1016/s1579-2129(06)60414-x · Cited by 25
Nakamura, M., Masui, S., Oshima, A., Okayama, A., & Ueshima, H. (2004) · Environmental Health and Preventive Medicine · doi:10.1007/bf02898094 · Cited by 25
Sustained-release bupropion for hospital-based smoking cessation: A randomized trial
Simon, J. A., Duncan, C. L., Huggins, J., Solkowitz, S. N., & Carmody, T. P. (2009) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntp047 · Cited by 25
Evaluating the validity of self-reported smoking in Mexican adolescents
Valladolid-López, M. D. C., Barrientos‐Gutiérrez, T., Reynales-Shigematsu, L. M., Thrasher, J. F., Peláez-Ballestas, I. D. P., Lazcano-Ponce, E. C., & Hernández‐Ávila, M. (2015) · BMJ Open · doi:10.1136/bmjopen-2014-007485 · Cited by 25
Metadata
- Authors
- Jarvis, M. J., Tunstall-Pedoe, H., Feyerabend, C., Vesey, C., & Saloojee, Y.
- Venue
- American Journal of Public Health
- Publisher
- American Public Health Association
- Published
- 1987-11
- Volume
- 77
- Issue
- 11
- Pages
- 1435-1438
- ISSN
- 0090-0036 (ISSN-L)
- 1541-0048
- OpenAlex
- W2147528426
- Cited by
- 994
- References
- 21
- Citations by year
- 2026: 9 · 2025: 12 · 2024: 14 · 2023: 14 · 2022: 27 · 2021: 22 · 2020: 25 · 2019: 29 · 2018: 37 · 2017: 35 · 2016: 32 · 2015: 37 · 2014: 34 · 2013: 44 · 2012: 40
- FWCI
- 11.10
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Public Health (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Smoking Behavior and Cessation
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
- Keywords
- smoking detection, cotinine, carbon monoxide, carboxyhemoglobin, thiocyanate, salivary biomarkers, urinary biomarkers, plasma biomarkers, questionnaire-based screening, sensitivity and specificity
- MeSH terms
- Carbon Monoxide, Chromatography, Gas, Cotinine, Evaluation Studies as Topic, Female, Humans, Male, Middle Aged, Nicotine, Pyrrolidinones, Surveys and Questionnaires, Saliva, Smoking, Thiocyanates
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