RESEARCH PAPER
Low cigarette smoking prevalence in peri-urban Peru: results from a population-based study of tobacco use by self-report and urine cotinine
| 1 | Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, USA |
| 2 | Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA |
| 3 | Biomedical Research Unit, A.B. PRISMA, San Miguel, Peru |
| 4 | Program in Global Disease Epidemiology and Control, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA |
| 5 | CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru |
| 6 | Department of Biostatistics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, USA |
| 7 | Center for Pharmacogenomics and Translational Research, Nemours Children Clinic, Jacksonville, USA |
CORRESPONDING AUTHOR
William Checkley
Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, 1830 E. Monument St, Baltimore, Maryland 21205, USA
Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, 1830 E. Monument St, Baltimore, Maryland 21205, USA
Submission date: 2017-01-04
Acceptance date: 2017-07-12
Publication date: 2017-07-21
Tob. Induc. Dis. 2017;15(July):32
KEYWORDS
ABSTRACT
Background:
A recent study found lower self-reported prevalence of tobacco smoking in a peri-urban area of Lima, Peru than previously reported in urban samples. These regions encompass substantial proportions of Peru’s population – ones at greater risk of disease due to reduced healthcare access – but have been less often studied. We validate low smoking prevalence with urine cotinine and characterize chronic disease and lung function outcomes between non-, occasional, and daily smokers.
Methods:
Data are from the CRONICAS Cohort Study, a population-based longitudinal study in four low-resource Peruvian settings, which began in 2010. Of a baseline cohort of 2978 adults, we prospectively followed 2583 (87%) to determine prevalence of chronic illness.
Results:
In a baseline sub-sample of 382 participants, median adjusted cotinine was 0.0 mcg/mg (IQR 0–0) for both self-reported non-smokers and occasional smokers compared to 172.3 mcg/mg (IQR 0–709.2) for daily smokers. Creatinine-adjusted cotinine validated daily smoking prevalence of 4.7% at a cutoff of 100 mcg/mg. Kappa statistic for daily smoking and creatinine- adjusted cotinine ≥100 mcg/mg was 0.65 (95% CI 0.47, 0.83), indicating substantial agreement. At baseline, we found 3.3% daily and 8.9% occasional smoking by self-report for the full cohort. Follow-up indicated little difference in chronic disease prevalence between groups. Daily smokers trended toward having a greater decline in FVC (−1%; 95% CI -2.9, 0.8) and FEV1 (−1.3%; 95% CI -3.2, 0.6) over 40 months when compared to non-smokers, whereas the decline in lung function for occasional smokers was similar compared to non-smokers (−0.2% FVC; 95% CI -1.5, 1.0) and (0% FEV1; 95% CI -1.3, 1.3).
Conclusions:
Our data places Peru within a previously-described pattern of smoking found in much of Latin America, favoring occasional over daily smoking and low cigarette consumption. We determine that there are not significant differences between smoking groups concerning chronic disease outcomes. We favor distinguishing between daily and occasional smokers in order to accurately characterize these low-use populations.
A recent study found lower self-reported prevalence of tobacco smoking in a peri-urban area of Lima, Peru than previously reported in urban samples. These regions encompass substantial proportions of Peru’s population – ones at greater risk of disease due to reduced healthcare access – but have been less often studied. We validate low smoking prevalence with urine cotinine and characterize chronic disease and lung function outcomes between non-, occasional, and daily smokers.
Methods:
Data are from the CRONICAS Cohort Study, a population-based longitudinal study in four low-resource Peruvian settings, which began in 2010. Of a baseline cohort of 2978 adults, we prospectively followed 2583 (87%) to determine prevalence of chronic illness.
