URINARY COTININE ASSAYS - USEFULNESS FOR DOSAGE ADJUSTMENT DURING REPLACEMENT NICOTINE THERAPY FOR SMOKING CESSATION

Replacement nicotine therapy (transdermal delivery systems provides si gnificantly higher quit rates (50 % after three months) than placebo t herapy but nevertheless fails in a substantial proportion of patients. To achieve optimal efficacy, the dosage of nicotine should be adjuste d to the needs of each individual. Urinary cotinine assays (using a co lorimetric method) have shown that the amount of nicotine absorbed var ies widely across individuals and is weakly correlated with cigarette consumption and Fagerstrom scores. Therefore, a biochemical marker (e. g., cotinine levels in serum, saliva, or urine) is needed to select th e initial nicotine dosage and to adjust this dosage subsequently. To e liminate withdrawal symptoms, it seems that the replacement therapy sh ould provide 60 % of the nicotine dose absorbed from cigarette smoke.