Changes in the salivary cotinine cut-offs to discriminate smokers and non-smokers before and after Spanish smoke-free legislation

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• dc.contributor.author Pérez-Martín, Hipólito
• dc.contributor.author Lidón-Moyano, Cristina
• dc.contributor.author González-Marrón, Adrián
• dc.contributor.author Fu, Marcela
• dc.contributor.author Pérez Ortuño, Raúl, 1976-
• dc.contributor.author Ballbé, Montse
• dc.contributor.author Martín-Sánchez, Juan Carlos
• dc.contributor.author Pascual Esteban, José A.
• dc.contributor.author Fernández, Esteve
• dc.contributor.author Martínez-Sánchez, Jose M.
• dc.date.accessioned 2023-01-23T07:30:28Z
• dc.date.issued 2022
• dc.description.abstract Introduction: high levels of cotinine in non-smokers indicate passive exposure to tobacco smoke. This study aims to evaluate variations in salivary cotinine cut-offs to discriminate smokers and non-smokers before and after the implementation of smoke-free legislation (Law 28/2005 and Law 42/2010) in a sample of the adult population of Barcelona, Spain. Methods: this longitudinal study analyzes salivary cotinine samples and self-reported information from a representative sample (n = 676) of the adult population from Barcelona before and after the approval of smoke-free legislation. We calculated the receiver operating characteristic (ROC) curves, to obtain optimal cotinine cut-off points to discriminate between smokers and non-smokers overall, by sex and age, and their corresponding sensitivity, specificity, and area under the curve. We used linear mixed-effects models, with individuals as random effects, to model the percentage change of cotinine concentration before and after the implementation of both laws. Results: The mean salivary cotinine concentration was significantly lower post-2010 law (-85.8%, p < 0.001). The ROC curves determined that the optimal cotinine cut-off points for discriminating non-smokers and smokers were 10.8 ng/mL (pre-2005 law) and 5.6 ng/mL (post-2010 law), with a post-2010 law sensitivity of 92.6%, specificity of 98.4%, and an area under the curve of 97.0%. The post-2010 law cotinine cut-off points were 5.6 ng/mL for males and 1.9 ng/mL for females. Conclusion: the implementation of Spanish smoke-free legislation was effective in reducing secondhand smoke exposure and, therefore, also in reducing the cut-off point for salivary cotinine concentration. This value should be used to better assess tobacco smoke exposure in this population.
• dc.format.mimetype application/pdf
• dc.identifier.citation Pérez-Martín H, Lidón-Moyano C, González-Marrón A, Fu M, Pérez-Ortuño R, Ballbè M, et al. Changes in the salivary cotinine cut-offs to discriminate smokers and non-smokers before and after Spanish smoke-free legislation. Cancer Epidemiol. 2022 Oct; 80: 102226. DOI: 10.1016/j.canep.2022.102226.
• dc.identifier.doi http://dx.doi.org/10.1016/j.canep.2022.102226
• dc.identifier.issn 1877-7821
• dc.identifier.uri http://hdl.handle.net/10230/55372
• dc.language.iso eng
• dc.publisher Elsevier
• dc.rights © Elsevier http://dx.doi.org/10.1016/j.canep.2022.102226
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.subject.keyword Biomarker
• dc.subject.keyword Cotinine
• dc.subject.keyword Cutoff value
• dc.subject.keyword Smoking status
• dc.subject.keyword Tobacco
• dc.title Changes in the salivary cotinine cut-offs to discriminate smokers and non-smokers before and after Spanish smoke-free legislation
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/acceptedVersion