Etzel R A
Center for Environmental Health and Injury Control, Centers for Disease Control, Atlanta, Georgia 30333.
Prev Med. 1990 Mar;19(2):190-7. doi: 10.1016/0091-7435(90)90020-k.
Cotinine, the major metabolite of nicotine, is a useful marker of exposure to tobacco smoke. It can be measured in plasma, urine, or saliva. However, distinguishing between active and passive smoking on the basis of a cotinine measurement may be difficult. In order to evaluate the relationship between saliva cotinine concentration and self-reported tobacco smoke exposure in both active and passive smokers, an English-language literature search using MEDLINE was conducted (1973-1989), and the bibliographies of identified articles were reviewed. Of 43 originally identified articles, only 22 met the criteria for inclusion. Specific information regarding population studied, reported tobacco smoke exposure, method of measurement, and cotinine concentrations was assessed. Passive smokers usually have cotinine concentrations in saliva below 5 ng/ml, but heavy passive exposure can result in levels greater than or equal to 10 ng/ml. Levels between 10 and 100 ng/ml may result from infrequent active smoking or regular active smoking with low nicotine intake. Levels greater than 100 ng/ml are probably the result of regular active smoking. Four categorizations of tobacco smoke exposure are suggested on the basis of saliva cotinine concentrations.
可替宁是尼古丁的主要代谢产物，是接触烟草烟雾的一个有用标志物。它可在血浆、尿液或唾液中检测。然而，根据可替宁测量结果区分主动吸烟和被动吸烟可能很困难。为了评估主动吸烟者和被动吸烟者唾液中可替宁浓度与自我报告的烟草烟雾接触之间的关系，利用医学索引数据库（MEDLINE）进行了一次英文文献检索（1973 - 1989年），并查阅了已识别文章的参考文献。在最初识别的43篇文章中，只有22篇符合纳入标准。评估了有关研究人群、报告的烟草烟雾接触情况、测量方法和可替宁浓度的具体信息。被动吸烟者唾液中的可替宁浓度通常低于5纳克/毫升，但重度被动接触可导致浓度大于或等于10纳克/毫升。10至100纳克/毫升之间的浓度可能是偶尔主动吸烟或尼古丁摄入量低的经常主动吸烟所致。大于100纳克/毫升的浓度可能是经常主动吸烟的结果。根据唾液可替宁浓度，建议对烟草烟雾接触进行四种分类。
