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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Determinar la cotinina en saliva en adolescentes y su relaci&#243;n con el h&#225;bito de fumar y la enfermedad respiratoria&#46;</p> <span class="elsevierStyleSectionTitle">Pacientes y m&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se estudiaron 420 adolescentes&#44; de ambos sexos&#44; con edades entre 14 y 21 a&#241;os &#40;media&#44; 16&#44;4 &#177; 1&#44;32&#41; de colegios p&#250;blicos y privados de Tenerife&#46; El 54&#44;7 &#37; eran varones y el 45&#44;3 &#37;&#44; mujeres&#46; Se trata de una encuesta individualizada&#44; seg&#250;n modelo de la American Thoracic Society y determinaci&#243;n de cotinina en saliva &#40;RIA&#41;&#46; Seg&#250;n el h&#225;bito tab&#225;quico los adolescentes estaban distribuidos de la siguiente forma&#58; 26&#44;5 &#37;&#44; fumadores habituales&#59; 11 &#37;&#44; fumadores espor&#225;dicos&#59; 3&#44;6 &#37;&#44; ex fumadores&#59; 45&#44;6&#37;&#44; fumadores pasivos&#44; y 13&#44;4 &#37;&#44; no expuestos al humo del tabaco&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">La media de cotinina en saliva en los fumadores habituales fue 225&#44;4 &#177; 167&#44;4 ng&#47;ml&#59; en los fumadores espor&#225;dicos&#44; 19&#44;5 &#177; 44&#44;9 ng&#47;ml&#59; en ex fumadores&#44; 17&#44;4 &#177; 51&#44;1 ng&#47;ml&#59; en fumadores pasivos&#44; 4&#44;2 &#177; 15&#44;0 ng&#47;ml&#44; y en los no expuestos&#44; 2&#44;2 &#177; 5&#44;8 ng&#47;ml&#46; Se encontr&#243; relaci&#243;n entre los valores de cotinina en saliva y el h&#225;bito tab&#225;quico &#40;p &#61; 0&#44;0001&#41;&#46;</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La media de cotinina en los fumadores de menos de 10 cigarrillos al d&#237;a fue de 142&#44;7 &#177; 131&#44;5 ng&#47;ml y en los de m&#225;s de 10 cigarrillos al d&#237;a de 340&#44;1 &#177; 144&#44;9 ng&#47;ml&#44; &#40;p &#61; 0&#44;0001&#41;&#46; Asimismo&#44; se encontr&#243; significaci&#243;n entre los valores de cotinina y el n&#250;mero de cigarrillos fumados habitualmente y en las &#250;ltimas 24 horas antes de la obtenci&#243;n de la muestra &#40;p &#61; 0&#44;0001&#41;&#46;</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Se observ&#243; mayor n&#250;mero de infecciones de v&#237;as bajas de repetici&#243;n &#40;p &#61; 0&#44;0001&#41;&#44; tos cr&#243;nica &#40;p &#61; 0&#44;0001&#41; y broncospasmo al ejercicio &#40;p &#61; 0&#44;0001&#41;&#44; en los adolescentes con mayores valores de cotinina&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">La cotinina en saliva se eleva con el mayor grado de consumo y de exposici&#243;n al tabaco&#46; Los adolescentes con infecciones de v&#237;as respiratoria bajas de repetici&#243;n&#44; tos cr&#243;nica y broncospasmo al ejercicio&#44; presentan concentraciones superiores de cotinina en saliva&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">To assess cotinine levels in the saliva of adolescents and the relationship between these levels&#44; smoking habits and respiratory disease&#46;</p> <span class="elsevierStyleSectionTitle">Patients and method</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">We studied 420 adolescents &#40;54&#46;7 &#37; boys and 45&#46;3&#37; girls&#41; aged between 14 and 21 years &#40;mean age&#44; 16&#46;4 &#177; 1&#46;32&#41;&#44; from state and private schools in Tenerife&#46; An individualized survey&#44; based on the American Thoracic Society&#39;s model&#44; was carried out and saliva cotinine concentrations were determined by radioimmunoassay&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Distribution according to smoking habits was as follows&#58; 26&#46;5 &#37; were regular smokers&#44; 11 &#37; were sporadic smokers&#44; 3&#46;6&#37; were former smokers&#44; 45&#46;6&#37; were passive smokers&#44; and 13&#46;4&#37; were not exposed to smoking&#46; Mean cotinine levels were 225&#46;4 ng&#47;ml in regular smokers&#44; 19&#46;5 ng&#47;ml in sporadic smokers&#44; 17&#46;4 ng&#47;ml in former smokers&#44; 4&#46;2 ng&#47;ml in passive smokers and 2&#46;2 ng&#47;ml in individuals not exposed to tobacco smoke&#44; which de-monstrated the correlation between saliva cotinine concentrations and smoking habits &#40;p &#61; 0&#46;0001&#41;&#46; The cotinine level in smokers of &#60; 10 cigarettes&#47;day was 142&#44;7 ng&#47;ml and in smokers of &#62; 10 cigarettes&#47;day it was 341&#44;1 ng&#47;ml &#40;p &#61; 0&#46;0001&#41;&#46; A significant correlation was also found between cotinine concentrations and the number of cigarettes smoked regularly and in the last 24 hours before sample collection &#40;p &#61; 0&#46;0001&#41;&#46; Lower respiratory tract infection &#40;p &#61; 0&#46;0001&#41;&#44; chronic cough &#40;p &#61; 0&#46;0001&#41; and bronchospasm on physical exercise &#40;p &#61; 0&#46;0001&#41; were more frequent in adolescents with higher cotinine concentrations&#46;</p> <span class="elsevierStyleSectionTitle">Conclusion</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Higher saliva cotinine concentrations were correlated with greater tobacco consumption and exposure to tobacco smoke&#46; Adolescents with lower respiratory tract infections&#44; chronic cough and bronchospasm on physical exercise had higher saliva cotinine concentrations&#46;</p>"
