title: Cotinine concentration in smokers from different countries: relationship with amount smoked and cigarette type.
abstract: This four-country study examined salivary cotinine as a marker for nicotine intake and addiction among smokers in relation to numbers and types of cigarettes smoked. Smoking characteristics of cigarette smokers in Brazil, China, Mexico, and Poland were identified using a standard questionnaire. Cotinine concentration was measured using a saliva sample from each participant; its relationship with numbers and types of cigarettes smoked was quantified by applying regression techniques. The main outcome measure was salivary cotinine level measured by gas chromatography. In all four countries, cotinine concentration increased linearly with cigarettes smoked up to 20 per day [11.3 ng/mL (95% confidence interval, 10.5-12.2)] and then stabilized as the number of cigarettes exceeded 20 [6.8 ng/mL per cigarette (95% confidence interval, 6.3-7.4) for up to 40 cigarettes]. On average, smokers of regular cigarettes consumed more cigarettes and had higher cotinine levels than light cigarette smokers. Cotinine concentration per cigarette smoked did not differ between regular and light cigarette smokers. Results suggest a saturation point for daily nicotine intake and minimal or no reduction in nicotine intake by smoking light cigarettes.
authors.affiliation: Division of Biostatistics, Department of Oncology, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA.
authors.forename: Amanda L
authors.initials: AL
authors.lastname: Blackford
authors.forename: Gonghuan
authors.initials: G
authors.lastname: Yang
authors.forename: Mauricio
authors.initials: M
authors.lastname: Hernandez-Avila
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Przewozniak
authors.forename: Witold
authors.initials: W
authors.lastname: Zatonski
authors.forename: Valeska
authors.initials: V
authors.lastname: Figueiredo
authors.forename: Erika
authors.initials: E
authors.lastname: Avila-Tang
authors.forename: Jiemin
authors.initials: J
authors.lastname: Ma
authors.forename: Neal L
authors.initials: NL
authors.lastname: Benowitz
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Samet
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016739:Behavior, Addictive; D015415:Biomarkers / Q000032:analysis; D001938:Brazil / Q000453:epidemiology; D002681:China / Q000453:epidemiology; D002849:Chromatography, Gas; D003367:Cotinine / Q000032:analysis*; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D009538:Nicotine / Q000008:administration & dosage / Q000032:analysis; D018722:Nicotinic Agonists / Q000008:administration & dosage / Q000032:analysis; D011044:Poland / Q000453:epidemiology; D012463:Saliva / Q000737:chemistry; D012494:Sampling Studies; D012907:Smoking / Q000453:epidemiology* / Q000378:metabolism; D011795:Surveys and Questionnaires; D013638:Tars / Q000032:analysis
chemical_list: D015415:Biomarkers; D018722:Nicotinic Agonists; D013638:Tars; C024746:tobacco tar; D009538:Nicotine; D003367:Cotinine