Results:
In a baseline sub-sample of 382 participants, median adjusted cotinine was 0.0 mcg/mg (IQR 0–0) for both self-reported non-smokers and occasional smokers compared to 172.3 mcg/mg (IQR 0–709.2) for daily smokers. Creatinine-adjusted cotinine validated daily smoking prevalence of 4.7% at a cutoff of 100 mcg/mg. Kappa statistic for daily smoking and creatinine- adjusted cotinine ≥100 mcg/mg was 0.65 (95% CI 0.47, 0.83), indicating substantial agreement. At baseline, we found 3.3% daily and 8.9% occasional smoking by self-report for the full cohort. Follow-up indicated little difference in chronic disease prevalence between groups. Daily smokers trended toward having a greater decline in FVC (−1%; 95% CI -2.9, 0.8) and FEV1 (−1.3%; 95% CI -3.2, 0.6) over 40 months when compared to non-smokers, whereas the decline in lung function for occasional smokers was similar compared to non-smokers (−0.2% FVC; 95% CI -1.5, 1.0) and (0% FEV1; 95% CI -1.3, 1.3).
Conclusions:
Our data places Peru within a previously-described pattern of smoking found in much of Latin America, favoring occasional over daily smoking and low cigarette consumption. We determine that there are not significant differences between smoking groups concerning chronic disease outcomes. We favor distinguishing between daily and occasional smokers in order to accurately characterize these low-use populations.
REFERENCES (51)
1.
World Health Organization. WHO report on the global tobacco epidemic, 2011: warning about the dangers of tobacco. In Geneva: World Health Organization; 2011.
2.
Yach D, Hawkes C, Gould CL, Hofman KJ. The global burden of chronic diseases: overcoming impediments to prevention and control. JAMA. 2004;291(21):2616–22.
3.
Champagne BM, Sebrie EM, Schargrodsky H, Pramparo P, Boissonnet C, Wilson E. Tobacco smoking in seven Latin American cities: the CARMELA study. Tob Control. 2010;19(6):457–62.
4.
Castro de la Mata R, Zavaleta Martinez-Vargas A. Epidemiología de drogas en la población urbana peruana 2005: encuesta de hogares. In: Lima, Centro de Información y Educación para la Prevención del Abuso de Drogas, 2006.
5.
Weygandt PL, Vidal-Cardenas E, Gilman RH, Avila-Tang E, Cabrera L, Checkley W. Epidemiology of tobacco use and dependence in adults in a poor peri-urban community in lima, Peru. BMC Pulm Med. 2012;12:9.
6.
Abrams DB, Follick MJ, Biener L, Carey KB, Hitti J. Saliva cotinine as a measure of smoking status in field settings. Am J Public Health. 1987;77(7):846–8.
7.
Vartiainen E, Seppala T, Lillsunde P, Puska P. Validation of self reported smoking by serum cotinine measurement in a community-based study. J Epidemiol Community Health. 2002;56(3):167–70.
8.
Haley NJ, Axelrad CM, Tilton KA. Validation of self-reported smoking behavior: biochemical analyses of cotinine and thiocyanate. Am J Public Health. 1983;73(10):1204–7.
9.
Benowitz NL, Perez-Stable EJ, Herrera B, Jacob P 3rd. Slower metabolism and reduced intake of nicotine from cigarette smoking in Chinese-Americans. J Natl Cancer Inst. 2002;94(2):108–15.
10.
Campuzano JC, Hernandez-Avila M, Jaakkola MS, Lazcano Ponce E, Kuri Morales P, Bautista P, Benowitz NL, Ceraso M, Blackford A, Samet JM. Determinants of salivary cotinine levels among current smokers in Mexico. Nicotine Tob Res. 2004;6(6):997–1008.
11.
Blackford AL, Yang G, Hernandez-Avila M, Przewozniak K, Zatonski W, Figueiredo V, Avila-Tang E, Ma J, Benowitz NL, Samet JM. Cotinine concentration in smokers from different countries: relationship with amount smoked and cigarette type. Cancer Epidemiol Biomark Prev. 2006;15(10):1799–804.
12.
Wagenknecht LE, Cutter GR, Haley NJ, Sidney S, Manolio TA, Hughes GH, Jacobs DR. Racial differences in serum cotinine levels among smokers in the coronary artery risk development in (young) adults study. Am J Public Health. 1990;80(9):1053–6.
13.
Jarvis MJ, Russell MA, Benowitz NL, Feyerabend C. Elimination of cotinine from body fluids: implications for noninvasive measurement of tobacco smoke exposure. Am J Public Health. 1988;78(6):696–8.
14.
