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KMID : 1156220140400060492
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Journal of Environmental Health Sciences
2014 Volume.40 No. 6 p.492 ~ p.501
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Validity Assessment of Self-reported Smoking Status: Results from the Korean National Environmental Health Survey (KoNEHS) 2009-2011
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Choi Wook-Hee
Park Kyung-Hwa
Kim Hyun-Jeong
Ryu Jung-Min
Yu Seung-Do
Choi Kyung-Hee
Kim Sue-Jin
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Abstract
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Objectives: The purpose of this study was to assess the validity of self-reported cigarette smoking status and investigate factors associated with the accuracy self-reported and measured urinary cotinine in Korean adults.
Methods: We used data from the 1st Korean National Environmental Health Survey (2009-2011) among adults aged ≥19 years (N=6,246). The survey examined self-reported smoking status, and urinary cotinine was regarded as the biomarker of exposure to tobacco smoke. Urinary cotinine was analyzed using a gas chromatography-mass spectrometry (GC/MS) and data analysis was conducted using IBM SPSS version 20.0, which uses the sample weight and calculates variance estimates to adjust for the unequal probability of selection into the survey.
Results: We calculated a cut-off point (53.3 ug/L) by using a ROC (Receiver Operating Characteristic) curve. The smoking prevalence was 24.6% based on self-reported data and 28.2% based on urinary cotinine concentrations. When we assessed the agreement between self-reported and urinary cotinine, we found an average agreement of 97.7% among self-reported smokers and 94.5% among self-reported non-smokers. Among self-reported smokers, factors affected the discrepancy were age, household economic status and average number of cigarettes smoked per day. On the other hand, gender, former smoking experience, and exposure to SHS (second hand smoke) were associated with discrepancies among self-reported non-smokers.
Conclusion: These results suggest that self-reported data on smoking status provide a valid estimate of actual smoking status. In future research, we will conduct a continuous monitoring study for reliability verification of the data to reduce potential interpretation errors.
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KEYWORD
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Adult, Cotinine, KoNEHS, Smoking, Urine
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