title: Pilot study of methods to measure saliva cotinine in Alaska Native women during pregnancy.
abstract: OBJECTIVE
  To evaluate NicAlert immunoassay test strips and liquid chromatography atmospheric-pressure ionization tandem mass spectrometry (LC/MS/MS) for the measurement of saliva cotinine levels in pregnant Alaska Native women.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Pregnant women completed a questionnaire about their tobacco use during pregnancy and that of others in the same household. Saliva samples were collected and tested using LC/MS/ MS and NicAlert immunoassay test strips.
  
  
  RESULTS
  Seventy-one women participated; 18 reported using tobacco products during pregnancy. Sixteen women reported smoking within the last 7 days of the interview. Median cotinine concentrations in the women who reported smoking in the last 7 days were 94.5 ng/mL using LC/MS/MS (N = 13) and 87.5 ng/mL using NicAlert (N = 11). Twenty-two women reported that they did not use tobacco and had no exposure to secondhand smoke. Median cotinine concentrations among those with no reported exposure to secondhand smoke were 0.0605 ng/mL using LC/MS/MS (N = 18) and 4.38 ng/mL using NicAlert (N = 17).
  
  
  CONCLUSIONS
  NicAlert strips can be used to quickly distinguish between users and nonusers of tobacco, but they are not adequately sensitive to detect and quantify lower concentrations of cotinine among nonsmokers with secondhand exposure. A more sensitive method such as LC/MS/MS is required for that purpose.
authors.affiliation: Southcentral Foundation, Anchorage, Alaska 99508, USA lhelzer@southcentralfoundation.com
authors.forename: Laurie J
authors.initials: LJ
authors.lastname: Helzer
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Heitkamp
authors.forename: Melissa
authors.initials: M
authors.lastname: Shein
authors.forename: Ruth A
authors.initials: RA
authors.lastname: Etzel
mesh_terms: D000328:Adult; D000413:Alaska; D019411:Clinical Laboratory Techniques; D003367:Cotinine / Q000032:analysis*; D003430:Cross-Sectional Studies; D005260:Female; D008401:Gas Chromatography-Mass Spectrometry; D006801:Humans; D007118:Immunoassay; D007198:Indians, North American / Q000235:genetics; D004930:Inuit; D009538:Nicotine / Q000032:analysis; D010865:Pilot Projects; D011247:Pregnancy; D012463:Saliva / Q000737:chemistry*; D012907:Smoking / Q000453:epidemiology / Q000208:ethnology*; D011795:Surveys and Questionnaires; D053719:Tandem Mass Spectrometry; D014028:Tobacco Smoke Pollution / Q000032:analysis*
chemical_list: D014028:Tobacco Smoke Pollution; D009538:Nicotine; D003367:Cotinine