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                        "paginaFinal" => "950"
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                      "titulo" => "Patolog&#237;a respiratoria en los j&#243;venes y h&#225;bito tab&#225;quico"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "C&#46; Galv&#225;n Fern&#225;ndez"
                            1 => "R&#46;G&#46; Su&#225;rez L&#243;pez de Vergara"
                            2 => "C&#46; Oliva Hern&#225;ndez"
                            3 => "E&#46; Dom&#233;nech Mart&#237;nez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Bronconeumol"
                        "fecha" => "2000"
                        "volumen" => "36"
                        "paginaInicial" => "186"
                        "paginaFinal" => "190"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10846601"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "7&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiology Standarization project"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46;r&#46; Ferris BJ"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Am Rev Resp Dis"
                        "fecha" => "1978"
                        "volumen" => "111"
                        "paginaInicial" => "36"
                        "paginaFinal" => "47"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "8&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The epidemiology of licit and illicit substance use among high school students in Greece"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46; Kokkevi"
                            1 => "C&#46; Stefanis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Public Health"
                        "fecha" => "1991"
                        "volumen" => "81"
                        "paginaInicial" => "48"
                        "paginaFinal" => "52"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1983916"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "9&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Consumo y actitudes de los adolescentes frente a sustancias adictivas&#58; Encuesta de prevalencia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46; Campins Mart&#237;"
                            1 => "J&#46; Gasch Blasi"
                            2 => "P&#46; Hereu Boher"
                            3 => "J&#46; Rossell&#243; Urgell"
                            4 => "J&#46; Vaqu&#233; Rafart"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "An Esp Pediatr"
                        "fecha" => "1996"
                        "volumen" => "45"
                        "paginaInicial" => "475"
                        "paginaFinal" => "478"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9036776"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "10&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Consumo de alcohol y tabaco en estudiantes de 3&#46;&#176; de BUP del municipio de Madrid"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "C&#46; Bonnet de Luna"
                            1 => "R&#46; L&#243;pez Gim&#233;nez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "An Esp Pediatr"
                        "fecha" => "1993"
                        "volumen" => "38"
                        "paginaInicial" => "49"
                        "paginaFinal" => "53"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8439079"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "11&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalencia del consumo de tabaco y alcohol&#44; actitudes y creencias en estudiantes de bachillerato de la provincia de Tarragona &#40;Espa&#241;a&#41;"
                      "autores" => array:1 [
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                          "etal" => false
                          "autores" => array:2 [
                            0 => "R&#46; P&#233;rez Oll&#233;"
                            1 => "J&#46; P&#233;rez Oll&#233;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "An Esp Pediatr"
                        "fecha" => "1996"
                        "volumen" => "45"
                        "paginaInicial" => "583"
                        "paginaFinal" => "590"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9133222"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "12&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Measuring the exposure of infants to tobacco smoke"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "R&#46;A&#46; Greenberg"
                            1 => "N&#46;J&#46; Halley"
                            2 => "R&#46;A&#46; Etzel"
                            3 => "F&#46;A&#46; Loda"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJM198404263101703"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "1984"
                        "volumen" => "310"
                        "paginaInicial" => "1075"
                        "paginaFinal" => "1078"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6708988"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "13&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Error in smoking measures&#58; effects of intervention on relations of cotinine and carbon monoxide to self-reported smoking"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "R&#46;P&#46; Murray"
                            1 => "J&#46;E&#46; Connet"
