Case Reports in Clinical Practice 2017. 2(2):46-49.

Role of Fireplaces in the Measurement of Exhaled Carbon Monoxide in Two Smokers with Chronic Obstructive Pulmonary Disease
Mehran Zarghami, Fatemeh Taghizadeh, Ali Sharifpoor


Carbon monoxide (CO) concentration in the body will be decreased after smoking cessation. However, confounding factors may influence the results. Exhaled CO (eCO) assessment of lung is a simple, noninvasive tool, but confounder factors such as gas fireplaces might influence results. We thus quantified the effect of them in two smokers with chronic obstructive pulmonary disease (COPD). We described one of these confounder factors in two smokers with COPD in a clinical trial study setting with IRCT201609271457N11 coding in IRCT. The amounts of eCO and carboxyhemoglobin of these patients rose while the average daily smoking decreased (in the first patient) or stopped smoking (in the second patient). We found that they had used the fireplace to heat their home. These measures decreased in both patients by discontinuing the use of the gas fireplace. The gas fireplaces influence the results of eCO assessments in smoking cessation programs.


Carbon monoxide; Chronic obstructive pulmonary disease; Smoking cessation

Full Text:



Sood A. Indoor fuel exposure and the lung in both developing and developed countries: An update. Clin Chest Med 2012 33(4) 649-65.

Cropsey KL, Jackson DO, Hale GJ, Carpenter MJ, Stitzer ML. Impact of self-initiated prequit smoking reduction on cessation rates Results of a clinical trial of smoking cessation among female prisoners. Addict Behav 2011; 36(1-2): 73-8.

Korte KJ, Capron DW, Zvolensky M, Schmidt NB. The Fagerstrom test for nicotine dependence: do revisions in the item scoring enhance the psychometric properties? Addict Behav 2013; 38(3) 1757-63.

Montuschi P, Kharitonov SA, Barnes PJ. Exhaled carbon monoxide and nitric oxide in COPD. Chest 2001; 120(2): 496-501.

Bedfont® Scientific Ltd. Smokerlyzer® Range [Online]. [cited 2017]; Available from: URL: 20Smokerlyzer%20Manual%20Issue%203.pdf

Silkoff PE, Stevens A, Pak J, Bucher-Bartelson B, Martin RJ. A method for the standardized offline collection of exhaled nitric oxide. Chest 1999; 116(3): 754-9.

Monninkhof E, van der V, van der Palen J, Mulder H, Pieterse M van Herwaarden C, et al. The effect of a minimal contact smoking cessation programme in out-patients with chronic obstructive pulmonary disease: a prepost-test study. Patient Educ Couns 2004; 52(3): 231-6.

Javors MA, Hatch JP, Lamb RJ. Cut-off levels for breath carbon monoxide as a marker for cigarette smoking. Addiction 2005; 100(2): 159-67.

Fortmann SP, Rogers T, Vranizan K, Haskell WL, Solomon DS, Farquhar JW. Indirect measures of cigarette use: Expired-air carbon monoxide versus plasma thiocyanate. Prev Med 1984; 13(1): 127-35.

Etzel RA. A review of the use of saliva cotinine as a marker of tobacco smoke exposure. Prev Med 1990; 19(2): 190-7.

Sato S, Nishimura K, Koyama H, Tsukino M, Oga T, Hajiro T, et al Optimal cutoff level of breath carbon monoxide for assessing smoking status in patients with asthma and COPD. Chest 2003; 124(5): 1749 54.

Wilson JS, Elborn JS, Fitzsimons D, McCrumGardner E. Do smokers with chronic obstructive pulmonary disease report their smoking status reliably? A comparison of selfreport and bio-chemical validation. Int J Nurs Stud 2011; 48(7): 856-62.

Christenhusz L, de Jongh F, van der V, Pieterse M, Seydel E, van der Palen J. Comparison of three carbon monoxide monitors for determination of smoking status in smokers and nonsmokers with and without COPD. J Aerosol Med 2007; 20(4): 475-83.

Biochemical verification of tobacco use and cessation. Nicotine Tob Res 2002; 4(2): 149-59.

Kauffman RM, Ferketich AK, Murray DM, Bellair PE, Wewers ME. Measuring tobacco use in a prison population. Nicotine Tob Res 2010; 12(6): 582-8.

Maclaren DJ, Conigrave KM, Robertson JA, Ivers RG, Eades S, Clough AR. Using breath carbon monoxide to validate self-reported tobacco smoking in remote Australian Indigenous communities. Popul Health Metr 2010; 8(1): 2.


  • There are currently no refbacks.

Creative Commons Attribution-NonCommercial 3.0

This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.