Kim Sun S, Kim Seongho, Gona Philimon N
Department of Nursing, University of Massachusetts Boston, USA.
Department of Social Welfare, Korean Bible University, Republic of Korea.
J Smok Cessat. 2021 Feb 15;2021:6678237. doi: 10.1155/2021/6678237. eCollection 2021.
It is critical to accurately identify individuals who continue to smoke even after treatment, as this may prompt the use of more intensive and effective treatment strategies to help them attain complete abstinence.
This study examined optimal cutoffs for exhaled carbon monoxide (CO) and salivary cotinine to identify smokers among Korean Americans in a smoking cessation clinical trial.
CO and cotinine were measured three to four times over 12 months from the quit day. Statistical analysis was conducted using Receiver Operating Characteristic (ROC) curves.
A CO cutoff of 5 parts per million provided robust sensitivity (80.8-98.3%) and perfect specificity (100%), and a salivary cotinine cutoff of level 2 (30-100 ng/ml) provided the best sensitivity (91.2-95.6%) and perfect specificity (100%). Using these cutoffs, the agreement between self-reports and the two biomarkers ranged from 88.6% to 97.7%. The areas under ROC curves (AUCs) of exhaled CO ranged from 0.90 to 0.99, all of which were significant (all values < 0.001), and the AUCs of salivary cotinine ranged from 0.96 to 0.98 (all values < 0.001).
Exhaled CO and salivary cotinine are complementary, and they should be used together to verify smoking abstinence for smokers in a clinical trial.
准确识别即使在接受治疗后仍继续吸烟的个体至关重要，因为这可能促使采用更强化和有效的治疗策略来帮助他们实现完全戒烟。
本研究在一项戒烟临床试验中，探讨了呼出一氧化碳（CO）和唾液可替宁的最佳临界值，以识别韩裔美国人中的吸烟者。
从戒烟日起的12个月内，对CO和可替宁进行三到四次测量。使用受试者工作特征（ROC）曲线进行统计分析。
CO临界值为百万分之5时，具有较高的灵敏度（80.8 - 98.3%）和完美的特异度（100%）；唾液可替宁临界值为2级（30 - 100 ng/ml）时，具有最佳的灵敏度（91.2 - 95.6%）和完美的特异度（100%）。使用这些临界值，自我报告与两种生物标志物之间的一致性范围为88.6%至97.7%。呼出CO的ROC曲线下面积（AUC）范围为0.90至0.99，均具有显著性（所有P值<0.001）；唾液可替宁的AUC范围为0.96至0.98（所有P值<0.001）。
呼出CO和唾液可替宁具有互补性，在临床试验中应将它们一起用于验证吸烟者是否戒烟。
