REVIEW ARTICLE


Urinary Cotinine as a Biomarker of Cigarette Smoke Exposure: A Method to Differentiate Among Active, Second-Hand, and Non-Smoker Circumstances



Andréia G.O. Fernandes1, Leonardo N. Santos2, Gabriela P. Pinheiro1, Diego da Silva Vasconcellos3, Sérgio Telles de Oliva3, Bruno J.D. Fernandes4, Ricardo D. Couto4, *
1 Program for Asthma Control in Bahia (ProAR) and Graduate Studies in Medicine and Health, Bahia Medical School , Federal University of Bahia - UFBA, Salvador, Bahia, Brazil
2 The Graduate Program in Immunology, Institute of Health Sciences, Federal University of Bahia - UFBA, Salvador, Bahia, Brazil
3 Environmental Analytical Chemistry Laboratory, Department of Analytical Chemistry, Institute of Chemistry, Federal University of Bahia - UFBA, Salvador, Bahia, Brazil.
4 Graduate Program in Pharmacy (PPGFAR-UFBA), Clinical Biochemistry and Lipid Metabolism Laboratory, Department of Clinical Chemistry and Toxicological Analyses, Faculty of Pharmacy, Federal University of Bahia - UFBA. Barão de Jeremoabo, Salvador, Bahia, Brazil


© 2020 Oliva Fernandes etal.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: (https://creativecommons.org/licenses/by/4.0/legalcode). This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Graduate Program in Pharmacy (PPGFAR-UFBA), Clinical Biochemistry and Lipid Metabolism Laboratory, Department of Clinical Chemistry and Toxicological Analyses, Faculty of Pharmacy, Federal University of Bahia/UFBA. Barão de Jeremoabo Street, 147, Ondina. Postal Code 40.170-115; Salvador, Bahia, Brazil, Tel:55 71 3283-6952/6900; E-mail: rdc@ufba.br


Abstract

Objective:

To review the literature on the use of urinary cotinine as a biological marker of cigarette smoke exposure.

Methods:

Narrative review of original and review articles on the topic of interest, published in Portuguese or English by June 2018, and selected in the following online databases: PubMed and Virtual Health Library (VHL).

Results:

Urinary cotinine is usually the recommended biomarker to estimate exposure to cigarette smoke, and can be used alone or, preferably, in association with questionnaires. Different analytical techniques can be used to quantify urinary cotinine and are differently performed because of urine sample interfering factors.

Conclusion:

The precise classification of smoking status is essential. It is advisable to use objective measurements regarding smoking habits since self-reported smoking may not always represent the true smoking status of the individual, particularly in groups that are more vulnerable to omitting the information of questionnaries, in addition, it has possible biases of memory. The accurate assessment of smoking is crucial to improve clinical management and counseling for different diseases as well as the establishment of preventive strategies. So, the use of urinary cotinine as a biomarker of cigarette smoke exposure seems to be a suitable assay to distinguish non-smokers from passive and active smokers.

Keywords: Biomarkers, Cotinine, Smoking, Exposure, Tobacco Smoke Pollution, Environmental Biomarkers.