Biomarkers of tobacco smoke exposure and asthma severity in adults

Gwendolyn Ho, Hao Tang, John A Robbins, Elisa Tong

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background Tobacco biomarkers including serum cotinine and urinary 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) have been used in research settings. Purpose The goal of the study was to examine the association of cotinine and NNAL with asthma outcomes in the U.S. adult population. Methods A cross-sectional design was used, using data from the National Health and Nutrition Examination Survey, 2007-2008, with participants aged >20 years with self-reported asthma (N=456). Past-year asthma exacerbations and emergency room/urgent care visits for asthma were examined. Analyses were conducted in 2013. Results Among adult asthmatics, 50.3% reported a past-year asthma attack (61.8% smokers, 46.6% nonsmokers, p=0.029). Among these, 24.7% reported a past-year emergency/urgent visit for asthma (34.7% smokers, 20.1% nonsmokers, p=0.034). Median concentrations of cotinine and creatinine-adjusted NNAL (NNAL/Cr) were significantly higher in those with a past-year asthma attack (0.43 ng/mL and 7.28 pg/mL) than in those without (0.06 ng/mL and 2.26 pg/mL), and highest in those with past-year emergency/urgent visits (0.93 ng/mL and 28.14 pg/mL). Among nonsmokers, increasing levels of log cotinine or log NNAL/Cr, adjusted for demographics, were significantly associated with past-year asthma exacerbation (log cotinine OR=1.46 [95% CI=1.1, 1.92]; log NNAL/Cr OR=1.42 [95% CI=1.07, 1.88]) and past-year emergency/urgent visit (log cotinine OR=1.95 [95% CI=1.32, 2.88]; log NNAL/Cr OR=1.58 [95% CI=1.23, 2.02]). Among smokers, increasing biomarker levels were not significantly associated with either outcome. Conclusions In a population-based cross-sectional analysis, increased cotinine and NNAL were found to be associated with asthma exacerbation and healthcare use in nonsmokers with asthma. If these findings are confirmed in prospective studies, these biomarkers might be candidates for clinical indicators of risk of asthma.

Original languageEnglish (US)
Pages (from-to)703-709
Number of pages7
JournalAmerican Journal of Preventive Medicine
Volume45
Issue number6
DOIs
StatePublished - Dec 2013

Fingerprint

Smoke
Tobacco
Cotinine
Asthma
Biomarkers
Emergencies
Nutrition Surveys
Ambulatory Care
Population
Hospital Emergency Service
Creatinine
Cross-Sectional Studies
Demography
Prospective Studies
Delivery of Health Care

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Epidemiology

Cite this

Biomarkers of tobacco smoke exposure and asthma severity in adults. / Ho, Gwendolyn; Tang, Hao; Robbins, John A; Tong, Elisa.

In: American Journal of Preventive Medicine, Vol. 45, No. 6, 12.2013, p. 703-709.

Research output: Contribution to journalArticle

@article{19ca151ea6c14cafa72732dc582fb94a,
title = "Biomarkers of tobacco smoke exposure and asthma severity in adults",
abstract = "Background Tobacco biomarkers including serum cotinine and urinary 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) have been used in research settings. Purpose The goal of the study was to examine the association of cotinine and NNAL with asthma outcomes in the U.S. adult population. Methods A cross-sectional design was used, using data from the National Health and Nutrition Examination Survey, 2007-2008, with participants aged >20 years with self-reported asthma (N=456). Past-year asthma exacerbations and emergency room/urgent care visits for asthma were examined. Analyses were conducted in 2013. Results Among adult asthmatics, 50.3{\%} reported a past-year asthma attack (61.8{\%} smokers, 46.6{\%} nonsmokers, p=0.029). Among these, 24.7{\%} reported a past-year emergency/urgent visit for asthma (34.7{\%} smokers, 20.1{\%} nonsmokers, p=0.034). Median concentrations of cotinine and creatinine-adjusted NNAL (NNAL/Cr) were significantly higher in those with a past-year asthma attack (0.43 ng/mL and 7.28 pg/mL) than in those without (0.06 ng/mL and 2.26 pg/mL), and highest in those with past-year emergency/urgent visits (0.93 ng/mL and 28.14 pg/mL). Among nonsmokers, increasing levels of log cotinine or log NNAL/Cr, adjusted for demographics, were significantly associated with past-year asthma exacerbation (log cotinine OR=1.46 [95{\%} CI=1.1, 1.92]; log NNAL/Cr OR=1.42 [95{\%} CI=1.07, 1.88]) and past-year emergency/urgent visit (log cotinine OR=1.95 [95{\%} CI=1.32, 2.88]; log NNAL/Cr OR=1.58 [95{\%} CI=1.23, 2.02]). Among smokers, increasing biomarker levels were not significantly associated with either outcome. Conclusions In a population-based cross-sectional analysis, increased cotinine and NNAL were found to be associated with asthma exacerbation and healthcare use in nonsmokers with asthma. If these findings are confirmed in prospective studies, these biomarkers might be candidates for clinical indicators of risk of asthma.",
author = "Gwendolyn Ho and Hao Tang and Robbins, {John A} and Elisa Tong",
year = "2013",
month = "12",
doi = "10.1016/j.amepre.2013.09.002",
language = "English (US)",
volume = "45",
pages = "703--709",
journal = "American Journal of Preventive Medicine",
issn = "0749-3797",
publisher = "Elsevier Inc.",
number = "6",

