A Study of Serum Nicotine Levels and Pulmonary Function Tests in Passive Cigarette Smokers

Background: In spite of enforced education and prevention strategies, tobacco use remains a major health risk. Nicotine exposure in passive smokers can engender plasma nicotine concentrations that are equivalent to levels produced by tobacco smoking and associated with neurobiological and behavioral processes associated with tobacco use.Aim of the Study: Measurement of serum nicotine levels and assessment of ventilatory function in passive cigarette smokers.Methods: 60 apparently healthy individuals were included in this study. They were classified into three groups:- Group (1): 30 passive smokers who did not smoke but either lived with a smoker or worked in an office or ward where smoking was allowed for at least one year.- Group (2): 15 active smokers who smoked more than 10 cigarettes per day for at least 10 years.- Group (3): 15 nonsmokers who neither lived with smokers nor worked in an environment where smoking was allowed (never exposed to tobacco smoking). For all subjects analysis for serum nicotine was done using High Performance Liquid Chromatography (HPLC). High performance liquid chromatography is a technique in analytic chemistry used to separate the components in a mixture, to identify each component, and to quantify each component. Also Pulmonary function test was performed for each subject (FVC, FEV1, PEFR, FEF50%, FEF75%) using Geratherm Respiratory GmbH Blue Cherry V1.2.2.1 with a built-in computer.Results: There was highly significant increase of serum nicotine level in smokers (38.041±19.723) than passive smokers (6.57±9.982). The cut-off level between serum nicotine of smokers and passive smokers was 20ng/ml. The serum levels of nicotine in all non-smokers were undetectable (less than 2ng/ml). As regard pulmonary function tests; there was significant and high significant decrease in all measured pulmonary function tests (except FVC) in smokers than non-smokers. And despite the non-significant difference in all measured pulmonary function tests between passive and active smokers, there was significant decrease in FEV1, FEV1/FVC and FEF5o% in passive smokers than non-smokers.Conclusion: Measurement of serum nicotine level can be used to improve self-reporting status in studies of smoking exposure in passive and active smokers and their relation to health. As most of smoker subjects have serum nicotine levels more than 20ng/ml (mean 38.04ng/ml), while most of passive smoker subjects have serum nicotine levels less than 20ng/ml (mean 6.57ng/ml), a serum nicotine level of 20ng/ml can be considered as a cut-off point between smokers and passive smokers. The observed association between environmental tobacco smoke exposure and reduction in pulmonary functions in passive and active asymptomatic smoking subjects emphasizes the importance of preventing exposure of non-smokers to Cigarette Smoke.