Overview of Cotinine Cutoff Values for Smoking Status Classification
- Authors
- Kim, Sungroul
- Issue Date
- Dec-2016
- Publisher
- Multidisciplinary Digital Publishing Institute (MDPI)
- Keywords
- cutoff value; cotinine; smoking status; biomarker
- Citation
- International Journal of Environmental Research and Public Health, v.13, no.12
- Journal Title
- International Journal of Environmental Research and Public Health
- Volume
- 13
- Number
- 12
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/8568
- DOI
- 10.3390/ijerph13121236
- ISSN
- 1661-7827
1660-4601
- Abstract
- While cotinine is commonly used as a biomarker to validate self-reported smoking status, the selection of an optimal cotinine cutoff value for distinguishing true smokers from true nonsmokers shows a lack of standardization among studies. This review describes how the cutoff values have been derived, and explains the issues involved in the generalization of a cutoff value. In this study, we conducted an English-language literature search in PubMed using the keywords "cotinine" and "cutoff" or "self-reported" and "smoking status" and "validation" for the years 1985-2014. We obtained 104 articles, 32 of which provided (1) sensitivity and specificity of a cutoff value and (2) determination methods for the given cutoff value. We found that the saliva cotinine cutoff value range of 10-25 ng/mL, serum and urine cotinine cutoff of 10-20 ng/mL and 50-200 ng/mL, respectively, have been commonly used to validate self-reported smoking status using a 2 x 2 table or a receiver operating characteristics (ROC) curve. We also found that recent large population-based studies in the U.S. and UK reported lower cutoff values for cotinine in serum (3 ng/mL) and saliva (12 ng/mL), compared to the traditionally accepted ones (15 and 14 ng/mg, respectively).
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