Cyanide concentrations in blood after cigarette smoking, as determined by a sensitive fluorimetric method

Using the sensitive fluorimetric method described here, we evaluated the determination of blood cyanide as a method for monitoring exposure to tobacco smoke. The mean concentration of cyanide in blood from eight nonsmokers was 0.098 (SD 0.036) mumol/L. The concentration of cyanide in blood of smokers who had refrained from smoking for at least 2 h before sampling peaked immediately after the subjects smoked a cigarette, then rapidly declined, with a half-life of about 4 min. Its rapid disappearance from blood makes cyanide an unsuitable marker of exposure to tobacco smoke. Because the ability of patients with hepatic dysfunction to detoxify cyanide has been presumed to be impaired, we monitored the concentrations of cyanide in the blood of four patients with severe hepatic insufficiency who smoked a cigarette. The rate of elimination of cyanide from blood after smoking was only slightly less in these patients than in the controls, and the difference was not statistically significant.