}

TY - JOUR

T1 - Biomarkers of tobacco smoke exposure and asthma severity in adults

AU - Ho, Gwendolyn

AU - Tang, Hao

AU - Robbins, John A

AU - Tong, Elisa

PY - 2013/12

Y1 - 2013/12

N2 - Background Tobacco biomarkers including serum cotinine and urinary 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) have been used in research settings. Purpose The goal of the study was to examine the association of cotinine and NNAL with asthma outcomes in the U.S. adult population. Methods A cross-sectional design was used, using data from the National Health and Nutrition Examination Survey, 2007-2008, with participants aged >20 years with self-reported asthma (N=456). Past-year asthma exacerbations and emergency room/urgent care visits for asthma were examined. Analyses were conducted in 2013. Results Among adult asthmatics, 50.3% reported a past-year asthma attack (61.8% smokers, 46.6% nonsmokers, p=0.029). Among these, 24.7% reported a past-year emergency/urgent visit for asthma (34.7% smokers, 20.1% nonsmokers, p=0.034). Median concentrations of cotinine and creatinine-adjusted NNAL (NNAL/Cr) were significantly higher in those with a past-year asthma attack (0.43 ng/mL and 7.28 pg/mL) than in those without (0.06 ng/mL and 2.26 pg/mL), and highest in those with past-year emergency/urgent visits (0.93 ng/mL and 28.14 pg/mL). Among nonsmokers, increasing levels of log cotinine or log NNAL/Cr, adjusted for demographics, were significantly associated with past-year asthma exacerbation (log cotinine OR=1.46 [95% CI=1.1, 1.92]; log NNAL/Cr OR=1.42 [95% CI=1.07, 1.88]) and past-year emergency/urgent visit (log cotinine OR=1.95 [95% CI=1.32, 2.88]; log NNAL/Cr OR=1.58 [95% CI=1.23, 2.02]). Among smokers, increasing biomarker levels were not significantly associated with either outcome. Conclusions In a population-based cross-sectional analysis, increased cotinine and NNAL were found to be associated with asthma exacerbation and healthcare use in nonsmokers with asthma. If these findings are confirmed in prospective studies, these biomarkers might be candidates for clinical indicators of risk of asthma.

AB - Background Tobacco biomarkers including serum cotinine and urinary 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) have been used in research settings. Purpose The goal of the study was to examine the association of cotinine and NNAL with asthma outcomes in the U.S. adult population. Methods A cross-sectional design was used, using data from the National Health and Nutrition Examination Survey, 2007-2008, with participants aged >20 years with self-reported asthma (N=456). Past-year asthma exacerbations and emergency room/urgent care visits for asthma were examined. Analyses were conducted in 2013. Results Among adult asthmatics, 50.3% reported a past-year asthma attack (61.8% smokers, 46.6% nonsmokers, p=0.029). Among these, 24.7% reported a past-year emergency/urgent visit for asthma (34.7% smokers, 20.1% nonsmokers, p=0.034). Median concentrations of cotinine and creatinine-adjusted NNAL (NNAL/Cr) were significantly higher in those with a past-year asthma attack (0.43 ng/mL and 7.28 pg/mL) than in those without (0.06 ng/mL and 2.26 pg/mL), and highest in those with past-year emergency/urgent visits (0.93 ng/mL and 28.14 pg/mL). Among nonsmokers, increasing levels of log cotinine or log NNAL/Cr, adjusted for demographics, were significantly associated with past-year asthma exacerbation (log cotinine OR=1.46 [95% CI=1.1, 1.92]; log NNAL/Cr OR=1.42 [95% CI=1.07, 1.88]) and past-year emergency/urgent visit (log cotinine OR=1.95 [95% CI=1.32, 2.88]; log NNAL/Cr OR=1.58 [95% CI=1.23, 2.02]). Among smokers, increasing biomarker levels were not significantly associated with either outcome. Conclusions In a population-based cross-sectional analysis, increased cotinine and NNAL were found to be associated with asthma exacerbation and healthcare use in nonsmokers with asthma. If these findings are confirmed in prospective studies, these biomarkers might be candidates for clinical indicators of risk of asthma.

UR - http://www.scopus.com/inward/record.url?scp=84887885464&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84887885464&partnerID=8YFLogxK

U2 - 10.1016/j.amepre.2013.09.002

DO - 10.1016/j.amepre.2013.09.002

M3 - Article

C2 - 24237911

AN - SCOPUS:84887885464

VL - 45

SP - 703

EP - 709

JO - American Journal of Preventive Medicine

JF - American Journal of Preventive Medicine

SN - 0749-3797

IS - 6

ER -