title: Urine cotinine as an index of smoking status in smokers during 96-hr abstinence: comparison between gas chromatography/mass spectrometry and immunoassay test strips.
abstract: Biomarkers such as carbon monoxide (CO) and cotinine (a nicotine metabolite) are used in tobacco cessation studies to assess smoking status. CO is easy to assess, is inexpensive, and provides immediate results. However, the short half-life of CO may limit its ability to identify smokers who have abstained for several hours. Quantitative methods (e.g., gas chromatography/mass spectrometry, or GC/MS) for measuring urine cotinine, which has a longer half-life, are valid and reliable, though costly and time consuming. Recently developed semiquantitative urine cotinine measurement techniques (i.e., urine immunoassay test strips, or ITS) address these disadvantages, though the value of ITS as a means of identifying abstaining smokers has not been evaluated. The present study examined ITS as a measure of smoking status in temporarily abstaining smokers. A total of 236 breath and urine samples were collected from smokers who participated in two separate studies involving three independent, 96-hr (i.e., Monday-Friday), Latin-square-ordered, abstinence or smoking conditions; a minimum 72-hr washout separated each condition. Each urine sample was analyzed with GC/MS and ITS. Under these study conditions, CO demonstrated moderate sensitivity (83.1%) and strong specificity (100%), whereas ITS assessment showed strong sensitivity (98.5%) and weak specificity (58.5%). In this study of short-term abstinence, ITS classified as nonabstinent nearly half of the samples collected from abstaining smokers. However, it classified nearly all nonabstinent smokers as currently smoking. Validation of ITS using GC/MS results from smokers undergoing more than 96 hr of abstinence may be valuable.
authors.affiliation: Department of Psychiatry, Virginia Commonwealth University, Richmond, CA 23298-0205, USA.
authors.forename: Michelle
authors.initials: M
authors.lastname: Acosta
authors.forename: August
authors.initials: A
authors.lastname: Buchhalter
authors.forename: Alison
authors.initials: A
authors.lastname: Breland
authors.forename: Duncan
authors.initials: D
authors.lastname: Hamilton
authors.forename: Thomas
authors.initials: T
authors.lastname: Eissenberg
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000032:analysis*; D002248:Carbon Monoxide / Q000032:analysis; D003367:Cotinine / Q000493:pharmacokinetics* / Q000652:urine*; D004311:Double-Blind Method; D005260:Female; D008401:Gas Chromatography-Mass Spectrometry / Q000592:standards; D006207:Half-Life; D006801:Humans; D007118:Immunoassay / Q000592:standards; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D012907:Smoking; D016540:Smoking Cessation; D014029:Tobacco Use Disorder / Q000175:diagnosis*
chemical_list: D015415:Biomarkers; D002248:Carbon Monoxide; D003367:Cotinine