Detecting smoking following smoking cessation treatment

Our study compared the results of self-report (SR) plus breath carbon monoxide (CO) monitoring to SR plus urine cotinine (COT) analysis of recent tobacco use for a recently completed smoking cessation study that compared the efficacy of different intensities of psychosocial treatments coupled with 8 weeks of patch treatment. Treatment outcomes were assessed 9, 26, and 52 weeks from treatment initiation in 200+ patients using both measurement types. COT was able to detect self-reported smoking in over 97% of the cases at all time points, while CO detected self-reported smoking 62, 84, and 89% of the time for the three follow-up assessments. Under 2% of those reporting nonsmoking were found to be smoking via CO, whereas COT found smoking to have occurred for 23, 15, and 7% of the 'nonsmoking' SRs at the three time points. Abstinence rates using SR plus CO were 49, 29, and 26%, contrasted with abstinence rates of 38, 26, and 25% for SR plus COT. These findings suggest that use of urine analysis for COT may lead to more accurate but lowered measured abstinence rates.