Perez-Stable EJ, Herrera B, Jacob P 3rd, Benowitz NL. Nicotine metabolism and intake in black and white smokers. JAMA. 1998;280(2):152–6.
15.
Benowitz NL, Zevin S, Jacob P 3rd. Sources of variability in nicotine and cotinine levels with use of nicotine nasal spray, transdermal nicotine, and cigarette smoking. Br J Clin Pharmacol. 1997;43(3):259–67.
16.
Sepkovic DW, Haley NJ. Biomedical applications of cotinine quantitation in smoking related research. Am J Public Health. 1985;75(6):663–5.
17.
Benowitz NL. The use of biologic fluid samples in assessing tobacco smoke consumption. NIDA Res Monogr. 1983;48:6–26.
18.
Benowitz NL, Kuyt F, Jacob P 3rd, Jones RT, Osman AL. Cotinine disposition and effects. Clin Pharmacol Ther. 1983;34(5):604–11.
19.
Willers S, Skarping G, Dalene M, Skerfving S. Urinary cotinine in children and adults during and after semiexperimental exposure to environmental tobacco smoke. Arch Environ Health. 1995;50(2):130–8.
20.
Haufroid V, Lison D. Urinary cotinine as a tobacco-smoke exposure index: a minireview. Int Arch Occup Environ Health. 1998;71(3):162–8.
21.
Ahijevych KL, Tyndale RF, Dhatt RK, Weed HG, Browning KK. Factors influencing cotinine half-life during smoking abstinence in African American and Caucasian women. Nicotine Tob Res. 2002;4(4):423–31.
22.
Kyerematen GA, Damiano MD, Dvorchik BH, Vesell ES. Smoking-induced changes in nicotine disposition: application of a new HPLC assay for nicotine and its metabolites. Clin Pharmacol Ther. 1982;32(6):769–80.
23.
Miranda JJ, Bernabe-Ortiz A, Smeeth L, Gilman RH, Checkley W, Group CCS. Addressing geographical variation in the progression of non-communicable diseases in Peru: the CRONICAS cohort study protocol. BMJ Open. 2012;2(1):e000610.
24.
Miranda JJ, Gilman RH, Smeeth L. Differences in cardiovascular risk factors in rural, urban and rural-to-urban migrants in Peru. Heart. 2011;97(10):787–96.
25.
World Health Organization. WHO STEPwise approach to surveillance (STEPS). STEPS manual. In Geneva: World Health Organization, 2017.
26.
Palipudi KM, Morton J, Hsia J, Andes L, Asma S, Talley B, Caixeta RD, Fouad H, Khoury RN, Ramanandraibe N, et al. Methodology of the global adult tobacco survey -- 2008-2010. Glob Health Promot. 2013;23(2):3–23.
27.
Cusumano AM, Gonzalez Bedat MC, Garcia-Garcia G, Maury Fernandez S, Lugon JR, Poblete Badal H, Elgueta Miranda S, Gomez R, Cerdas Calderon M, Almaguer Lopez M, et al. Latin American dialysis and renal transplant registry: 2008 report (data 2006). Clin Nephrol. 2010;74(Suppl 1):S3–8.
28.
James H, Tizabi Y, Taylor R. Rapid method for the simultaneous measurement of nicotine and cotinine in urine and serum by gas chromatography-mass spectrometry. J Chromatogr B Biomed Sci Appl. 1998;708(1–2):87–93.
29.
Chilmonczyk BA, Knight GJ, Palomaki GE, Pulkkinen AJ, Williams J, Haddow JE. Environmental tobacco smoke exposure during infancy. Am J Public Health. 1990;80(10):1205–8.
30.
Chilmonczyk BA, Salmun LM, Megathlin KN, Neveux LM, Palomaki GE, Knight GJ, Pulkkinen AJ, Haddow JE. Association between exposure to environmental tobacco smoke and exacerbations of asthma in children. N Engl J Med. 1993;328(23):1665–9.
31.
Etzel RA. A review of the use of saliva cotinine as a marker of tobacco smoke exposure. Prev Med. 1990;19(2):190–7.
32.
