Urine test for the assessment of smoking status.

A simple, quick and inexpensive test for smoking status would be useful in a variety of settings. The non-polar barbituric acid derivative 1,3-dibutyl-2-thiobarbituric acid (DBTB) is described as a novel derivatisation reagent for nicotine and its metabolites in the König reaction to assess smoking status. The relative performance of qualitative methods for assessing smoking status using DBTB and the previously employed derivatisation reagent 1,3-diethyl-2-thiobarbituric acid (DETB), as well as quantitatively-based methods for determining 'total nicotine metabolites' (TNMs) using these two reagents, were evaluated against a cotinine-based radioimmunoassay (RIA) as the 'gold standard'. Clinical sensitivity and specificity for all the approaches studied were in excess of 94%. Simple qualitative assessment by eye was superior to quantitatively-based measures of smoking status. Correlation between estimation of nicotine metabolites using DBTB, DETB and RIA were good. The most efficient and convenient method to distinguish between smokers and non-smokers was the simple qualitative method using the more lipophilic reagent DBTB.