Annals of Health Law
STRATEGY AGAINST SMOKING
off concentration of fifteen ng/mL201 might already be reached within
In comparing the different biomarkers, nicotine203 and carbon
monoxide204 cannot provide an accurate detection of the smoking status due
to their limited half-life. The only way to guarantee an acceptable detection
rate would be daily testing which is inefficient and hardly feasible.
Thiocyanate has the longest half-life205 but lacks the required accuracy
because it does not allow a reliable distinction between light and non-smokers.206 Anabasine and anatabine ensure a comparably precise and
accurate verification of the smoking status207 but testing is very expensive208
Cotinine complies best with the above-mentioned criteria, as it combines a
comparably lengthy half-life with cheap assays and reasonable accuracy
and precision.209 Naturally, there is still room for improvement for the
There are several methods to quantify cotinine varying with regard to
time, accuracy, precision and cost.211 The most feasible and most
common212 option is a urinary cotinine test. The most promising diagnostic
product seems to be the so-called cotinine immunoassay strip.213 In contrast
to blood testing it is non-invasive and easy to perform. Further, it is
cheaper and more accurate than testing saliva, which can be influenced by
consuming sugar or wax214 and is harder to measure.215
The remaining difficulties are the short time period of detection and the
inability to differentiate between smoking, smoking substitutes, nicotine-
201. See, e.g., SRNT, supra note181, at 151.
202. Cf. SRNT, supra note 181, at 152.
203. See Gilbert, supra note 179, at 298; Luty, supra note 183, at 43.
204. SRNT, supra note 181, at 150-52; Jatlow, supra note 186, at 203.
205. Schulz et al., supra note 193, at 247.
206. Foss & Lund-Larsen, supra note 194, passim; Gilbert, supra note 179, at 302.
207. Peyton Jacob III et al., supra note 189, at 733; Peyton Jacob III et al., supra note
188, at 1671-72.
208. SRNT, supra note 181, at 150.
209. But see Jeffrey R. Idle, Titrating Exposure to Tobacco Smoke Using Cotinine – A
Minefield of Misunderstandings, 43 J. CLIN. EPIDEMIOL. 313 passim (1990).
210. See Yeh et al., supra note 196, passim.
211. See SRNT, supra note 181, at 150; Yeh et al., supra note 196, at 1045.
212. Benowitz, supra note 195, passim; Gilbert, supra note 179, at 298.
213. See, e.g., John T. Bernert et al., Use of Cotinine Immunoassay Test Strips for
Preclassifying Urine Samples from Smokers and Nonsmokers Prior to Analysis by LC-MS-MS, 29 J. ANALYTICAL TOXICOLOGY 814 passim (2005); Yeh et al., supra note 196, passim.
214. See Nina G. Schneider et al., Saliva Cotinine Levels as a Function of Collection
Method, 92 ADDICTION 347 passim (1997).