Objectives: The reliability of surveys on smoking habits based on questionnaires was investigated, using the urinary cotinine content as an objective index. Methods: The subjects tested were 2,849 office workers of middle age, who responded to questions concerning their smoking status, and also their urinary cotinine was measured by the HPLC method. Results: The boundary value between smokers and non-smokers, determined by the histogram independent of the questionnaire, was 63.1 and 79.4 ng/mg of creatinine for males and females, respectively. The rate of misclassification of the non-smokers and former smokers as smokers was 1.3% for males and 1.8% for females, whereas that of current smokers as non-smokers was 6.3% and 2.1%. We also assessed the effect of smoke inhalation on the urinary cotinine value, and found a significant difference for males in the cotinine value by the presence of inhalation and also its depth. Conclusions: The rate of misclassification in this study was considered to be comparatively low. Several studies have also assessed the reliability of the questionnaire on smoking habits, and found different misclassification rates, indicating the dependence on the race and number of subjects tested. To our knowledge, there were only a few surveys on smoking among large groups, particularly in Japan, such as this one, therefore the results obtained in this study are meaningful.
Smoking ; Cotinine ; Indexes ; seconds ; Urine

OBJECTIVETo establish a GC/MS method for analysis of cotinine (COT), phenylglyoxylic acid (PA) and mandelic acid (MA) in human urine.

METHODSHuman urine samples were extracted by CCl(3) and derivatized with MSTFA after dried completely. The contents of COT, PA and MA were measured by GC/MS method with DB-5MS capillary column and EI ion-source.

RESULTThe calibration curves for COT in urine samples were linear over the concentration ranges of 0.0002 approximately 3.5 microg ml(-1), while PA and MA were both of 1.25 approximately 160 microg ml(-1). The limits of quantification were 0.0002 microg ml(-1), 1.25 microg ml(-1) and 1.25 microg ml(-1) for COT, PA and MA, respectively. The assay recoveries for COT, PA and MA ranged from 89.53% approximately 102.4%, 84.88% approximately 91.46% and 83.46% approximately 13.6%, respectively.

CONCLUSIONThe established method can detect cotinine, phenylglyoxylic acid and mandelic acid simultaneously, which would be used in routine assessment and monitoring of the internal exposure to nicotine and styrene in human body.

Cotinine ; urine ; Environmental Pollutants ; urine ; Gas Chromatography-Mass Spectrometry ; Glyoxylates ; urine ; Humans ; Mandelic Acids ; urine

OBJECTIVETo establish the method of gas chromatograph-mass spectrometry (GC-MS) for the determination of the cotinine (COT) in human urine.

METHODSThe conjugated trans-3'-hydroxycotinine (THOC) and COT were hydrolyzed in human urine with beta-glucuronidase. The composition of COT was extracted with the mixture of dichloromethane and n-butyl acetate (2:1) and was separated with HP-5MS fused-silica capillary column. The GC-MS was used for determining its content.

RESULTSThe monitoring limit of this method was 0.02 microg/L. Its recovery rate was higher than 90%, Its accuracy rate was 4.30%. It was used for the determination of the cotinine in human urine in Guangzhou Biological Bank the Elderly Cohort.

CONCLUSIONThe GC-MS method is a good microanalysis for monitoring the cotinine in human urine rapidly and accurately with little background disturbance. It has been applied in our Guangzhou Cohort Study for determining cotinine in human urine.

Cotinine ; urine ; Female ; Gas Chromatography-Mass Spectrometry ; methods ; Humans ; Male ; Sensitivity and Specificity ; Smoking ; urine

OBJECTIVES: This study was conducted to validate self-reported smoking among high school students using urinary cotinine. METHODS: A self report of smoking behavior was collected together with urine sample for cotinine analysis from 130 male and female students in two vocational high school students in November, 2007. Validity and agreement between self-reported smoking and urinary cotinine was analyzed with STATA 9.0 for different definitions of current smokers, and frequent and daily smokers. Urinary cotinine concentration was measured by the DRI Cotinine Assay for urine (Microgenics Corp., Fremont, CA) on Toshiba 200FR. The cut-off point of urinary cotinine was 50 ng/dl. RESULTS: The concentrations of urinary cotinine were significantly different according to the frequency and amount of smoking. Sensitivity and specificity was 90.9% and 91.8% respectively, and the Cohen's kappa value was 0.787 among the current smokers who smoked at least one day during one month preceding the survey. The comparable high sensitivity, specificity, and kappa value were shown also among the other definitions of current smokers, that is, subjective smokers, and weekly smokers. CONCLUSIONS: The results showed the high validity of self-reported smoking among high school students. However, due to the small sample size and limitation of the participants, it is cautious to generalize the results to overall high school students.
Adolescent ; *Adolescent Behavior ; Cotinine/*urine ; Female ; Humans ; Korea/epidemiology ; Male ; Self Disclosure ; Smoking/epidemiology/*urine ; Students

