Objectives To estimate and compare the salivary cotinine levels using a semiquantitative method, called NicAlert, between three groups: non-smokers, daily smokers of cigarettes and daily smokers of midwakh, and to compare the carbon monoxide (CO) levels among these groups.
Materials and methods A total of 159 adult male volunteers aged 20 and above were included, with 54 current cigarette smokers, 52 current midwakh smokers and 53 non-smokers. Estimate of breath carbon monoxide and salivary cotinine were collected, as well as sociodemographic characteristics and details of smoking habits and second-hand smoke exposure among participants. Institutional review board approval was obtained and data were analysed using SPSS V.21 with the Kruskal-Wallis test used to obtain differences in the distribution.
Results There was no significant difference in the median breath CO and salivary cotinine levels between cigarette and midwakh smokers. Levels of breath CO were significantly higher in cigarette and midwakh smokers as compared with non-smokers (19.5, 17.5 and 6.0, respectively, p<0.05); the same relationship was observed for cotinine levels among cigarette and midwakh smokers as compared with non-smokers (4.0, 3.0 and 0.0, respectively, p≤0.05). Additionally, the values of both salivary cotinine and breath CO increased with the frequency of tobacco use.
Conclusion These are the first data that we are aware of that demonstrate that in terms of at least two key biomarkers of tobacco use, there are comparable levels of exposure between cigarettes and midwakh users, demonstrating a need for intensified attention to the use of midwakh.
- global health
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Contributors RBS: conception of the idea, data collection, design, analysis, drafting of the work. JS: analysis and interpretation, revising draft. SAS: design, data collection, interpretation of results, revising draft. JM: design, data collection, interpretation of results, revising draft. LL: data interpretation, drafting the work. MW: design, revising critically for intellectual content. All authors gave the final approval of the version to be published. All authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Funding This study was funded by New York University Abu Dhabi (grant no. NYUADPHRC-PILOT2014-RSHAIKH35000).
Competing interests None declared.
Patient consent Obtained.
Ethics approval Institutional Ethics and Research Committee, Gulf Medical University, Ajman, United Arab Emirates.
Provenance and peer review Not commissioned; externally peer reviewed.