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Nicotine dependence and biochemical exposure measures in the second trimester of pregnancy

Kwok, T'ng Chang; Taggar, Jaspal; Cooper, Sue; Lewis, Sarah; Coleman, Tim

Authors

T'ng Chang Kwok

Dr JASPAL TAGGAR Jaspal.Taggar@nottingham.ac.uk
Clinical Associate Professor and Headof Primary Care Undergraduate Education

TIM COLEMAN tim.coleman@nottingham.ac.uk
Professor of Primary Care



Abstract

Introduction: The Heaviness of Smoking Index (HSI) is validated to measure nicotine dependence in nonpregnant smokers,
and in these smokers, mean salivary and serum cotinine levels are related by a ratio of 1.25. However, as nicotine metabolism
increases during gestation, these findings may differ in pregnancy. We investigated the validity of HSI in pregnancy by comparing
this with 3 biochemical measures; and in a search for a less-invasive cotinine measure in pregnancy, we also explored the
relationship between mean blood and salivary cotinine levels.
Methods: Cross-sectional analyses using baseline data from the Smoking, Nicotine, and Pregnancy Trial. Participants were
16–46 years old, 12–24 weeks gestation, smoked more than 5 cigarettes per day and had exhaled carbon monoxide (CO) readings
of at least 8 ppm. Linear regression was used to examine correlations between HSI and blood cotinine, and salivary cotinine
and exhaled CO. Correlation between blood and salivary cotinine was investigated using linear regression through the origin.
Results: HSI scores were associated with blood cotinine (R2 = 0.20, n = 662, p < .001), salivary cotinine (R2 = 0.11, n = 967,
p < .001), and exhaled CO (R2 = 0.13, n = 1,050, p < .001). Salivary and blood cotinine levels, taken simultaneously, were highly
correlated (R2 = 0.91, n = 628, p < .001) and the saliva:blood level ratio was 1.01 (95% CI 0.99–1.04).
Conclusions: Correlations between HSI and biochemical measures in pregnancy were comparable with those obtained outside
pregnancy, suggesting that HSI has similar validity in pregnant smokers. Salivary and blood cotinine levels are roughly equivalent
in pregnant smokers.

Journal Article Type Article
Publication Date Apr 1, 2014
Journal Nicotine & Tobacco Research
Electronic ISSN 1462-2203
Publisher Oxford University Press
Peer Reviewed Peer Reviewed
Volume 16
Issue 2
APA6 Citation Kwok, T. C., Taggar, J., Cooper, S., Lewis, S., & Coleman, T. (2014). Nicotine dependence and biochemical exposure measures in the second trimester of pregnancy. Nicotine and Tobacco Research, 16(2), doi:10.1093/ntr/ntt127
DOI https://doi.org/10.1093/ntr/ntt127
Publisher URL http://ntr.oxfordjournals.org/content/16/2/145.abstract
Copyright Statement Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0

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Copyright Statement
Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0





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