OBJECTIVES: We investigated the validity of the dipstick method (Mossman Associates Inc. USA) and the expired CO method to distinguish between smokers and nonsmokers. We also elucidated the related factors of the two methods. METHODS: This study included 244 smokers and 50 exsmokers, recruited from smoking cessation clinics at 4 local public health centers, who had quit for over 4 weeks. We calculated the sensitivity, specificity and Kappa coefficient of each method for validity. We obtained ROC curve, predictive value and agreement to determine the cutoff of expired air CO method. Finally, we elucidated the related factors and compared their effect powers using the standardized regression coefficient. RESULTS: The dipstick method showed a sensitivity of 92.6%, specificity of 96.0% and Kappa coefficient of 0.79. The best cutoff value to distinguish smokers was 5-6ppm. At 5 ppm, the expired CO method showed a sensitivity of 94.3%, specificity of 82.0% and Kappa coefficient of 0.73. And at 6 ppm, sensitivity, specificity and Kappa coefficient were 88.5%, 86.0% and 0.64, respectively. Therefore, the dipstick method had higher sensitivity and specificity than the expired CO method. The dipstick and expired CO methods were significantly increased with increasing smoking amount. With longer time since the last smoking, expired CO showed a rapid decrease after 4 hours, whereas the dipstick method showed relatively stable levels for more than 4 hours. CONCLUSIONS: The dipstick and expired CO methods were both good indicators for assessing smoking status. However, the former showed higher sensitivity and specificity and stable levels over longer hours after smoking, compared to the expired CO method.
Adult ; Carbon Monoxide/*analysis/metabolism ; Cotinine/metabolism/*urine ; Female ; Humans ; Male ; Middle Aged ; ROC Curve ; Sensitivity and Specificity ; Smoking/*metabolism/urine

PURPOSE: This cross-sectional study aimed to examine the association between self-reported exposure status to second-hand smoke and urinary cotinine level in pregnant nonsmokers. MATERIALS AND METHODS: We recruited pregnant nonsmokers from the prenatal care clinics of a university hospital and two community health centers, and their urinary cotinine concentrations were measured. RESULTS: Among a total of 412 pregnant nonsmokers, the proportions of self-reported exposure to second-hand smoke and positive urinary cotinine level were 60.4% and 3.4%, respectively. Among those, 4.8% of the participants who reported exposure to second-hand smoke had cotinine levels of 40 ng/mL (the kappa value = 0.029, p = 0.049). Among those who reported living with smokers (n = 170), "smoking currently permitted in the whole house" (vs. not permitted at home) was associated with positive urinary cotinine in the univariable analysis. Furthermore, this variable showed a significant association with positive urinary cotinine in the stepwise multiple logistic regression analysis [Odds ratio (OR), 15.6; 95% Confidence interval (CI) = 2.1-115.4]. CONCLUSION: In the current study, the association between self-reported exposure status to second-hand smoke and positive urinary cotinine in pregnant nonsmokers was poor. "Smoking currently permitted in the whole house" was a significant factor of positive urinary cotinine in pregnant nonsmokers. Furthermore, we suggest that a complete smoking ban at home should be considered to avoid potential adverse effects on pregnancy outcomes due to second-hand smoke.
Adult ; Cotinine/*urine ; *Environmental Exposure ; Female ; Humans ; Pregnancy ; Regression Analysis ; *Tobacco Smoke Pollution

