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Int. J. Environ. Res. Public Health 2016, 13(12), 1236; doi:10.3390/ijerph13121236

Overview of Cotinine Cutoff Values for Smoking Status Classification

Department of Environmental Health Sciences, Soonchunhyang University, Asan 31538, Korea
Academic Editor: Paul B. Tchounwou
Received: 4 September 2016 / Revised: 10 November 2016 / Accepted: 14 November 2016 / Published: 14 December 2016
(This article belongs to the Section Global Health)
View Full-Text   |   Download PDF [452 KB, uploaded 14 December 2016]   |  

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 × 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). View Full-Text
Keywords: cutoff value; cotinine; smoking status; biomarker cutoff value; cotinine; smoking status; biomarker
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Kim, S. Overview of Cotinine Cutoff Values for Smoking Status Classification. Int. J. Environ. Res. Public Health 2016, 13, 1236.

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