Utility and Cutoff Value of Hair Nicotine as a Biomarker of Long-Term Tobacco Smoke Exposure, Compared to Salivary Cotinine
Abstract
:1. Introduction
2. Experimental Section
2.1. Population
2.2. Questionnaire
2.3. Measurement of Hair Nicotine
2.4. Measurement of Salivary Cotinine
2.5. Statistical Analysis
3. Results
3.1. Concentrations of Hair Nicotine and Salivary Cotinine
Demographic Characteristics | Non-Smokers (baseline n = 77) | Passive Smokers (baseline n = 105) | Active Smokers (baseline n = 107) | |
---|---|---|---|---|
Age, median years (IQR) | 36 (26–53) | 45 (34–52) | 40 (27–51) | |
Female, % | 60.5 | 72.1 | 64.1 | |
Race, % | ||||
Asian | 36.8 | 9.5 | 9.4 | |
African-American | 13.1 | 51.4 | 45.8 | |
White | 40.7 | 26.7 | 32.0 | |
Other | 9.4 | 12.4 | 12.8 | |
University or higher degree completed, % | 75 | 24 | 41 | |
Number of cigarettes per day, median (IQR) | - | - | 15 (10–20) | |
Hair treatment, % | 38.2 | 45.7 | 42.1 | |
Biomarker Concentrations | Non-Smokers | Passive Smokers | Active Smokers | |
Hair nicotine (ng/mg), median (IQR) (% < LOD) | Baseline | 0.23 (0.08–0.44) (82) | 0.36 (0.17–3.03) (52) | 16.2 (4.0–40.6) (2.8) |
Follow-up | - | 0.29 (0.20–3.30) (59) | 16.4 (3.3–27.3) (1.6) | |
Salivary cotinine (ng/mL), median (IQR) (% < LOD) | Baseline | 0.27 (0.04–0.61) (30) | 0.27 (0.04–0.80) (26) | 181.0 (76.3–290.2) (2.8) |
Follow-up | - | 0.41(0.035–1.08) (27) | 135.1 (62.2–228.6) (0) |
3.2. Associations of Biomarker Concentrations at Baseline and Follow-Up
3.3. Association between Hair Nicotine, Salivary Cotinine and the Number of Cigarettes Smoked Daily
Variable | Hair nicotine (Adjusted R2 = 0.28) | Salivary cotinine ( Adjusted R2 = 0.13) | ||||
---|---|---|---|---|---|---|
Conc. (ng/mg) | p-value | Ratio (95% CI) | Conc. (ng/mL) | p-value | Ratio (95 % CI) | |
Number of cigarette smoked per day | ||||||
Per 5 cigarette | 14.43 | 0.003 | 1.05 (1.02–1.09) | 59.6 | 0.02 | 1.03 (1.01–1.05) |
Age | ||||||
Per unit increase (age-median) | 13.88 | 0.24 | 1.01 (0.99–1.04) | 58.7 | 0.04 | 1.01 (1.00–1.03) |
Gender (Reference = Male) | ||||||
Female | 8.17 | 0.10 | 0.60 (0.32–1.12) | 92.5 | 0.01 | 1.60 (1.12–2.27) |
Race (Reference = White) | ||||||
Black | 56.19 | <0.0001 | 4.10 (2.28–7.38) | 47.8 | 0.25 | 0.83 (0.59–1.15) |
Education | ||||||
Per unit increase (low to high) | 11.59 | 0.31 | 0.85 (0.61–1.17) | 62.3 | 0.42 | 1.08 (0.90–1.29) |
Hair treatment (Reference = No) | ||||||
Yes | 8.45 | 0.11 | 0.62 (0.34–1.11) | Not applicable |
3.4. Comparison of Biomarker Levels for Nonsmokers and Passive Smokers
3.5. Cutoff Values of Hair Nicotine and Salivary Cotinine
4. Discussion
4.1. Correlation between Hair Nicotine and Salivary Cotinine Concentrations
4.2. Association of Hair Nicotine with the Number of Cigarette Smoked Daily
4.3. Hair Nicotine as a Biomarker of SHS Exposure
4.4. Cutoff Values
5. Conclusions
Supplementary Files
Supplementary File 1Acknowledgments
Author Contributions
Conflicts of Interest
References
- Gilligan, C.; Sanson-Fisher, R.; Eades, S. Assessing the accuracy of self-reported smoking status and impact of passive smoke exposure among pregnant Aboriginal and Torres Strait Islander women using cotinine biochemical validation. Drug Alcohol Rev. 2010, 29. [Google Scholar] [CrossRef]
- Benowitz, N.L.; Jacob, P., III. Metabolism of nicotine to cotinine studied by a dual stable isotope method. Pharmacol. Ther. 1994, 56. [Google Scholar] [CrossRef]
