Punto de corte óptimo de la concentración de cotinina en saliva para discriminar entre fumadores y no fumadores en la población adulta de Barcelona

Martínez‐Sánchez, Jose M.; Fu, Marcela; Ariza, Carles; López, María José; Saltó, Esteve; Pascual, José Antonio; Schiaffino, Anna; Borràs, Josep M.; Peris, Mercé; Agudo, Antonio; Nebot, Manel; Fernández, Esteve

doi:10.1016/j.gaceta.2009.03.003

Cited by 13 publications

(20 citation statements)

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“…Non-smokers were defined as individuals that, at the time of the interview, reported that they did not smoke, and they had a salivary cotinine concentration ≤10 ng/mL [17]. This group included individuals that had never smoked and ex-smokers.…”

Section: Methodsmentioning

confidence: 99%

Impact of the Spanish Smoke-Free Legislation on Adult, Non-Smoker Exposure to Secondhand Smoke: Cross-Sectional Surveys before (2004) and after (2012) Legislation

Sureda

Martínez‐Sánchez

et al. 2014

PLoS ONE

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BackgroundIn 2006, Spain implemented a national smoke-free legislation that prohibited smoking in enclosed public places and workplaces (except in hospitality venues). In 2011, it was extended to all hospitality venues and selected outdoor areas (hospital campuses, educational centers, and playgrounds). The objective of the study is to evaluate changes in exposure to secondhand smoke among the adult non-smoking population before the first law (2004-05) and after the second law (2011–12).MethodsRepeated cross-sectional survey (2004–2005 and 2011–2012) of a representative sample of the adult (≥16 years) non-smoking population in Barcelona, Spain. We assess self-reported exposure to secondhand smoke (at home, the workplace, during leisure time, and in public/private transportation vehicles) and salivary cotinine concentration.ResultsOverall, the self-reported exposure to secondhand smoke fell from 75.7% (95%CI: 72.6 to 78.8) in 2004-05 to 56.7% (95%CI: 53.4 to 60.0) in 2011–12. Self-reported exposure decreased from 32.5% to 27.6% (−15.1%, p<0.05) in the home, from 42.9% to 37.5% (−12.6%, p = 0.11) at work/education venues, from 61.3% to 38.9% (−36.5%, p<0.001) during leisure time, and from 12.3% to 3.7% (−69.9%, p<0.001) in public transportation vehicles. Overall, the geometric mean of the salivary cotinine concentration in adult non-smokers fell by 87.2%, from 0.93 ng/mL at baseline to 0.12 ng/mL after legislation (p<0.001).ConclusionsSecondhand smoke exposure among non-smokers, assessed both by self-reported exposure and salivary cotinine concentration, decreased after the implementation of a stepwise, comprehensive smoke-free legislation. There was a high reduction in secondhand smoke exposure during leisure time and no displacement of secondhand smoke exposure at home.

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Section: Methodsmentioning

confidence: 99%

Impact of the Spanish Smoke-Free Legislation on Adult, Non-Smoker Exposure to Secondhand Smoke: Cross-Sectional Surveys before (2004) and after (2012) Legislation

Sureda

Martínez‐Sánchez

et al. 2014

PLoS ONE

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“…En este sentido, la concentración de cotinina en saliva, aunque tiene una corta vida media y puede variar dependiendo del día de recogida, puede discriminar a partir de un determinado punto de corte a las personas que fuman de las que no fuman 18,20 . Además, la concentración de cotinina proporciona información sobre el riesgo individual de desarrollar enfermedad de las personas fumadoras 25,26 .…”

Section: Estrategia Individual Frente Al Tabaquismounclassified

“…La población diana de las intervenciones de "alto riesgo" serían las personas fumadoras. El punto de corte de la concentración de cotinina que discrimina la persona fumadora de la no fumadora en la población adulta española es de 10 ng/ml 20 . Las concentraciones de cotinina en suero (muy similares a las determinadas en saliva) superiores a 15 ng/ml se asocian positivamente con desarrollar un cáncer de pulmón 25,26 siendo las concentraciones de cotinina más elevadas las que tienen mayor asociación con un cáncer de pulmón.…”

Section: Estrategia Individual Frente Al Tabaquismounclassified

“…Curva A: Distribución observada; curva B: escenario ficticio con el desplazamiento de la distribución debido a la estrategia poblacional. La línea vertical indica el punto de corte considerado a partir del cual se discrimina la población fumadora (de alto riesgo) de la no fumadora (con concentración de cotinina inferiores a 10 ng/ml 20 ).…”

