TobacAlert Urine Card TobacAlert determines degree of tobacco smoke exposure by measuring cotinine in urine. Nicotine, main drug in tobacco smoke, is processed by body into cotinine. (require urine sample)

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TobacAlert Information

• TobacAlert is the first point of care test for tobacco products that is so accurate it can measure second hand smoke exposure
• It tests for Cotinine (a Nicotine metabolite) in urine
• It is a unique immunochromatographic technology and is patented
• It is a fast, inexpensive and easy to use disposable strip. It is not for medical use.
• Requires no mixing or measuring of reagents, or calibration of equipment
• Does not require a machine or trained person to read
• Does not require "first morning urine"
• Can be used with saliva using the TobacAlert Saliva Test, for less sensitive applications

TobacAlert:  Who Can Use It?

• Smokers and non smokers to measure tobacco exposure
• Parents to detect if children are smoking or being exposed to second hand smoke
• Employees of bars, restaurants and other establishments
• Employers and insurance companies
• Students and athletes
• Researchers

Reading the Strip

The strip contains antibody gold particles that migrate through specialized "traps". The LOWEST red band indicates the cotinine level.

The strip is extremely sensitive and can read 6 nanograms of cotinine per millilitre (6 billionths of a gram in one fifth of a teaspoon)

Tobacco Tests

1.    Reference lab tests:

GC (gas chromatography)
HPLC (high performance liquid chromatography)
Radio immunoassay
Enzyme linked Immunosorbent assay

• Expensive
• Not point of care (samples need to be shipped)
• Slow results (days or weeks)

2.    CO (carbon monoxide) tester

• Non specific to tobacco (false readings)
• Background interference (traffic, heating and cooking emissions)
• Expensive equipment
• CO effect on body is short lived (short half life)
• Poor for light smokers and second hand smoke (low CO levels)
• Does not work with smokeless tobacco products

3.    Colorimetric assays (chemical based)

• Not specific (false readings from reaction to other compounds)
• Cannot detect low levels (second hand smoke and light smoking)
• Require calibration to urine volume (fluid intake can affect the test)
• Require a trained eye (different people read different results)

Cotinine

1.    Cotinine has been shown to be the best biomarker for tobacco exposure

• Is a nicotine metabolite
• It has a long half life, over 20 hours (remains in the body long enough to be reliably tested)
• It registers non smoke tobacco use

2.    Nicotine and other biomarkers

• Nicotine has a short half life
• Thiocyanate is affected by diet

Smoking:  the Bad News

• About 46.5 million adults were current smokers in 2000, 53% became daily smokers before 18 years old.
• At least 4 million adolescents smoke
• Nicotine is the drug in tobacco that causes addiction

Limitations Of The Test

TobacAlert™ is not for medical use. TobacAlert™ is only for use with human urine. A positive result indicates tobacco product exposure and the presence of cotinine in the sample. Erroneous results can be caused by technical or procedural errors or by adulteration or contamination of the sample.  TobacAlert™ should not be used if the urine is dark, red, or otherwise abnormally colored. The test should be delayed until the urine is clear and normal in appearance. The assay provides only a preliminary result. In order to obtain a confirmed analytical result, a more specific alternate chemical method is needed. Gas Chromatography/Mass Spectrometry (GC/MS) is the preferred confirmation method.

Stability

Stability testing has demonstrated that TobacAlert™ strips have a shelf life of at least two years when stored at ambient temperatures.

How Well Does TobacAlert™ Detect Second Hand Smoke Exposure?

Studies showed that TobacAlert™ could accurately detect significant second hand smoke exposure as reported by individuals. Urine samples from 79 smokers and 92 non-smokers were collected and subjects filled out a questionnaire about whether they smoked, where they were exposed to smoke, and how many hours they were exposed in the last 48 hours in their home, work and socially. They were then tested with  TobacAlert™ and the results tabulated. Table 1 shows that with increasing exposure to smoke there was an increasing number of subjects testing positive in the TobacAlert™ Test. This ranged from minimally exposed subjects (36% tested as "1") to smokers and tobacco product users (100% tested positive). 92% of subjects with home exposure and more than 10 hours exposure in the previous 48 hours, tested as "1".

Table 1

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