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      Salivary cotinine concentrations in daily smokers in Barcelona, Spain: a cross-sectional study

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          Abstract

          Background

          Characterizing and comparing the determinant of cotinine concentrations in different populations should facilitate a better understanding of smoking patterns and addiction. This study describes and characterizes determinants of salivary cotinine concentration in a sample of Spanish adult daily smoker men and women.

          Methods

          A cross-sectional study was carried out between March 2004 and December 2005 in a representative sample of 1245 people from the general population of Barcelona, Spain. A standard questionnaire was used to gather information on active tobacco smoking and passive exposure, and a saliva specimen was obtained to determine salivary cotinine concentration. Two hundred and eleven adult smokers (>16 years old) with complete data were included in the analysis. Determinants of cotinine concentrations were assessed using linear regression models.

          Results

          Salivary cotinine concentration was associated with the reported number of cigarettes smoked in the previous 24 hours ( R 2 = 0.339; p < 0.05). The inclusion of a quadratic component for number of cigarettes smoked in the regression analyses resulted in an improvement of the fit ( R 2 = 0.386; p < 0.05). Cotinine concentration differed significantly by sex, with men having higher levels.

          Conclusion

          This study shows that salivary cotinine concentration is significantly associated with the number of cigarettes smoked and sex, but not with other smoking-related variables.

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          Most cited references38

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          Cotinine as a biomarker of environmental tobacco smoke exposure.

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            Pharmacology of nicotine: addiction and therapeutics.

            N Benowitz (1995)
            Nicotine maintains tobacco addiction and has therapeutic utility to aid smoking cessation and possibly to treat other medical diseases. Nicotine acts on nicotinic cholinergic receptors, which demonstrate diversity in subunit structure, function, and distribution within the nervous system, presumably mediating the complex actions of nicotine described in tobacco users. The effects of nicotine in people are influenced by the rate and route of dosing and by the development of tolerance. The metabolism of nicotine is now well characterized in humans. A few individuals with deficient C-oxidation of nicotine, unusually slow metabolism of nicotine, and little generation of cotinine have been described. Nicotine affects most organ systems in the body, although its contribution to smoking-related disease is still unclear. Nicotine as a medication is currently available as a gum, a transdermal delivery device, and a nasal spray, all of which are used for smoking cessation. Nicotine is also being investigated for therapy of ulcerative colitis, Alzheimer's disease, Parkinson's disease, Tourette's syndrome, sleep apnea, and attention deficit disorder.
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              Assessment of exposure to environmental tobacco smoke.

              We present a theoretical framework for assessment of exposure to environmental tobacco smoke (ETS), and review current methods in order to provide guidelines for different types of studies. Exposure assessment should include both a quantitative dimension and consideration of time-specificity of exposure. The ultimate aim is to measure the concentrations of ETS encountered by an individual for different time periods in various microenvironments. The first step is to identify an indicator of ETS. Personal monitoring of air nicotine and respirable suspended particulates (RSPs) are the most direct assessment methods. Indirect assessment methods include stationary measurements of tobacco smoke constituents in different microenvironments and/or questionnaire-derived information, modelled with time-activity information. Biomarkers, such as nicotine and/or cotinine in body fluids or hair, can be used as surrogate measures of dose, although they are usually affected by individual processes in the body after exposure. The best approach to assess ETS exposure will depend on the aim of the study, the health outcome, and the resources. Personal monitoring of nicotine or RSPs is the best method in studies of short-term health effects with small study samples. Stationary measurements of indoor air nicotine or RSPs are suitable for overall monitoring of ETS in different microenvironments over time. Questionnaires and interviews are suitable when studying health outcomes with a long latency period and rare diseases requiring large study populations. Cotinine in body fluids and nicotine concentration in hair can be used to assess cumulative exposure over days or months, respectively. A combination of different methods is often the best approach.
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                Author and article information

                Journal
                BMC Public Health
                BMC Public Health
                BioMed Central
                1471-2458
                2009
                3 September 2009
                : 9
                : 320
                Affiliations
                [1 ]Tobacco Control & Research Unit, Institut Català d'Oncologia (ICO-IDIBELL). Av. Gran Via de L'Hospitalet 199-203, 08907 L'Hospitalet de Llobregat (Barcelona), Spain
                [2 ]Department of Clinical Sciences, School of Medicine, Campus de Bellvitge, Universitat de Barcelona. Pavelló de Govern, Feixa Llarga s/n, 08907 L'Hospitalet de Llobregat (Barcelona), Spain
                [3 ]Bioanalysis Research Group, Neuropsychopharmacology Programme, IMIM-Hospital del Mar. Parc de Recerca Biomèdica de Barcelona, Doctor Aiguader 88, Barcelona, Spain
                [4 ]Department of Experimental and Health Sciences, Universitat Pompeu Fabra. Parc de Recerca Biomèdica de Barcelona, Doctor Aiguader 88, 08003 Barcelona, Spain
                [5 ]Ajuntament de Terrassa. Crta. de Montcada 596, 08223 Terrassa, Spain
                [6 ]Nutrition, Environment & Cancer Unit, Institut Català d'Oncologia (ICO-IDIBELL). Av. Gran Via de L'Hospitalet 199-203, L'Hospitalet de Llobregat (Barcelona), Spain
                [7 ]Evaluation & Intervention Methods Unit, Agència de Salut Pública de Barcelona (ASPB). Pl. Lesseps 1, 08023 Barcelona, Spain
                [8 ]CIBER de Epidemiología y Salud Pública (CIBERESP). Parc de Recerca Biomèdica de Barcelona, Doctor Aiguader 88 1a Planta, 08003 Barcelona, Spain
                [9 ]Pla Director d'Oncologia. Av. Gran Via de L'Hospitalet 199-203, 08907 L'Hospitalet de Llobregat (Barcelona), Spain
                [10 ]Department of Preventive Medicine, USC Institute for Global Health, Keck School of Medicine USC, California, USA
                [11 ]Norris Comprehensive Cancer Center. 1441 Eastlake Avenue, Room 4436, MS 44; Los Angeles CA 90033, USA
                Article
                1471-2458-9-320
                10.1186/1471-2458-9-320
                2749042
                19728886
                d1e0ecc3-8ed3-46c2-8418-ea6cebd7cbf6
                Copyright © 2009 Fu et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 18 May 2009
                : 3 September 2009
                Categories
                Research Article

                Public health
                Public health

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