Compliance review in the course of smoking cessation by determining nicotine/cotinine levels

Nicotine is not normally present in the human body. The only significant source of nicotine are the dried leaves of the tobacco plant „Nicotiana tabacum” when it enters the body through smoking cigarettes, pipes and cigars, inhaling snuff or using chewing tobacco. Nicotine is rapidly absorbed in the body, and its metabolism has many facets. It is mainly transformed through oxidation to cotinine and nicotine N-oxides and to numerous, in part as yet unidentified metabolites.
Determining the nicotine metabolite cotinine has advantages over determining carboxyhaemoglobin or thiocycanate. Cotinine and other nicotine metabolites are tobacco-specific, have a longer half-life in the blood and urine (> 10 hours) than carboxyhaemoglobin, for instance. Carboxyhaemoglobin and thiocyanate do not necessarily have to be degradation products of tobacco; they may also originate from various other materials. Nicotine itself and carboxyhaemoglobin have a much shorter half-life than cotinine and nicotine metabolites.

Area of application
Cotinine determination can be used for:
- Checking patient compliance during pregnancy
- Assessing additional risk with existing cardiovascular diseases
- Distinguishing between smokers, non-smokers and passive smokers
- Monitoring patient compliance in the course of smoking cessation/abstinence

Half-lives

  • Nicotine:
    30 to 60 minutes in smokers
    2 to 3 hours in non-smokers
  • Cotinine:
    7-40 hours

Sample material
serum, plasma, urine

Note
the use of nicotine patches also leads to positive results. Cross-reactions with other medications or other natural substances (e.g. caffeine) have not yet been established.

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