- Nafstad, P.; Botten, G.; Hagen, J.A. Comparison of three methods for estimating environmental tobacco smoke exposure among children aged between 12 and 36 months. Int. J. Epidemiol. 1995, 24. [Google Scholar] [CrossRef]
- Benowitz, N.L.; Jacob, P., III; Fong, I. Nicotine metabolic profile in man: Comparison of cigarette smoking and transdermal nicotine. J. Pharmacol. Exp. Ther. 1994, 268, 296–303. [Google Scholar]
- Benowitz, N.L. Biomarkers of environmental tobacco smoke exposure. Environ. Health Perspect. 1999, 107, 349–355. [Google Scholar] [CrossRef]
- Jarvis, M.; Tunstall-Pedoe, H.; Feyerabend, C. Biochemical markers of smoke absorption and self reported exposure to passive smoking. J. Epidemiol. Community Health 1984, 38, 335–339. [Google Scholar] [CrossRef]
- Repace, J.L.; Jinot, J.; Bayard, S. Air nicotine and saliva cotinine as indicators of workplace passive smoking exposure and risk. Risk Anal. 1998, 18, 71–83. [Google Scholar] [CrossRef]
- McCusker, K. Mechanisms of respiratory tissue injury from cigarette smoking. Amer. J. Med. 1992, 93, S18–S21. [Google Scholar] [CrossRef]
- Jacob, P., III; Yu, L.; Shulgin, A.T. Minor tobacco alkaloids as biomarkers for tobacco use: Comparison of users of cigarettes, smokeless tobacco, cigars, and pipes. Amer. J. Public Health 1999, 89, 731–736. [Google Scholar] [CrossRef]
- Uematsu, T. Utilization of hair analysis for therapeutic drug monitoring with a special reference to ofloxacin and to nicotine. Forensic Sci. Int. 1993, 63, 261–268. [Google Scholar] [CrossRef]
- Al Delaimy, W.K. Hair as a biomarker for exposure to tobacco smoke. Tob. Control 2002, 11, 176–182. [Google Scholar] [CrossRef]
- Al Delaimy, W.K.; Crane, J.; Woodward, A. Is the hair nicotine level a more accurate biomarker of environmental tobacco smoke exposure than urine cotinine? J. Epidemiol. Community Health 2002, 56, 66–71. [Google Scholar] [CrossRef]
- Kim, S.R.; Wipfli, H.; Navas-Acien, A. Determinants of hair nicotine concentrations in nonsmoking women and children: A multicountry study of secondhand smoke exposure in homes. Cancer Epidem. Biomarker. Prev. 2009, 18, 3407–3414. [Google Scholar] [CrossRef]
- Kim, S.R.; Wipfli, H.; Avila-Tang, E. Method validation for measurement of hair nicotine level in nonsmokers. Biomed. Chromatogr. 2009, 23, 273–279. [Google Scholar] [CrossRef]
- Feyerabend, C.; Russell, M.A. A rapid gas-liquid chromatographic method for the determination of cotinine and nicotine in biological fluids. J. Pharm. Pharmacol. 1990, 42, 450–452. [Google Scholar] [CrossRef]
- Gallardo, E.; Barroso, M.; Queiroz, J.A. Current technologies and considerations for drug bioanalysis in oral fluid. Bioanalysis 2009, 1, 637–667. [Google Scholar] [CrossRef]
- Kim, S.R.; Jung, A. Optimum cutoff value of urinary cotinine distinguishing South Korean adult smokers from nonsmokers using data from the KNHANES (2008–2010). Nicotine Tob. Res. 2013, 15, 1608–1616. [Google Scholar] [CrossRef]
- Benowitz, N.L. Cotinine as a biomarker of environmental tobacco smoke exposure. Epidemiologic Rev. 1996, 18, 188–204. [Google Scholar] [CrossRef]
- Al Delaimy, W.K.; Crane, J.; Woodward, A. Questionnaire and hair measurement of exposure to tobacco smoke. J. Expos. Anal. Environ. Epidem. 2000, 10, 378–384. [Google Scholar]
- Eliopoulos, C.; Klein, J.; Koren, G. Validation of self-reported smoking by analysis of hair for nicotine and cotinine. Ther. Drug Monit. 1996, 18, 532–536. [Google Scholar] [CrossRef]
- Klein, J.; Koren, G. Hair analysis—A biological marker for passive smoking in pregnancy and childhood. Hum. Exp. Toxicol. 1999, 18, 279–282. [Google Scholar] [CrossRef]