                            2 => "G&#46;G&#46; Lauger"
                            3 => "H&#46;T&#46; Voelker"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Public Health"
                        "fecha" => "1993"
                        "volumen" => "83"
                        "paginaInicial" => "1251"
                        "paginaFinal" => "1257"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8363000"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "14&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Disposition of nicotine and eihth metabolites in smokers and nonsmokers&#58; identification in smokers of two metabolites that are longer lived than cotinine"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "G&#46; Kyerematen"
                            1 => "M&#46; Morga"
                            2 => "B&#46; Chattopadhyay"
                            3 => "D&#46; De Bethizy"
                            4 => "E&#46; Vesell"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Pharmacol Ther"
                        "fecha" => "1990"
                        "volumen" => "48"
                        "paginaInicial" => "641"
                        "paginaFinal" => "651"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2249376"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "15&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Half-lives of selected tobacco smoke exposure markers"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "C&#46; Linch"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Eur J Respir Dis"
                        "fecha" => "1984"
                        "volumen" => "65"
                        "paginaInicial" => "63"
                        "paginaFinal" => "67"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "16&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Serum cotinine as a measure of tobacco smoke exposure in children"
                      "autores" => array:1 [
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                          "etal" => false
                          "autores" => array:3 [
                            0 => "E&#46;N&#46; Pattishall"
                            1 => "G&#46;L&#46; Strope"
                            2 => "R&#46;A&#46; Etzel"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Dis Child"
                        "fecha" => "1985"
                        "volumen" => "139"
                        "paginaInicial" => "1101"
                        "paginaFinal" => "1104"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4061405"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "17&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nicotine and its metabolites&#46; Radioimmunoassays for nicotine and cotinine"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;J&#46; Langone"
                            1 => "H&#46;B&#46; Gjika"
                            2 => "H&#46; Van Vukanis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Biochem"
                        "fecha" => "1971"
                        "volumen" => "12"
                        "paginaInicial" => "5025"
                        "paginaFinal" => "5030"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "18&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "High-performance Liquid-cromatographic-method compared with modified radioimmunoassay of cotinine in plasma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
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                            1 => "J&#46;F&#46; Livesey"
                            2 => "E&#46;A&#46; Escares"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Chem"
                        "fecha" => "1991"
                        "volumen" => "37"
                        "paginaInicial" => "1989"
                        "paginaFinal" => "1993"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1934477"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "19&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Simple selected ion monitoring capillary gas cromatofraphic-mass spectrometric method for the determination of cotinine in serum&#44; urine and oral samples"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "S&#46;A&#46; McAdams"
                            1 => "M&#46;L&#46; Codeiro"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Chromategr"
                        "fecha" => "1993"
                        "volumen" => "615"
                        "paginaInicial" => "148"
                        "paginaFinal" => "153"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "20&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Passive exposure to tobacco smoke&#58; saliva cotinine concentrations in a representative population sample non smokin schoolchildren"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;J&#46; Jarvis"
                            1 => "M&#46;A&#46; Russel"
                            2 => "C&#46; Fayerabend"
                            3 => "J&#46;R&#46; Eiser"
                            4 => "M&#46; Morgan"
                            5 => "P&#46; Gammage"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Br Med J"
                        "fecha" => "1985"
                        "volumen" => "291"
                        "paginaInicial" => "927"
