ASSESSMENT OF SMOKING IN PATIENTS WITH SE VERE CHRONIC RESPIRATORY-FAILURE TREATED WITH OXYGEN FOR LONG PERIODS AT HOME

Two hundred and fifty patients with chronic respiratory insufficiency (202 men and 48 women), being treated by oxygen therapy at home were i ncluded in a study, which aim was to estimate the proportion of patien ts who were either smokers or exposed to passive smoking, by the use o f a questionnaire and measurement of cotininuria. Urinary sample and a utoquestionnaire collection was carried out by the nurses of the Lorra ine's association of home respiratory assistance. Urinary cotinine was measured by radio immuno assay. Twenty one smokers, 186 ex-smokers an d 43 non-smokers were identified through the questionnaire. Of the 21 self confessed smokers 20 had a urinary cotinine level over 250 ng/ml, 1 smoker lower than 250 ng/ml; among the professed non-smokers, 42 ha d a level lower than 100 ng/ml and 1 over 250 ng/ml but the cotininuri a creatinuria ratio classified this latter in the non-smokers non expo sed to passive smoking group. Among the 186 declared ex-smokers, 20 ov er 250 ng/ml were probably smokers, 160 lower than 100 ng/ml could be considered as non-smokers, and finally 100 in between could be assesse d as non-smokers exposed to passive smoking. The results enabled 43 sm okers (17%) and 5 (2%) exposed to passive smoking to be identified. Th ey confirm the unreliability of smoking habits questionnaires and the importance of cotininuria in the detection of nicotine poisoning.