Am. J. Respir. Crit. Care Med., Vol 150, No. 5, 11 1994, 1229-1233.
Patterns of cigarette consumption and cotinine levels among African American women smokers
KL Ahijevych and ME Wewers
Ohio State University College of Nursing, Adult Health and Illness Nursing Department, Columbus.
Cigarette smoking intensifies a number of serious health problems,
including lung cancer, hypertension, low birth weight, and infant
mortality, that disproportionately affect black Americans. Cotinine, a
major nicotine metabolite, is one indicator of smoke exposure. It has been
reported that black women have higher mean cotinine levels than white
women. This divergence may be attributed to biologic factors or to
inaccuracy in reporting cigarette use. The purpose of this study was to
characterize nicotine dependence and the relationship between self-
reported cigarette use and cotinine levels among black women smokers. The
sample consisted of 142 black women cigarette smokers recruited
individually at urban health centers and worksites. A cotinine/cigarette
ratio was determined for light, moderate, and heavy smokers. Underreporting
of cigarette consumption, previously defined as cotinine value > 25
ng/ml/cigarette, ranged from 86% among light smokers to 70% among moderate
smokers and 21% among heavy smokers. There were significant differences in
cotinine/cigarette and nicotine dependence scores across levels of smoking.
Average cotinine/cigarette values were higher in black women compared with
previous reports for Mexican American women smokers. No comparable values
are available for white women. Additional study is needed to begin to
explain variations in levels of cotinine, as well as perceived nicotine
dependence among black women.
