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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 Aug; 29(4):437-46.TD

Abstract

Exposure to environmental tobacco smoke (ETS) is most often estimated using questionnaires, but they are unreliable. Biomarkers can provide valid information on ETS exposure, the preferred biomarker being cotinine. However, no reference range of hair cotinine exists to distinguish among active, passive, and unexposed nonsmokers. This study identifies cutoffs to validate cotinine as a marker for exposure to ETS. Data were obtained from six databases (four US, one Canada, one France). Active smoking and exposure to ETS were measured in the hair of women of reproductive age, pregnant women, their children, and neonates. Subjects were classified into active smokers, passively exposed to ETS, and unexposed nonsmokers. A total of 1746 cases were available for analysis. For active smokers, mean hair cotinine concentrations (95% confidence interval) were 2.3 to 3.1 ng/mg for nonpregnant women and 1.5 to 1.9 ng/mg for pregnant women. In the group of passive smokers, mean hair cotinine concentrations were 0.5 to 0.7 ng/mg for nonpregnant women, 0.04 to 0.09 ng/mg for pregnant women, 0.9 to 1.1 for children, and 1.2 to 1.7 for neonates. Among unexposed nonsmokers, mean hair cotinine was 0.2 to 0.4 ng/mg in nonpregnant women, 0.06 to 0.09 ng/mg in pregnant women, and 0.3 to 0.4 ng/mg in children. Cutoff values for hair cotinine were established to distinguish active smokers from passive or unexposed (0.8 ng/mg for nonpregnant women and 0.2 ng/mg for pregnant women). A cutoff value of 0.2 ng/mg was accurate in discriminating between exposed children and unexposed. These new values should facilitate clinical diagnosis of active and passive exposure to tobacco smoke. Such diagnosis is critical in pregnancy and in a large number of tobacco-induced medical conditions.

Authors+Show Affiliations

Public Health Sciences, Leslie Dan Faculty of Pharmacy, University of Toronto, Ontario, Canada.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Review
Systematic Review

Language

eng

PubMed ID

17667798

Citation

Florescu, Ana, et al. "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." Therapeutic Drug Monitoring, vol. 29, no. 4, 2007, pp. 437-46.
Florescu A, Ferrence R, Einarson TR, et al. 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(4):437-46.
Florescu, A., Ferrence, R., Einarson, T. R., Selby, P., Kramer, M., Woodruff, S., Grossman, L., Rankin, A., Jacqz-Aigrain, E., & Koren, G. (2007). 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. Therapeutic Drug Monitoring, 29(4), 437-46.
Florescu A, et al. 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(4):437-46. PubMed PMID: 17667798.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 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. AU - Florescu,Ana, AU - Ferrence,Roberta, AU - Einarson,Thomas R, AU - Selby,Peter, AU - Kramer,Michael, AU - Woodruff,Susan, AU - Grossman,Lindsey, AU - Rankin,Allison, AU - Jacqz-Aigrain,Evelyn, AU - Koren,Gideon, PY - 2007/8/2/pubmed PY - 2008/3/28/medline PY - 2007/8/2/entrez SP - 437 EP - 46 JF - Therapeutic drug monitoring JO - Ther Drug Monit VL - 29 IS - 4 N2 - Exposure to environmental tobacco smoke (ETS) is most often estimated using questionnaires, but they are unreliable. Biomarkers can provide valid information on ETS exposure, the preferred biomarker being cotinine. However, no reference range of hair cotinine exists to distinguish among active, passive, and unexposed nonsmokers. This study identifies cutoffs to validate cotinine as a marker for exposure to ETS. Data were obtained from six databases (four US, one Canada, one France). Active smoking and exposure to ETS were measured in the hair of women of reproductive age, pregnant women, their children, and neonates. Subjects were classified into active smokers, passively exposed to ETS, and unexposed nonsmokers. A total of 1746 cases were available for analysis. For active smokers, mean hair cotinine concentrations (95% confidence interval) were 2.3 to 3.1 ng/mg for nonpregnant women and 1.5 to 1.9 ng/mg for pregnant women. In the group of passive smokers, mean hair cotinine concentrations were 0.5 to 0.7 ng/mg for nonpregnant women, 0.04 to 0.09 ng/mg for pregnant women, 0.9 to 1.1 for children, and 1.2 to 1.7 for neonates. Among unexposed nonsmokers, mean hair cotinine was 0.2 to 0.4 ng/mg in nonpregnant women, 0.06 to 0.09 ng/mg in pregnant women, and 0.3 to 0.4 ng/mg in children. Cutoff values for hair cotinine were established to distinguish active smokers from passive or unexposed (0.8 ng/mg for nonpregnant women and 0.2 ng/mg for pregnant women). A cutoff value of 0.2 ng/mg was accurate in discriminating between exposed children and unexposed. These new values should facilitate clinical diagnosis of active and passive exposure to tobacco smoke. Such diagnosis is critical in pregnancy and in a large number of tobacco-induced medical conditions. SN - 0163-4356 UR - https://www.unboundmedicine.com/medline/citation/17667798/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_ L2 - https://doi.org/10.1097/FTD.0b013e318074df6e DB - PRIME DP - Unbound Medicine ER -