Case study on changes in exhalation of carbon monoxide and nitrogen oxide in breath and skin gas during 2-day smoking cessation and restart.

It is generally accepted that the breath of current smokers contains higher carbon monoxide (CO) and lower nitric oxide (NO) and that smoking cessation increases NO and decreases CO in breath. However, it remains unknown whether cigarette cessation reversibly changes breath NO/CO levels and how smoking cessation and restart could modify CO/NO-producing abilities in breath and skin gas. In the present case study, a so-called healthy smoker repeatedly performed 2-day smoking cessation and restart. To compare breath and skin exhalation, minute exhalation volumes per body surface of CO (VCO), NO (VNO) and nitrogen oxide (NO(x), VNO(x)) in breath and skin gas were calculated using gas chromatography with a semiconductor sensor, chemiluminescence method and respiro-monitor. We found a rapid decrease of breath VCO during smoking cessation and an increase of breath VCO after restart, insignificant changes in skin VCO, insignificant changes in breath and skin VNO, and significant biphasic and reversible changes in breath and skin VNO(x)/VNO(2) (= VNO(x) - VNO). Dominant NO(x) was NO in breath and NO(2) in skin gas. These results suggested that CO and NO(x) in breath and skin gas could be reversibly and acutely altered during 2-day smoking cessation and restart even in the case of a long-term cigarette smoker.