Stages of change, smoking characteristics, and cotinine concentrations in smokers: Setting priorities for smoking cessation

Objective: We assessed whether the salivary cotinine content of daily smokers varied with the readiness to quit and smoking characteristics. Methods: This cross-sectional study was conducted in Barcelona, Spain (n= 1245) in 2004-2005. We administered a questionnaire to assess smoking behaviour and collected saliva to determine the cotinine content. We determined the distribution of 278 adult daily smokers across different stages of change and categorised them by individual and smoking characteristics. We used medians and interquartile ranges (IQR) to relate cotinine concentrations to different stages of change, tobacco consumption, and nicotine dependence based on the Fagerström Test for Nicotine Dependence (FTND). Results: Around 68%, 22%, and 11% of smokers were in precontemplation, contemplation, and preparation stages, respectively. A mean of 17.0 cigarettes was smoked daily, with no differences among stages of change. The median cotinine concentration was 151.3. ng/ml (IQR: 83.2-227.8. ng/ml), with no differences among stages of change. The cigarette consumption scores, FTND, and time to first cigarette of the day were positively associated with cotinine concentration. Conclusions: The cotinine concentration was similar among the stages of change, but varied within each stage according to the number of cigarettes smoked, time to first cigarette of the day, and nicotine dependence.