- Title
- Assessing tobacco use in an African population: serum and urine cotinine cut-offs from South Africa
- Creator
- Ware, Lisa J.; Charlton, Karen; Kruger, Ruan; Breet, Yolandi; Van Rooyen, Johannes; Huisman, Hugo; Botha, Shani; Uys, Aletta S.; Rennie, Kirsten L.; Naidoo, Nirmala; Kowal, Paul; Schutte, Aletta E.
- Relation
- Drug and Alcohol Dependence Vol. 195, p. 82-89
- Publisher Link
- http://dx.doi.org/10.1016/j.drugalcdep.2018.11.022
- Publisher
- Elsevier Ireland
- Resource Type
- journal article
- Date
- 2019
- Description
- Background: Cotinine, a nicotine metabolite, is used to measure tobacco use and exposure, but recommended cut-offs to differentiate tobacco users from those exposed through the environment range from 3 to 58 ng/ml in serum, and 2.5 to 550 ng/ml in urine. Cut-offs may differ by ethnicity, sex and age. As data from adults in Africa are scarce, our aim was to evaluate cut-offs for serum and urine cotinine that best predict self-reported tobacco use in South African adults. Methods: Two datasets were explored: African-PREDICT (n = 941 black and white healthy young adults, 20-30 years, serum cotinine); and WHO SAGE Wave 2 (n = 604 adults, 18-102 years, urine cotinine). Population specific cut-offs (ROC analyses) were compared with published cut-offs and self-reported tobacco use. Results: Overall, 19% (293 of 1545) reported current tobacco use. The following cotinine cut-offs showed the highest sensitivity and specificity: serum =15 ng/ml in black and white men, and white women; serum =10 ng/ml in black women; urine =300 ng/ml for black, mixed ancestry, and older adults (50-plus years); urine =500 ng/ml for younger adults (18-49 years). Specificity was lower for urine than for serum cotinine. Conclusion: Our study suggests that a serum cotinine level of =15 ng/ml and a urine cotinine level of =300 ng/ml best distinguish current tobacco users from non-users generally in the South African adult population.
- Subject
- smoking; tobacco; cotinine; biomarkers; sub-saharan africa
- Identifier
- http://hdl.handle.net/1959.13/1464081
- Identifier
- uon:46909
- Identifier
- ISSN:0376-8716
- Language
- eng
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