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Differentiating between smokers and nonsmokers using serum cotinine.

Erin L Tompkins1, Thomas A Beltran2, Sheryl A Bedno3

  • 1Department of Internal Medicine, Womack Army Medical Center, Fort Bragg, NC 28310, USA.

Biomarkers in Medicine
|August 7, 2019
PubMed
Summary
This summary is machine-generated.

Optimal serum cotinine cut points for identifying adult cigarette smokers vary significantly by gender and race/ethnicity. Tailoring these cut points improves accuracy in smoking status assessment.

Keywords:
biomarkercigarettesgendernicotinesurveytobacco

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Area of Science:

  • Biochemistry
  • Public Health
  • Epidemiology

Background:

  • Biomarkers like serum cotinine are crucial for assessing tobacco smoke exposure.
  • Establishing accurate cotinine cut points is essential for classifying smoking status in epidemiological studies.
  • Previous research may not fully account for demographic variations in cotinine metabolism and excretion.

Purpose of the Study:

  • To evaluate the implications of cotinine cut points in various subgroups of smokers and nonsmokers.
  • To determine optimal serum cotinine thresholds for adult cigarette smokers using recent national data.
  • To investigate whether optimal cut points differ across demographic factors such as gender and race/ethnicity.

Main Methods:

  • Analysis of data from 13,357 adult participants from the National Health and Nutrition Examination Survey (2009-2014).
  • Utilized Receiver Operating Characteristic (ROC) curve analysis to identify optimal serum cotinine cut points.
  • Employed Rao-Scott chi-squared tests to assess associations between group characteristics and smoking status.

Main Results:

  • The optimal serum cotinine cut point for adult cigarette smokers was determined to be 3.63 ng/ml, achieving 96.7% sensitivity and 93.0% specificity.
  • Significant differences in optimal cotinine cut points were observed when stratifying by gender and race/ethnicity.
  • These findings indicate that a single universal cut point may not be appropriate for all demographic groups.

Conclusions:

  • Notable differences exist in subgroup-specific cotinine cut points compared to previously established thresholds.
  • The use of gender- or race/ethnicity-specific cotinine cut points is recommended for improved accuracy when feasible.
  • Tailored cut points can potentially enhance the precision of clinical recommendations and public health interventions related to smoking cessation.