Aim: To assess and compare the carbon monoxide (CO) levels in smokers and nonsmokers.
Materials and methods: The CO levels of 200 participants (150 smokers and 50 nonsmokers) who visited the tobacco cessation center (TCC) at the Sibar Institute of Dental Sciences (SIDS), Guntur, Andhra Pradesh, India, were analyzed.
Results: The exhaled CO levels of smokers and nonsmokers were 7.40 ± 5.90 and 1.06 ± 0.71, respectively. A cutoff of 2.5 ppm or above was given with 81% sensitivity and 72% specificity to distinguish smokers from nonsmokers. There was also a significant positive correlation between CO levels and daily cigarette consumption and CO levels and duration of smoking, with r = 0.63, p = 0.0001 and r = 0.272, p = 0.001, respectively.
Conclusion: The purpose of the current study is to educate people regarding the ill effects caused by smoking and emphasize the role of using a breath analyzer to determine one's smoking status by providing visual proof of CO exposure and the necessity of quitting.
Clinical significance: To educate and create awareness among smokers through behavior counseling and CO breath analyzers as well as to enhance the lifestyle by preventing the ill effects of CO on the respiratory system and the environment.
Omare MO, Kibet JK, Cherutoi JK, et al. A review of tobacco abuse and its epidemiological consequences. Z Gesundh Wiss 2022;30(6):1485–1500. DOI: 10.1007/s10389-020-01443-4
Hawkins LH, Cole PV, Harris JR. Smoking habits and blood carbon monoxide levels. Environ Res 1976;11(3):310–318. DOI: 10.1016/0013-9351(76)90092-x
Cox BD, Whichelow MJ. Carbon monoxide levels in the breath of smokers and nonsmokers: effect of domestic heating systems. J Epidemiol Community Health 1985;39(1):75–78. DOI: 10.1136/jech.39.1.75
Gourgoulianis KI, Gogou E, Hamos V, et al. Indoor maternal smoking doubles adolescents’ exhaled carbon monoxide. Acta Paediatr 2002;91(6):712–713. DOI: 10.1080/080352502760069160
Pan KT, Leonardi GS, Ucci M, et al. Can exhaled carbon monoxide be used as a marker of exposure? A cross-sectional study in young adults. Int J Environ Res Public Health 2021;18(22):11893. DOI: 10.3390/ijerph182211893
Maga M, Janik MK, Wachsmann A, et al. Influence of air pollution on exhaled carbon monoxide levels in smokers and non-smokers. A prospective cross-sectional study. Environ Res 2017;152:496–502. DOI: 10.1016/j.envres.2016.09.004
Russell MAH, Cole PV, Brown E. Passive smoking: absorption by non-smokers of carbon monoxide from room-air polluted by tobacco smoke. Postgrad Med J 1973;49(576):688–692. DOI: 10.1136/pgmj.49.576.688
Wald NJ, Idle M, Boreham J, et al. Carbon monoxide in breath in relation to smoking and carboxyhaemoglobin levels. Thorax 1981;36(5):366–369. DOI: 10.1136/thx.36.5.366
Ghorbani R, Blomberg A, Schmidt FM. Impact of breath sampling on exhaled carbon monoxide. J Breath Res 2020;14(4):047105. DOI: 10.1088/1752-7163/abb479
Jarvis MJ, Belcher M, Vesey C, et al. Low cost carbon monoxide monitors in smoking assessment. Thorax 1986;41(11):886–887. DOI: 10.1136/thx.41.11.886
Deveci SE, Deveci F, Açik Y, et al. The measurement of exhaled carbon monoxide in healthy smokers and non-smokers. Respir Med 2004;98(6):551–556. DOI: 10.1016/j.rmed.2003.11.018
Jamrozik K, Vessey M, Fowler G, et al. Controlled trial of three different antismoking interventions in general practice. Br Med J (Clin Res Ed) 1984;288(6429):1499–1503. DOI: 10.1136/bmj.288.6429.1499
Bonita R, Duncan J, Truelsen T, et al. Passive smoking as well as active smoking increases the risk of acute stroke. Tob Control 1999;8(2):156–160. DOI: 10.1136/tc.8.2.156
Yamaya M, Sekizawa K, Ishizuka S, et al. Increased carbon monoxide in exhaled air of subjects with upper respiratory tract infections. Am J Respir Crit Care Med 1998;158(1):311–314. DOI: 10.1164/ajrccm.158.1.9711066
Cropsey KL, Eldridge GD, Weaver MF, et al. Expired carbon monoxide levels in self-reported smokers and nonsmokers in prison. Nicotine Tob Res 2006;8(5):653–659. DOI: 10.1080/14622200600789684
Middleton ET, Morice AH. Breath carbon monoxide as an indication of smoking habit. Chest 2000;117(3):758–763. DOI: 10.1378/chest.117.3.758
Irving JM, Clark EC, Crombie IK, et al. Evaluation of a portable measure of expired-air carbon monoxide. Prev Med 1988;17(1):109–115. DOI: 10.1016/0091-7435(88)90076-x
Ringold A, Goldsmith JR, Helwig HL, et al. Estimating recent carbon monoxide exposures. A rapid method. Arch Environ Health 1962;5:308–318. DOI: 10.1080/00039896.1962.10663288
Cunnington AJ, Hormbrey P. Breath analysis to detect recent exposure to carbon monoxide. Postgrad Med J 2002;78(918):233–237. DOI: 10.1136/pmj.78.918.233
Crowley TJ, Andrews AE, Cheney J, et al. Carbon monoxide assessment of smoking in chronic obstructive pulmonary disease. Addict Behav 1989;14(5):493–502. DOI: 10.1016/0306-4603(89)90069-5
Jarvis MJ, Tunstall-Pedoe H, Feyerabend C, et al. Comparison of tests used to distinguish smokers from nonsmokers. Am J Public Health 1987;77(11):1435–1438. DOI: 10.2105/ajph.77.11.1435
Hoffmann D, Adams JD, Wynder EL. Formation and analysis of carbon monoxide in cigarette mainstream and side stream smoke. Prev Med 1979;8(3):344–350. DOI: 10.1016/0091-7435(79)90011-2
Rani M, Bonu S, Jha P, et al. Tobacco use in India: prevalence and predictors of smoking and chewing in a national cross sectional household survey. Tob Control 2003;12(4):e4. DOI: 10.1136/tc.12.4.e4
Singh RJ, Lal PG. Second-hand smoke: a neglected public health challenge. Indian J Public Health 2011;55(3):192–198. DOI: 10.4103/0019-557X.89950
Zetterquist W, Marteus H, Johannesson M, et al. Exhaled carbon monoxide is not elevated in patients with asthma or cystic fibrosis. Eur Respir J 2002;20(1):92–99. DOI: 10.1183/09031936.02.00245302
Tonnesen P, Nørregaard J, Mikkelsen K, et al. A Double-blind trial of a nicotine inhaler for smoking cessation. JAMA 1993;269(10):1268–1271. DOI: 10.1001/jama.1993.03500100066029