1. Changes in the salivary cotinine cut-offs to discriminate smokers and non-smokers before and after Spanish smoke-free legislation.
- Author
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Pérez-Martín H, Lidón-Moyano C, González-Marrón A, Fu M, Pérez-Ortuño R, Ballbè M, Martín-Sánchez JC, Pascual JA, Fernández E, and Martínez-Sánchez JM
- Subjects
- Adult, Cross-Sectional Studies, Female, Humans, Longitudinal Studies, Male, Non-Smokers, Saliva, Cotinine analysis, Tobacco Smoke Pollution analysis
- 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., (Copyright © 2022 Elsevier Ltd. All rights reserved.)
- Published
- 2022
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