Carboxyhemoglobin and thiocyanate as biomarkers of exposure to carbon monoxide and hydrogen cyanide in tobacco smoke

Exp Toxicol Pathol. 2006 Nov;58(2-3):101-24. doi: 10.1016/j.etp.2006.07.001. Epub 2006 Sep 14.


The determination of biomarkers in human body fluids is a useful tool, which allows the quantitative assessment of the exposure to chemicals or complex mixtures of chemicals and of early biological effects as a result of the exposure. Biomarkers require validation before their successful application in human studies. This review describes some general purposes of human biomonitoring and biomarkers including the requirements for validation. Risk assessment and harm reduction of smoking and tobacco products, respectively, is a very suitable field for the application of biomarkers. A brief historical review shows that the application of biomarkers of exposure and effect in human smoking goes back more than 150 years. Two 'classical' biomarkers of exposure to tobacco, namely carboxyhemoglobin (COHb and its equivalent carbon monoxide in exhalate, COex) and thiocyanate (SCN) in body fluids are discussed in terms of sources of exposure, metabolism, disposition kinetics and influencing host factors. Data on COHb/COex and SCN in nonsmokers and smokers as well as the power to discriminate between smokers and nonsmokers are presented. Both biomarkers are significantly correlated with the daily cigarette consumption. Smoking machine-derived yields of the precursors carbon monoxide and hydrogen cyanide were not correlated with COHb/COex and SCN, respectively. It is concluded that, while COHb/COex is a useful biomarker for assessing the smoke inhalation, preferably in controlled studies, the application of SCN in body fluids as a biomarker for smoking is limited, mainly due to the abundance of other sources for SCN.

Publication types

  • Review

MeSH terms

  • Biomarkers
  • Breath Tests
  • Carbon Monoxide / analysis
  • Carbon Monoxide / metabolism*
  • Carboxyhemoglobin / analysis*
  • Environmental Monitoring / methods*
  • Humans
  • Hydrogen Cyanide / analysis
  • Hydrogen Cyanide / metabolism*
  • Models, Biological
  • Smoke / analysis
  • Smoking / metabolism*
  • Thiocyanates / analysis*


  • Biomarkers
  • Smoke
  • Thiocyanates
  • Hydrogen Cyanide
  • Carbon Monoxide
  • Carboxyhemoglobin
  • thiocyanate