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While the study did not assess the levels of urine cotinine or carboxyhemoglobin, we selected CO as a biological marker because it is simple and quick to measure, less expensive than a battery of laboratory tests, and noninvasive, making it more agreeable to the subjects as reported by Middleton et al

The Nrf2sMAF heterodimer binds to the antioxidant response element (ARE), which leads to the transcription of genes encoding antioxidant and detoxification enzymes such as SOD, CAT, GP X , heme oxygenase 1 (HO-1), NAD(P)H quinone dehydrogenase 1 (NQO1), which protect cells from oxidative stress and toxins (124126) (Figure 3)