                        "paginaFinal" => "929"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "21&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Factors determining exposure to passive smoking in young adults living at home&#58; quantitative analysis using saliva cotinine concentrations"
                      "autores" => array:1 [
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                          "etal" => false
                          "autores" => array:4 [
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                            1 => "A&#46;D&#46; McNeill"
                            2 => "A&#46; Bryant"
                            3 => "A&#46;H&#46; Russell"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Intern J Epidemiol"
                        "fecha" => "1991"
                        "volumen" => "20"
                        "paginaInicial" => "126"
                        "paginaFinal" => "131"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "22&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "On the measurement of tobacco use by adolescents"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "K&#46;E&#46; Bauman"
                            1 => "G&#46;G&#46; Koch"
                            2 => "E&#46;S&#46; Bryan"
                            3 => "N&#46;J&#46; Haley"
                            4 => "M&#46;I&#46; Downtown"
                            5 => "M&#46;A&#46; Orlandi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Epidemiol"
                        "fecha" => "1989"
                        "volumen" => "130"
                        "paginaInicial" => "327"
                        "paginaFinal" => "337"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2665477"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "23&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Salivary cotinine levels and involuntary tobacco somoke exposure in children and adults New Mexico"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "D&#46;B&#46; Coultas"
                            1 => "C&#46;D&#46; Howard"
                            2 => "G&#46;T&#46; Peake"
                            3 => "B&#46;J&#46; Skipper"
                            4 => "J&#46;M&#46; Samet"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/ajrccm/136.2.305"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am Rev Respir Dis"
                        "fecha" => "1987"
                        "volumen" => "136"
                        "paginaInicial" => "305"
                        "paginaFinal" => "309"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3619189"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "24&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The relationship of salivary cotinine to respiratory symptoms&#44; spirometry and exercise-induced bronchospasm in sevenyearold children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
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                            1 => "M&#46;J&#46; Jarvis"
                            2 => "C&#46; Feyerabend"
                          ]
                        ]
                      ]
                    ]
                  ]
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                    0 => array:2 [
                      "doi" => "10.1164/ajrccm/142.1.147"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am Rev Respir Dis"
                        "fecha" => "1990"
                        "volumen" => "142"
                        "paginaInicial" => "147"
                        "paginaFinal" => "151"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2368962"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "25&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Risc factors for acute wheezing in infants and children&#58; viruses&#44; passive smoker and IgE antibodies to inhalant allergens"
                      "autores" => array:1 [
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                          "etal" => true
                          "autores" => array:6 [
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                            1 => "E&#46;S&#46; Pomeranz"
                            2 => "L&#46;E&#46; Gelber"
                            3 => "W&#46; Price"
                            4 => "H&#46; Farris"
                            5 => "F&#46; Hayden"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
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                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatrics"
                        "fecha" => "1993"
                        "volumen" => "92"
                        "paginaInicial" => "535"
                        "paginaFinal" => "540"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8414823"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
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Vol. 54. Núm. 2.
Páginas 114-119 (febrero 2001)
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Vol. 54. Núm. 2.
Páginas 114-119 (febrero 2001)
Acceso a texto completo
Tabaquismo en adolescentes, valores de cotinina en saliva y enfermedad respiratoria
Smoking in adolescents, saliva cotinine concentrations and respiratory disease
Visitas
8894
R.G. Suárez López de Vergaraa,
Autor para correspondencia
jmdorta@arquired.es