PURPOSE: In this study, the effectiveness of a motivational interviewing smoking cessation YOU-TURN program for adolescents was examined. The program was based on the self-determination theory. METHODS: The study was carried out with a nonequivalent control group pretest-posttest design. Participants in the present study were 136 high school students living in D city. The students were assigned to the experimental group (n=52) who participated in the motivational interviewing smoking cessation YOU-TURN program based on self-determination theory, or to the control group (n=84) who participated in a general smoking cessation program. Data were collected from September 1, 2013 through April 30, 2014. Collected data were analyzed using SPSS PC+ 21.0 with Chi-square test, Fisher's exact test, t-test, Mann-Whitney U test, Repeated Measures ANOVA, and MANOVA-Wilk's Lambda. RESULTS: The experimental group had a significant increase in basic psychological needs, and duration of quitting-smoking in comparison with the control group. The experimental group had a significant decrease in cigarettes smoked per day and cotinine in urine in comparison with the control group. CONCLUSION: The motivational interviewing YOU-TURN program, when delivered to adolescents who smoked, was effective in discouraging smoking, and can be utilized as an effective nursing intervention for adolescents who smoke.
Adolescent ; Cotinine/urine ; Female ; Humans ; Male ; *Motivational Interviewing ; *Personal Autonomy ; *Program Evaluation ; Psychology, Adolescent ; *Smoking Cessation

OBJECTIVE: To prepare monoclonal antibody against cotinine (COT) and to establish immunoassay for detecting COT in human urinary samples. METHODS: BALB/c mice were immunized with synthesized cotinine-bovine serum albumin (COT-BSA) to screen monoclonal antibody with technique of cell fusion. The monoclonal antibody was used for the indirect competitive enzyme-linked immunosorbent assay (ic-ELISA) and colloidal gold immunochromatographic strip assay for the detection of COT in human urine. RESULTS: The monoclonal antibody against COT was identified by ic-ELISA with a 50%inhibitive concentration (IC CONCLUSIONS The ic-ELISA and colloidal gold immunochromatographic strip assay using the prepared monoclonal antibody against COT have been proved to be reliable for the rapid detection of COT in human urines, which may be used for monitoring of environmental tobacco smoke.
Animals ; Antibodies, Monoclonal ; Cotinine/urine* ; Enzyme-Linked Immunosorbent Assay ; Gold Colloid ; Humans ; Mice ; Mice, Inbred BALB C ; Urinalysis/methods*

This study examined urinary cotinine levels and self-reported smoking among pregnant women in Korea and the factors associated with smoking during pregnancy. The subjects were selected from pregnant women who visited 30 randomly sampled obstetric clinics and prenatal care hospitals in Korea in 2006. Smoking status was determined by self-reporting and urinary cotinine measurement. A total of 1,090 self-administered questionnaires and 1,057 urine samples were analyzed. The percentage of smoking revealed by self-reporting was 0.55% (95% confidence interval [CI], 0.11-0.99) and that revealed by urinary cotinine measurement (>100 ng/mL) was 3.03% (95% CI, 1.99-4.06). The kappa coefficient of agreement between self-reported smoking status and urinary cotinine measurement was 0.20 (95% CI, 0.03-0.37). Multiple logistic regression analysis revealed that early gestational period, low educational level, and being married to a smoker were significant risk factors for smoking during pregnancy. Smoking among pregnant women in Korea is not negligible, and those who are concerned to maternal and child health should be aware of this possibility among pregnant women in countries with similar cultural background.
Adult ; Cotinine/*urine ; Female ; Humans ; Korea/epidemiology ; Middle Aged ; Pregnancy ; Reproducibility of Results ; Self-Examination/*statistics & numerical data ; Sensitivity and Specificity ; Smoking/*epidemiology/*urine ; Young Adult

PURPOSE: This study was conducted to develop and evaluate a web-based education program for secondary stroke prevention. METHODS: A web-based secondary stroke prevention education program was developed using the system's life cycle methods and evaluated by comparing the effects of education among three groups, a web group, a booklet group and a control group. RESULTS: Knowledge level of both patients and family, as well as some health behavior compliance in the web-based and booklet education groups were significantly higher than those of the control group. Family support in the web-based and booklet education groups was significantly higher than that of the control group after 12 weeks. The urine cotinine level in the web-based education group was significantly lower than that of the control group after 12 weeks. Medication adherence, blood pressure and perceived health status were not statistically different among the three groups at any time. CONCLUSION: Web-based and booklet education programs were equally effective regarding the level of knowledge of patients and their families, family support, health behavior compliance, and urine cotinine level. These results demonstrate the potential use of a web-based education program for secondary stroke prevention.
Aged ; Blood Pressure ; Caregivers/psychology ; Cotinine/urine ; Demography ; Female ; Health Behavior ; Health Promotion ; Humans ; *Internet ; Male ; Middle Aged ; Patient Education as Topic/*methods ; Program Evaluation ; Stroke/*prevention & control/psychology