Section: Estrategia Poblacional Frente Al Tabaquismounclassified

“…La concentración de cotinina en saliva ha sido utilizada para describir algunas característica del consumo de tabaco 12 , estudiar la exposición al HAT en población general 13,14 y evaluar el impacto de medidas sanitarias frente al tabaquismo en distintas poblaciones 13,[15][16][17] . La distribución de la concentración de cotinina en la población general ha sido descrita en diversas poblaciones 18,19 , incluyendo la española 14,20 . Todos estos estudios describen la distribución poblacional de la concentración de cotinina como una distribución bimodal donde se diferencia claramente la población fumadora de la no fumadora.…”

Section: Introductionunclassified

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Estrategia individual y poblacional en las intervenciones frente a la epidemia del tabaquismo

Martínez‐Sánchez

Tresserras³

et al. 2011

Adicciones

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The population strategy for intervention on risk factors became known through the work of Geoffrey Rose in the field of public health and preventive medicine in relation to cardiovascular diseases in the late twentieth century. Currently, one of the risk factors with the most impact on health is the smoking epidemic. The aim of this study is to describe and put into practice the preventive medicine strategies proposed by Geoffrey Rose in the control of this smoking epidemic. To illustrate the situation, we have used the data on salivary cotinine concentration from a representative sample of the adult population in the city of Barcelona.In conclusion, public tobacco control policies worldwide should take into account the utility of the population strategy for addressing this important health issue, without ignoring "high risk" interventions of proven effectiveness.Key words: tobacco control, population strategy, high-risk strategy, cotinine RESUMEN ABSTRACTLa estrategia poblacional de las intervenciones frente a los factores de riesgo se dio a conocer por los trabajos de Geoffrey Rose en el campo de la salud pública y la medicina preventiva de las enfermedades cardiovasculares a finales del siglo XX. En la actualidad, uno de los factores de riesgo con mayor impacto sobre la salud es el tabaquismo. El objetivo de este trabajo es describir y aplicar las estrategias de la medicina preventiva propuesta por Geoffrey Rose en el control de la epidemia del tabaquismo. Para ilustrarlo hemos utilizado los datos de concentración de cotinina en saliva de una muestra representativa de la población adulta de la ciudad de Barcelona. En conclusión, las políticas públicas de control de tabaquismo en todo el mundo deberían tener en consideración la utilidad de la estrategia poblacional para el abordaje de este importante problema de salud, sin menospreciar intervenciones seleccionadas dirigidas a colectivos de "alto riesgo" que sean de probada eficacia. Estrategia individual y poblacional en las intervenciones frente a la epidemia del tabaquismo Individual and population-based strategies for tobacco control

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Development of an ultrasensitive immunochromatography test to detect nicotine metabolites in oral fluids

et al. 2011

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Passive exposure to tobacco smoke causes a variety of illnesses ranging from allergic responses to cancer. Assessment of exposure to second-hand tobacco smoke (SHS), particularly among vulnerable populations enables intervention and prevention of future disease. A minimally invasive oral fluids-based onsite test to detect such exposure would create a valuable tool for researchers and clinicians. Here we describe the development of a test that uses an inexpensive reader that utilizes a CMOS image sensor to reliably quantify a reporter signal and determine nicotine exposure. The rapid lateral flow test consists of a nitrocellulose strip with a control line containing goat anti-rabbit IgG, used as an internal standard, and a test line containing BSA-cotinine conjugate. To run the test, diluted sample containing antibodies against cotinine, the major metabolite of nicotine, is mixed with protein A-gold nanoparticles and placed on the sample pad. As the sample runs up to the nitrocellulose pad, antibodies in the running buffer bind to available cotinine. If cotinine is absent, the antibodies will bind to the BSA-cotinine derivative immobilized on the test line, resulting in an intense purple-red band. The concentration of cotinine equivalents in the sample can be estimated from interpretation of the test line. In this article we describe the effect of different cotinine derivatives, oral fluid pretreatment, and application and running buffers on assay sensitivity. The test can reliably detect as little as 2 ng mL(-1) cotinine equivalents. The assay is sensitive, simple, rapid, inexpensive, and easily implementable in point-of-care facilities to detect second-hand smoke exposure.

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Punto de corte óptimo de la concentración de cotinina en saliva para discriminar entre fumadores y no fumadores en la población adulta de Barcelona

Abstract: The optimal cut-point to discriminate smoking status in the adult population is 9.2 ng/ml, with sensitivities and specificities around 90%. The cut-point was higher in men and in younger people. The cut-point increases with higher prevalence of daily smokers.

Cited by 13 publications

References 28 publications

Impact of the Spanish Smoke-Free Legislation on Adult, Non-Smoker Exposure to Secondhand Smoke: Cross-Sectional Surveys before (2004) and after (2012) Legislation

Impact of the Spanish Smoke-Free Legislation on Adult, Non-Smoker Exposure to Secondhand Smoke: Cross-Sectional Surveys before (2004) and after (2012) Legislation

Estrategia individual y poblacional en las intervenciones frente a la epidemia del tabaquismo

Development of an ultrasensitive immunochromatography test to detect nicotine metabolites in oral fluids

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