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PLASMA NICOTINE/COTININE LEVELS AS BIOMARKER OF ACTIVE SMOKING IN PATIENTS WITH PSYCHIATRIC DISORDERS

ANA-MARIA VLĂSCEANU 1#, VIORELA G. NIȚESCU 2#, ANNE-MARIE CIOBANU 1*, MIRIANA STAN 1, ADRIAN COSMIN ROȘCA 3, CARMEN L. CHIȚESCU 4, ARISTEIDES M. TSATSAKIS 5, DANIELA L. BACONI 1

1“Carol Davila” University of Medicine and Pharmacy, Faculty of Pharmacy, Bucharest, Romania
2“Grigore Alexandrescu” Emergency Clinical Hospital for Children, Pediatric Clinic 2, Ward ATI -Toxicology, Bucharest, Romania
3“Ovidius” University of Constanța, Department of Drug Analysis, Biopharmacy and Biological Medicines,Constanța, Romania
4“Dunărea de Jos” University of Galați, Faculty of Medicine and Pharmacy, Galaţi, Romania
5University of Crete, Faculty of Medicine, Department of Forensic Sciences and Toxicology, Heraklion, Greece

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Cotinine, the main metabolite of nicotine, is commonly used as a biomarker to assess direct exposure to tobacco smoke. In addition, cotinine can be used as a measurement tool for passive smoking. Regarding patients with various pathologies, including those with psychiatric conditions, an objective evaluation of the smoking habit is necessary, based on the determination of cotinine levels in biological samples, not on estimated self-reports of consumption. In the present study, we aimed to quantify the levels of nicotine and cotinine in plasma in a group of patients with psychiatric disorders, both active and passive smokers. The average level of cotinine in non-smokers patients, was significantly lower compared to smokers patients (p < 0.001), indicating moderate passive exposure to tobacco smoke in this case. The plasma concentration of nicotine in active smoking patients was significantly lower than that of cotinine, with the nicotine/cotinine ratio having subunit values (p < 0.001). The concentration of cotinine presented a statistically significant correlation with the nicotine addiction score evaluated by the Fagerström test. This result suggests that the physicians involved in treatment programs in psychiatric patients should implement the cotinine measurements and not rely solely on self-reported smoking status.