Jung S, Lee IS, Kim SB, Moon CS, Jung JY, Kang YA, Park MS, Kim YS, Kim SK, Chang J, et al. Urine Cotinine for assessing tobacco smoke exposure in Korean: analysis of the Korea National Health and nutrition examination survey (KNHANES). Tuberc Respir Dis (Seoul). 2012;73(4):210–8.
33.
Fried PA, Perkins SL, Watkinson B, McCartney JS. Association between creatinine-adjusted and unadjusted urine cotinine values in children and the mother's report of exposure to environmental tobacco smoke. Clin Biochem. 1995;28(4):415–20.
34.
Expert Committee on the D, Classification of Diabetes M. Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care. 2003;26(Suppl 1):S5–20.
35.
Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, Jones DW, Materson BJ, Oparil S, Wright JT Jr, et al. The seventh report of the joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. JAMA. 2003;289(19):2560–72.
36.
Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28(7):412–9.
37.
National Cholesterol Education Program Expert Panel on Detection E, Treatment of High Blood Cholesterol in A. Third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III) final report. Circulation. 2002;106(25):3143–421.
38.
Howe LD, Galobardes B, Matijasevich A, Gordon D, Johnston D, Onwujekwe O, Patel R, Webb EA, Lawlor DA, Hargreaves JR. Measuring socio-economic position for epidemiological studies in low- and middle-income countries: a methods of measurement in epidemiology paper. Int J Epidemiol. 2012;41(3):871–86.
39.
Fleiss JL. Measuring nominal scale agreement among many raters. Psychol Bull. 1971;76(5):378–82.
40.
GATS: Global Adult Tobacco Survey, Fact Sheet, Mexico, 2009. [http://global.tobaccofreekids....]. Last accessed: 15 July 2017.
41.
GATS: Global Adult Tobacco Survey, Fact Sheet, Costa Rica, 2015. [http://www.who.int/tobacco/sur...]. Last accessed: 15 July 2017.
42.
GATS: Global Adult Tobacco Survey, Fact Sheet, Panama, 2013. [http://www.who.int/tobacco/sur...]. Last accessed: 15 July 2017.
43.
Tapia-Conyer R, Kuri-Morales P, Hoy-Gutierrez MJ. Epidemiologic overview of smoking in Mexico. Salud Publica Mex. 2001;43(5):478–84.
44.
Samet JM, Schrag SD, Howard CA, Key CR, Pathak DR. Respiratory disease in a New Mexico population sample of Hispanic and non-Hispanic whites. Am Rev Respir Dis. 1982;125(2):152–7.
45.
Menezes AM, Lopez MV, Hallal PC, Muino A, Perez-Padilla R, Jardim JR, Valdivia G, Pertuze J, de Oca MM, Talamo C, et al. Prevalence of smoking and incidence of initiation in the Latin American adult population: the PLATINO study. BMC Public Health. 2009;9:151.
47.
GATS: Global Adult Tobacco Survey, Fact Sheet, Uruguay, 2009.[http://www.who.int/tobacco/sur...]. Last accessed: 15 July 2017.
48.
Detterbeck FC, Mazzone PJ, Naidich DP, Bach PB. Screening for lung cancer: diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2013;143(5 Suppl):e78S–92S.
49.
Smith RA, Manassaram-Baptiste D, Brooks D, Doroshenk M, Fedewa S, Saslow D, Brawley OW, Wender R. Cancer screening in the United States, 2015: a review of current American cancer society guidelines and current issues in cancer screening. CA Cancer J Clin. 2015;65(1):30–54.
50.
Bach PB, Mirkin JN, Oliver TK, Azzoli CG, Berry DA, Brawley OW, Byers T, Colditz GA, Gould MK, Jett JR, et al. Benefits and harms of CT screening for lung cancer: a systematic review. JAMA. 2012;307(22):2418–29.
51.
Jaklitsch MT, Jacobson FL, Austin JH, Field JK, Jett JR, Keshavjee S, MacMahon H, Mulshine JL, Munden RF, Salgia R, et al. The American Association for Thoracic Surgery guidelines for lung cancer screening using low-dose computed tomography scans for lung cancer survivors and other high-risk groups. J Thorac Cardiovasc Surg. 2012;144(1):33–8.
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