Correspondencia: Dra. R.G. Suárez López de Vergara. Urbanización Guajara Delta, 55. 38205 La Laguna. Santa Cruz de Tenerife.
, C. Galván Fernándeza, C. Oliva Fernándezb, E. Doménech Martínezc, F. Barroso Guerreroc
a Centros de Salud Finca España y Laguna-Geneto. La Laguna
b Hospital de Nuestra Señora de la Candelaria. Santa Cruz de Tenerife
c Facultad de Medicina de La Laguna. Tenerife
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Estadísticas
Objetivo

Determinar la cotinina en saliva en adolescentes y su relación con el hábito de fumar y la enfermedad respiratoria.

Pacientes y métodos

Se estudiaron 420 adolescentes, de ambos sexos, con edades entre 14 y 21 años (media, 16,4 ± 1,32) de colegios públicos y privados de Tenerife. El 54,7 % eran varones y el 45,3 %, mujeres. Se trata de una encuesta individualizada, según modelo de la American Thoracic Society y determinación de cotinina en saliva (RIA). Según el hábito tabáquico los adolescentes estaban distribuidos de la siguiente forma: 26,5 %, fumadores habituales; 11 %, fumadores esporádicos; 3,6 %, ex fumadores; 45,6%, fumadores pasivos, y 13,4 %, no expuestos al humo del tabaco.

Resultados

La media de cotinina en saliva en los fumadores habituales fue 225,4 ± 167,4 ng/ml; en los fumadores esporádicos, 19,5 ± 44,9 ng/ml; en ex fumadores, 17,4 ± 51,1 ng/ml; en fumadores pasivos, 4,2 ± 15,0 ng/ml, y en los no expuestos, 2,2 ± 5,8 ng/ml. Se encontró relación entre los valores de cotinina en saliva y el hábito tabáquico (p = 0,0001).

La media de cotinina en los fumadores de menos de 10 cigarrillos al día fue de 142,7 ± 131,5 ng/ml y en los de más de 10 cigarrillos al día de 340,1 ± 144,9 ng/ml, (p = 0,0001). Asimismo, se encontró significación entre los valores de cotinina y el número de cigarrillos fumados habitualmente y en las últimas 24 horas antes de la obtención de la muestra (p = 0,0001).

Se observó mayor número de infecciones de vías bajas de repetición (p = 0,0001), tos crónica (p = 0,0001) y broncospasmo al ejercicio (p = 0,0001), en los adolescentes con mayores valores de cotinina.

Conclusiones

La cotinina en saliva se eleva con el mayor grado de consumo y de exposición al tabaco. Los adolescentes con infecciones de vías respiratoria bajas de repetición, tos crónica y broncospasmo al ejercicio, presentan concentraciones superiores de cotinina en saliva.

Palabras clave:
Adolescencia
Hábito tabáquico
Cotinina en saliva
Enfermedad respiratoria
Objective

To assess cotinine levels in the saliva of adolescents and the relationship between these levels, smoking habits and respiratory disease.

Patients and method

We studied 420 adolescents (54.7 % boys and 45.3% girls) aged between 14 and 21 years (mean age, 16.4 ± 1.32), from state and private schools in Tenerife. An individualized survey, based on the American Thoracic Society's model, was carried out and saliva cotinine concentrations were determined by radioimmunoassay.

Results

Distribution according to smoking habits was as follows: 26.5 % were regular smokers, 11 % were sporadic smokers, 3.6% were former smokers, 45.6% were passive smokers, and 13.4% were not exposed to smoking. Mean cotinine levels were 225.4 ng/ml in regular smokers, 19.5 ng/ml in sporadic smokers, 17.4 ng/ml in former smokers, 4.2 ng/ml in passive smokers and 2.2 ng/ml in individuals not exposed to tobacco smoke, which de-monstrated the correlation between saliva cotinine concentrations and smoking habits (p = 0.0001). The cotinine level in smokers of < 10 cigarettes/day was 142,7 ng/ml and in smokers of > 10 cigarettes/day it was 341,1 ng/ml (p = 0.0001). A significant correlation was also found between cotinine concentrations and the number of cigarettes smoked regularly and in the last 24 hours before sample collection (p = 0.0001). Lower respiratory tract infection (p = 0.0001), chronic cough (p = 0.0001) and bronchospasm on physical exercise (p = 0.0001) were more frequent in adolescents with higher cotinine concentrations.

