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Carbon monoxide monitoring in smoking cessation

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

  • biochemical measures are generally used in smoking cessation studies rather than in routine clinical practice
  • one of the available biochemical measures is exhaled carbon monoxide. Measurements are not specific to cigarettes and half-life is short (3 to 5 hours).
    • levels fall to normal in 24 hours

Exhaled carbon monoxide in nonsmokers and smokers

Exhaled carbon monoxide (ppm)

Exhaled carbon monoxide (ppm)

Nonsmoker

0-6

Light

7-10

Moderate

10-20

Heavy

> 20

Another biochemical marker of smoking is cotinine, the primary metabolite of nicotine, which can be detected in serum, saliva, and urine

  • it has a long half-life (16 hours) and can detect smoking in the preceding 3 to 4 days, but requires laboratory analysis
  • cotinine will generate a false-positive test result in patients using nicotine replacement

Reference:

  • 1.Brunnhuber K et al. Putting evidence into practice: Smoking cessation. BMJ Group (Summer 2007).

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