Estimates of Nondisclosure of Cigarette Smoking Among Pregnant and Nonpregnant Women of Reproductive Age in the United States
Estimates of Nondisclosure of Cigarette Smoking Among Pregnant and Nonpregnant Women of Reproductive Age in the United States
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DOI：
10.1093/aje/kwq381
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发表时间：
2011-02-01
影响因子：
5
通讯作者：
Bernert, John T.
中科院分区：
文献类型：
--
作者：
Dietz, Patricia M.;Homa, David;Bernert, John T.
尽管基于临床的研究使用生化验证来估计否认吸烟但实际上吸烟的孕妇的百分比，但尚未计算出美国孕妇吸烟状况的基于人群的估计。作者分析了1999-2006年全国健康与营养调查的数据，估计了994名20-44岁未报告吸烟但血清可替宁水平超过主动吸烟定义临界点的孕妇和3203名非孕妇的百分比（未披露）。主动吸烟被定义为自我报告吸烟或血清可替宁浓度超过主动吸烟的临界值。总体而言，13.0%（95%可信区间（CI）： 8.8, 17.1）的孕妇和29.7%（95%可信区间（CI）： 27.3, 32.1）的非孕妇是活跃吸烟者。妊娠期主动吸烟者的不知情程度（22.9%,95% CI: 11.8, 34.6）高于非妊娠期吸烟者（9.2%,95% CI: 7.1, 11.2）。在怀孕的活跃吸烟者中，不知情与年龄较小（20-24岁）有关。在未怀孕的活跃吸烟者中，不披露与墨西哥裔美国人和非西班牙裔黑人种族/民族有关。依赖于自我报告吸烟状况的研究和监测系统容易低估吸烟率，特别是孕妇，而低报可能因人口特征而异。
Although clinic-based studies have used biochemical validation to estimate the percentage of pregnant women who deny smoking but are actually smokers, a population-based estimate of nondisclosure of smoking status in US pregnant women has not been calculated. The authors analyzed data from the 1999-2006 National Health and Nutrition Examination Survey and estimated the percentage of 994 pregnant and 3,203 nonpregnant women 20-44 years of age who did not report smoking but had serum cotinine levels that exceeded the defined cut point for active smoking (nondisclosure). Active smoking was defined as self-reporting smoking or having a serum cotinine concentration that exceeded the cut point for active smoking. Overall, 13.0% (95% confidence interval (CI): 8.8, 17.1) of pregnant women and 29.7% (95% CI: 27.3, 32.1) of nonpregnant women were active smokers. Nondisclosure was higher among pregnant active smokers (22.9%, 95% CI: 11.8, 34.6) than among nonpregnant smokers (9.2%, 95% CI: 7.1, 11.2). Among pregnant active smokers, nondisclosure was associated with younger age (20-24 years). Among nonpregnant active smokers, nondisclosure was associated with Mexican-American and non-Hispanic black race/ethnicity. Studies and surveillance systems that rely on self-reported smoking status are subject to underestimation of smoking prevalence, especially among pregnant women, and underreporting may vary by demographic characteristics.