Conclusion

Higher saliva cotinine concentrations were correlated with greater tobacco consumption and exposure to tobacco smoke. Adolescents with lower respiratory tract infections, chronic cough and bronchospasm on physical exercise had higher saliva cotinine concentrations.

Key words:
Adolescence
Smoking habits
Saliva cotinine concentrations
Respiratory disease
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Bibliografía
[1.]
J.F. Pascual Lledó, J.L. Viejo Bañuelos, F. Gallo Marín, C. De Abajo Cucurrull, A. Pueyo Bastida.
Tabaquismo escolar. Estudio epidemiológico transversal en una población de 4.281 escolares.
Arch Bronconeumol, 32 (1996), pp. 69-75
[2.]
M. Twonsend, H. Wilkes, A. Haines, M. Jarvis.
Adolescent smokers seen in general practice: health, lifestyle, physycal mesaurements, and response to antismoking advice.
Br Med J, 300 (1991), pp. 947-950
[3.]
R.G. Suárez, C. Galván, E. Doménech.
Prevalencia de tabaquismo en el adolescente y su relación con otros hábitos tóxicos.
An Esp Pediatr, 110 (1998), pp. 41
[4.]
R.G. Suárez, C. Galván, E. Doménech, F. Barroso.
Exposición al tabaco y niveles de cotinina en el niño.
Rev Clin Esp, 199 (1999), pp. 362-365
[5.]
R. Morton.
Playing with smoke, but not without fire.
Lancet, 347 (1996), pp. 1782
[6.]
C. Galván Fernández, R.G. Suárez López de Vergara, C. Oliva Hernández, E. Doménech Martínez.
Patología respiratoria en los jóvenes y hábito tabáquico.
Arch Bronconeumol, 36 (2000), pp. 186-190
[7.]
J.r. Ferris BJ.
Epidemiology Standarization project.
Am Rev Resp Dis, 111 (1978), pp. 36-47
[8.]
A. Kokkevi, C. Stefanis.
The epidemiology of licit and illicit substance use among high school students in Greece.
Am J Public Health, 81 (1991), pp. 48-52
[9.]
M. Campins Martí, J. Gasch Blasi, P. Hereu Boher, J. Rosselló Urgell, J. Vaqué Rafart.
Consumo y actitudes de los adolescentes frente a sustancias adictivas: Encuesta de prevalencia.
An Esp Pediatr, 45 (1996), pp. 475-478
[10.]
C. Bonnet de Luna, R. López Giménez.
Consumo de alcohol y tabaco en estudiantes de 3.° de BUP del municipio de Madrid.
An Esp Pediatr, 38 (1993), pp. 49-53
[11.]
R. Pérez Ollé, J. Pérez Ollé.
Prevalencia del consumo de tabaco y alcohol, actitudes y creencias en estudiantes de bachillerato de la provincia de Tarragona (España).
An Esp Pediatr, 45 (1996), pp. 583-590
[12.]
R.A. Greenberg, N.J. Halley, R.A. Etzel, F.A. Loda.
Measuring the exposure of infants to tobacco smoke.
N Engl J Med, 310 (1984), pp. 1075-1078
[13.]
R.P. Murray, J.E. Connet, G.G. Lauger, H.T. Voelker.
Error in smoking measures: effects of intervention on relations of cotinine and carbon monoxide to self-reported smoking.
Am J Public Health, 83 (1993), pp. 1251-1257
[14.]
G. Kyerematen, M. Morga, B. Chattopadhyay, D. De Bethizy, E. Vesell.
Disposition of nicotine and eihth metabolites in smokers and nonsmokers: identification in smokers of two metabolites that are longer lived than cotinine.
Clin Pharmacol Ther, 48 (1990), pp. 641-651
[15.]
C. Linch.
