The association between cotinine-measured smoking intensity and sleep quality

Abstract

INTRODUCTION Cigarette smoking is suggested to be associated with sleep problems. This study evaluated the quantitative association between urinary cotinine-verified smoking intensity and sleep quality assessed by the Pittsburgh Sleep Quality Index (PSQI). METHODS This was a cross-sectional study of 189970 participants from the Kangbuk Samsung Health Study recruited between 2016 and 2018. Logistic regression analysis adjusted for covariates was performed to estimate the association between urinary cotinine levels assessed by quartiles and poor sleep quality, defined as global PSQI score >5. RESULTS The odds ratios (OR) and 95% confidence intervals (CI) for poor sleep quality comparing the highest urinary cotinine quartile to non-smokers were: 1.23 (95% CI: 1.16-1.30) for overall, 1.19 (95% CI: 1.12-1.26) for males, and 1.55 (95% CI: 1.29-1.87) for females. Among self-reported never smokers, cotinineverified smokers had higher odds for decreased sleep quality compared to cotinineverified never smokers with OR of 1.26 (95% CI: 1.08-1.46). CONCLUSIONS Elevated urinary cotinine levels were associated with poor sleep quality in relatively young and middle-aged South Korean adults. Higher odds for poor sleep quality among cotinine-verified smokers who self-reported as never smokers also demonstrate the value of quantitative measurement of urinary cotinine. Prospective studies are warranted to clarify the cause-effect relationship between smoking and sleep quality.

Night time smoking among Bangladeshi adults: effect on sleep quality and musculoskeletal health

“…It is well established that smokers have poorer sleep quality than nonsmokers (Liao et al, 2019;Oh et al, 2022). Current findings strengthened that night time smoking habit significantly increases the risk of poor sleep quality of desk-based officials compared to individuals those does not have night time smoking habit.…”

Active smoking in urban households: An association between urinary cotinine metabolite level and serum eGFR concentration

“…In addition, our study found that both genders had the same urinary cotinine metabolite concentration, in contrast to a previous study that found higher concentrations in males than in females 37 . Our findings showed that those with lower education level than elementary school and aged >37 years showed higher urinary cotinine metabolite level, which might be important risk factors for smoking 38 . Moreover, this study found that those who were unemployed, used conventional cigarettes, and smoked ≥10 cigarettes per day showed higher urinary cotinine metabolite levels.…”

“…Smoking might affect renal function by causing chronic endothelial dysfunction, oxidative stress, and hardening of the glomeruli [44][45][46] . Moreover, exposure to passive smoking has been reported to be associated with significantly increased lipid peroxidation in the liver, increased catalase activity in the kidney, cardiac and blood vessel diseases, abnormal renal blood flow, and renal afflictions over time 38 . However, a few studies have identified a non-linear relationship between smoking and renal function in different populations through stratified analysis 22 .…”

Association between the oxidative balance score and thyroid function: Results from the NHANES 2007–2012 and Mendelian randomization study

“…Excessive production of ROS can cause hyperthyroidism, often accompanied by low TSH, high FT3, and FT4 [ 44 ]. Many articles studying smoking usually use cotinine as a surrogate quantitative measure to illustrate the strong correlation between the two [ 45 , 46 ]. In the present study, smoking data were used as a proxy because GWAS data for cotinine were not available.…”