Investigation of Urine Cotinine Levels as Indicators of Tobacco Use and Passive Smoking, with Parameters of Metabolic Syndrome, Among Adults in Chena Wacha
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Date
2015-03
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Addis Ababa University
Abstract
Background: Active and passive cigarette smokers produce the nicotine metabolite, cotinine,
which can be detected in the urine. Smoking increases the risk of metabolic syndrome, includes
abnormalities in lipid profile, blood glucose, blood pressure, BMI and waist circumference.
Objective: The study, investigate urine cotinine levels as indicators of tobacco use and passive
smoking, with parameters of metabolic syndrome among adult in Chenna wacha, SNNPR.
Method: A cross sectional study was done on a total of seventy smokers (46 active and 24
passive). Smoking history was obtained from the participants which was then used to calculate
smoking consumption in pack-years. In this study, current active smokers were classified based
on the number of pack-years as into mild to moderate (1 – 10 pack-years) and heavy (more than
10 pack-years. Parameters of metabolic syndrome were determined using standard methods,
while urine cotinine was determined using COT® one step cotinine test device at a cut-off of 200
ng/mL. Data analyses were performed with SPSS16.0 system.
Result: The finding of the study indicates that 88.7 % of active smokers and 11.3 % of passive
smokers were positive for urine cotinine, with substantial agreement between cotinine test results
and self-reported cigarette use (kappa 0.63). Among five children taken from four families in
which there was an active smoker in the home, two out of the five (40%) were positive for urine
cotinine. The study also shows that the prevalence of metabolic syndrome, based on the
occurrence of at least three components of metabolic syndrome, was 5/46 (10.8 %) in active
smokers and 2/19 (10.5 %) among passive smokers. Taking mild to moderate smokers as
reference, heavy smokers were relatively underweight with statistical significance (OR 7.90; p=
0.004). Adult passive smokers were not significantly underweight compared with mild-to-
moderate smokers (OR 2.09; p= 0.234). As the number of pack-years of smoking increased
among smokers, they had an increased number of parameters of metabolic syndrome.
Conclusion: This study shows that urine cotinine measurements are a practically convenient and
valuable tool for objectively assessing smoking and passive smoking in Ethiopia, and detected
passive smokers, including children as young as 6 years old. Some parameters of metabolic
syndrome showed a significant association with the level of smoking.
Key words: Cotinine, urine, metabolic syndrome
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Keywords
Cotinine; Urine; Metabolic syndrome