Nicotine dependence and urinary nicotine, cotinine and hydroxycotinine levels in daily smokers

Abstract

Introduction: Nicotine dependence and smoking frequency are critical factors for smoking cessation. The aims of this study are 1) to determine if nicotine dependence FTND scores are associated with urinary levels of nicotine metabolites, 2) to assess the relationship of hydroxycotinine/cotinine ratio with FTND score and cigarettes smoked per day (CPD) and 3) to identify significant predictors of cigarettes per day among biomarker concentrations and individual FTND items. Methods: Urine samples and questionnaire data of 239 daily smokers were obtained. Nicotine, cotinine and hydroxycotinine urinary levels were determined by UPLC MS/MS. Multiple linear regression models were developed to explore the relationship between nicotine, cotinine , hydroxycotinine levels and separate FTND scores (for all 6 items). Results: We found significant correlations between the different urinary biomarker concentrations, and the FTND score. The time before the first cigarette after waking (TTFC) was significantly associated with the nicotine, cotinine and hydroxycotinine concentrations. No association was found between the ratio of hydroxycotinine to cotinine and either the FTND or the CPD. A model including four FTND questions, sex, age and the cotinine concentration, accounted for 45 % of the variance of CPD. Conclusions: There are significant relationships between urinary levels of nicotine, cotinine and hydroxycotinine and the FTND score. Especially the FTND question about TTFC is relevant for explaining the biomarker concentrations. CPD (below 15) was significantly explained by four FTND dependence items and urinary cotinine levels in a regression model.

Effects of omega-3 fatty acid supplementation on cigarette craving and oxidative stress index in heavy-smoker males: A double-blind, randomized, placebo-controlled clinical trial

“…Some previous studies have shown a significant positive correlation between the concentration of urinary cotinine and the levels of nicotine dependence and CPD, both of which are predictors of quitting behavior (DiFranza et al, 2013;Jung et al, 2012;Van Overmeire et al, 2016). However, these studies did not assess the correlation in heavy smokers with severe nicotine dependence.…”

Peripheral Biomarkers of Tobacco-Use Disorder: A Systematic Review

“…A cross-sectional study of 239 smokers measuring urinary nicotine, cotinine, and 3-HC found that levels of all three of these markers were positively correlated with FTND scores (29). The time to first cigarette (TTFC) item of the FTND was positively correlated with urinary levels of nicotine, cotinine, and 3-HC.…”

“…Expired CO is increased acutely (6-9 hours) after combustible tobacco use, whereas cotinine, the primary metabolite of nicotine, has a longer half life (5-7 days) thus giving a longer-term measure of exposure to nicotine, regardless of the route of administration (21). However, growing evidence suggests that these, other exposure markers, are associated with dependence severity and risk of relapse (22, 23). Biomarkers not directly related to nicotine metabolism have been increasingly studied in TUD, such as markers of cardiovascular disease (CVD), inflammation, oxidative stress, and hypothalamic-pituitary-adrenal (HPA) axis reactivity (24-26).…”