Measurement of Tobacco Smoke Exposure: Comparison of Toenail Nicotine Biomarkers and Self-Reports

Abstract

Background: Accurate measurement tools of exposure for use in large epidemiologic studies are lacking. Biomarkers of tobacco exposure provide additional advantages to self-reports and there is a need to further develop and validate them. The objective is to compare toenail nicotine levels, a novel biomarker of tobacco exposure, with self-reports of tobacco exposure from a large cohort study. Methods: In this cross-sectional analysis, toenail samples were collected from 2,485 women participating in the Nurses' Health Study in 1982. Detailed self-reports of smoking habits and reported exposure to secondhand smoke (SHS) were collected from these women near the time of toenail collection. The toenail samples were analyzed by a high-performance liquid chromatography method for measuring nicotine. Results: The 5 to 95 percentile range of toenail nicotine was from 0.06 to 4.06 ng/mg toenail and the median

Current research on cigarette toxicity: critical appraisal in view of clinical laboratory

“…The overreaching finding of the study shows that toenail nicotine levels picked up overall burden of tobacco smoke and provided further information on exposure not picked by self-reported history. 83 High performance liquid chromatography (HPLC) was the method employed for detection of nicotine in the nail samples. This technique has limitation of less separation efficiency, albeit its precise and highly reproducible potential.…”

“…84 However, its objective measure of exposure to cigarette smoking highlights its precision as compared to self-reports. 83 The innovative advancement of HPLC to incorporate mass spectrometry (MS) is shown to be a powerful qualitative and quantitative analytical technique. Its strengths as being highly sensitive and specific, but marred with high instrument cost has been outlined.…”

“…This has led to novel development and validation of alternatives such as toenails, hairs, and detection of multiple metabolites of nicotine exposure. 19,83,85,86 However, what has not been largely discussed and adopted for the benefit of LMICs is the potential of haematological and haemorheological parameters as possible clinical diagnostic markers for cigarette toxicity.…”

Association between passive smoking in adulthood and phalangeal bone mineral density: results from the KRAM study—the Danish Health Examination Survey 2007–2008

“…Benson and Shulman found that serum cotinine was associated with decreased BMD in both genders [33]. Another possibility could be toenail nicotine biomarkers, which have been showed to have high validity as a measure of passive smoking and active smoking [34]. A recent review, however, investigating the relationship between self-reported passive smoking and biomarkers of nicotine in the body found that the majority of studies included in the Table 3 Multiple linear regression analysis on variables associated with bone mineral density (grammes per square centimetre; g/cm 2 ) in all participants, never smokers and daily smokers Data are shown as coefficient (β) and partial correlation coefficients (r p ) a Participants who answered 'don't know' were excluded (n=1,351) review indicated that self-reported exposure to passive smoking was consistent with biomarker concentrations [35].…”

Nail analysis for the detection of drugs of abuse and pharmaceuticals: a review

“…Pre-analytical and analytical techniques LC-ECD or GC-MS were used for the detection of nicotine, cotinine, and caffeine in toenails [32,[49][50][51][52][53][54][55][56]. To allow the detection of the tobacco-specific N-nitrosamines 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) and N-nitrosonornicotine (NNN) in toenails, which are only present at very low concentrations, a more sensitive technique using LC-ESI-MS-MS was developed [51,57].…”