Next Article in Journal
Synergising Public Health Concepts with the Sendai Framework for Disaster Risk Reduction: A Conceptual Glossary
Previous Article in Journal
Removal and Biodegradation of Nonylphenol by Four Freshwater Microalgae
Open AccessReview

Overview of Cotinine Cutoff Values for Smoking Status Classification

Department of Environmental Health Sciences, Soonchunhyang University, Asan 31538, Korea
Academic Editor: Paul B. Tchounwou
Int. J. Environ. Res. Public Health 2016, 13(12), 1236;
Received: 4 September 2016 / Revised: 10 November 2016 / Accepted: 14 November 2016 / Published: 14 December 2016
(This article belongs to the Section Global Health)
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
Show Figures

Figure 1

MDPI and ACS Style

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

Show more citation formats Show less citations formats
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

Search more from Scilit
Back to TopTop