- Nafstad, P.; Jaakkola, J.J.; Hagen, J.A.; Zahlsen, K.; Magnus, P. Hair nicotine concentrations in mothers and children in relation to parental smoking. J. Expos. Anal. Environ. Epidem. 1997, 7, 235–239. [Google Scholar]
- Pichini, S.; Altieri, I.; Pellegrini, M. The analysis of nicotine in infants’ hair for measuring exposure to environmental tobacco smoke. Forensic Sci. Int. 1997, 84, 253–258. [Google Scholar] [CrossRef]
- Sorensen, M.; Bisgaard, H.; Stage, M. Biomarkers of exposure to environmental tobacco smoke in infants. Biomarkers 2007, 12, 38–46. [Google Scholar] [CrossRef]
- Ho, M.K.; Faseru, B.; Choi, W.S. Utility and relationships of biomarkers of smoking in African-American light smokers. Cancer Epidem. Biomarker. Prev. 2009, 18, 3426–3434. [Google Scholar] [CrossRef]
- Joseph, A.M.; Hecht, S.S.; Murphy, S.E. Relationships between cigarette consumption and biomarkers of tobacco toxin exposure. Cancer Epidem. Biomarker. Prev. 2005, 14, 2963–2968. [Google Scholar] [CrossRef]
- Strasser, A.A.; Benowitz, N.L.; Pinto, A.G. Nicotine metabolite ratio predicts smoking topography and carcinogen biomarker level. Cancer Epidem. Biomarker. Prev. 2011, 20, 234–238. [Google Scholar] [CrossRef]
- Collins, C.C.; Epstein, D.H.; Parzynski, C.S. Puffing behavior during the smoking of a single cigarette in tobacco-dependent adolescents. Nicotine Tob. Res. 2010, 12, 164–167. [Google Scholar] [CrossRef]
- Jarvis, M.J.; Tunstall-Pedoe, H.; Feyerabend, C. Comparison of tests used to distinguish smokers from nonsmokers. Amer. J. Public Health 1987, 77, 1435–1438. [Google Scholar] [CrossRef]
- Florescu, A.; Ferrence, R.; Einarson, T.R. Reference values for hair cotinine as a biomarker of active and passive smoking in women of reproductive age, pregnant women, children, and neonates: Systematic review and meta-analysis. Ther. Drug Monit. 2007, 29, 437–446. [Google Scholar] [CrossRef]
- Benowitz, N.L.; Bernert, J.T.; Caraballo, R.S. Optimal serum cotinine levels for distinguishing cigarette smokers and nonsmokers within different racial/ethnic groups in the United States between 1999 and 2004. Amer. J. Epidemiol. 2009, 169, 236–248. [Google Scholar]
- Flegal, K.M.; Brownie, C.; Haas, J.D. The effects of exposure misclassification on estimates of relative risk. Amer. J. Epidemiol. 1986, 123, 736–751. [Google Scholar]
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Kim, S.; Apelberg, B.J.; Avila-Tang, E.; Hepp, L.; Yun, D.; Samet, J.M.; Breysse, P.N. Utility and Cutoff Value of Hair Nicotine as a Biomarker of Long-Term Tobacco Smoke Exposure, Compared to Salivary Cotinine. Int. J. Environ. Res. Public Health 2014, 11, 8368-8382. https://doi.org/10.3390/ijerph110808368
Kim S, Apelberg BJ, Avila-Tang E, Hepp L, Yun D, Samet JM, Breysse PN. Utility and Cutoff Value of Hair Nicotine as a Biomarker of Long-Term Tobacco Smoke Exposure, Compared to Salivary Cotinine. International Journal of Environmental Research and Public Health. 2014; 11(8):8368-8382. https://doi.org/10.3390/ijerph110808368
Chicago/Turabian StyleKim, Sungroul, Benjamin J. Apelberg, Erika Avila-Tang, Lisa Hepp, Dongmin Yun, Jonathan M. Samet, and Patrick N. Breysse. 2014. "Utility and Cutoff Value of Hair Nicotine as a Biomarker of Long-Term Tobacco Smoke Exposure, Compared to Salivary Cotinine" International Journal of Environmental Research and Public Health 11, no. 8: 8368-8382. https://doi.org/10.3390/ijerph110808368