Half-lives of selected tobacco smoke exposure markers.
Eur J Respir Dis, 65 (1984), pp. 63-67
[16.]
E.N. Pattishall, G.L. Strope, R.A. Etzel.
Serum cotinine as a measure of tobacco smoke exposure in children.
Am J Dis Child, 139 (1985), pp. 1101-1104
[17.]
J.J. Langone, H.B. Gjika, H. Van Vukanis.
Nicotine and its metabolites. Radioimmunoassays for nicotine and cotinine.
Biochem, 12 (1971), pp. 5025-5030
[18.]
S.L. Perkins, J.F. Livesey, E.A. Escares, et al.
High-performance Liquid-cromatographic-method compared with modified radioimmunoassay of cotinine in plasma.
Clin Chem, 37 (1991), pp. 1989-1993
[19.]
S.A. McAdams, M.L. Codeiro.
Simple selected ion monitoring capillary gas cromatofraphic-mass spectrometric method for the determination of cotinine in serum, urine and oral samples.
J Chromategr, 615 (1993), pp. 148-153
[20.]
M.J. Jarvis, M.A. Russel, C. Fayerabend, J.R. Eiser, M. Morgan, P. Gammage, et al.
Passive exposure to tobacco smoke: saliva cotinine concentrations in a representative population sample non smokin schoolchildren.
Br Med J, 291 (1985), pp. 927-929
[21.]
M.J. Jarvis, A.D. McNeill, A. Bryant, A.H. Russell.
Factors determining exposure to passive smoking in young adults living at home: quantitative analysis using saliva cotinine concentrations.
Intern J Epidemiol, 20 (1991), pp. 126-131
[22.]
K.E. Bauman, G.G. Koch, E.S. Bryan, N.J. Haley, M.I. Downtown, M.A. Orlandi.
On the measurement of tobacco use by adolescents.
Am J Epidemiol, 130 (1989), pp. 327-337
[23.]
D.B. Coultas, C.D. Howard, G.T. Peake, B.J. Skipper, J.M. Samet.
Salivary cotinine levels and involuntary tobacco somoke exposure in children and adults New Mexico.
Am Rev Respir Dis, 136 (1987), pp. 305-309
[24.]
D.P. Strachan, M.J. Jarvis, C. Feyerabend.
The relationship of salivary cotinine to respiratory symptoms, spirometry and exercise-induced bronchospasm in sevenyearold children.
Am Rev Respir Dis, 142 (1990), pp. 147-151
[25.]
A. Duff, E.S. Pomeranz, L.E. Gelber, W. Price, H. Farris, F. Hayden, et al.
Risc factors for acute wheezing in infants and children: viruses, passive smoker and IgE antibodies to inhalant allergens.
Pediatrics, 92 (1993), pp. 535-540
[26.]
D.G. Cook, P.H. Whincup, O. Papacosta, D.P. Strachan, M.J. Jarvis, A. Bryant.
Relation of passive smoking in assessed by salivary cotinine concentration and questionnaire to spirometric indice in children.
Thorax, 48 (1993), pp. 14-20
[27.]
R. Etzel.
A review of the use of saliva cotinine as a marker of tobacco smoke exposure.
Prev Medicine, 19 (1990), pp. 190-197
[28.]
A.D. McNeill, M.J. Jarvis, J.A. Stapleton, J.M. West, A. Bryant.
Nicotine intake in young smokers: Longitudinal study of saliva cotinine concentrations.
Am J Public Health, 79 (1989), pp. 172-175
[29.]
D.B. Coultas, C.A. Stidley, J.M. Samet.
Cigarette yields of tar and nicotine and markes of exposure to tobacco smoke.
Am Rev Respir Dis, 148 (1993), pp. 435-440
Copyright © 2001. Asociación Española de Pediatría
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