Cotinine levels in relation to smoking behavior and addiction in young adolescent smokers.
The goal of this study was to identify associations among self-reported nicotine exposure, nicotine addiction, and actual nicotine intake as measured by salivary cotinine levels in adolescent smokers. A total of 170 adolescent smokers with a mean age of 15 years were recruited from seven northern Californian public high schools. Data were collected on smoking behaviors, addiction, craving, and withdrawal. Nicotine dependence was assessed using a modified teen Fagerström Tolerance Questionnaire (mtFTQ), a modified Nicotine Dependence Syndrome Scale (mNDSS), and a simple self-rating. Withdrawal was assessed using the Minnesota Withdrawal Questionnaire, and craving was assessed using a survey created by the authors. Salivary cotinine levels were collected from and analysed in participants who self-identified as smokers; data from the 54 participants who smoked in the past 4 days and whose salivary cotinine levels were greater than 0.1 ng/ml were used in the analysis. Among this group of adolescent smokers, the mean number of cigarettes smoked per day was 3.51 (SD = 3.44) and the mean level of salivary cotinine was 44.1 ng/ml (Mdn = 24.2). Even at this low level of nicotine exposure, cotinine was highly correlated with measures of nicotine dependence such as the mtFTQ (r = 0.497, p = .001), NDSS (r = 0.439, p = .002), timing of craving in the morning (r = -0.601, p = .000), and self-rated addiction (r = 0.562, p = .000). Most interesting, cotinine levels reached a plateau at around 4-5 cigarettes/day.
Rubinstein
Mark L
ML
Division of Adolescent Medicine, University of California, San Francisco, San Francisco, CA 94118, USA. mrubin@itsa.ucsf.edu
Thompson
Pamela J
PJ
Benowitz
Neal L
NL
Shiffman
Saul
S
Moscicki
Anna-Barbara
AB
D000293:Adolescent; D016739:Behavior, Addictive / Q000453:epidemiology*; D003367:Cotinine / Q000032:analysis*; D005260:Female; D006801:Humans; D008297:Male; D012463:Saliva / Q000737:chemistry; D012907:Smoking / Q000097:blood* / Q000453:epidemiology*; D016540:Smoking Cessation / Q000379:methods; D011795:Surveys and Questionnaires
D003367:Cotinine