Validation of Self-Reported Smokeless Tobacco Use by Measurement of Serum Cotinine Concentration Among US Adults
Validation of Self-Reported Smokeless Tobacco Use by Measurement of Serum Cotinine Concentration Among US Adults
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DOI：
10.1093/aje/kwu182
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发表时间：
2014-10-01
影响因子：
5
通讯作者：
King, Brian A.
中科院分区：
文献类型：
--
作者：
Agaku, Israel T.;King, Brian A.
尽管研究人员已经评估了自我报告吸烟与生物标志物水平之间的关系，但自我报告无烟烟草（SLT）使用信息的有效性尚不确定。我们使用2003-2004年、2005-2006年、2007-2008年和2009-2010年国家健康与营养检查调查（NHANES）的汇总数据，比较年龄在千分之一至18岁的美国成年人中自我报告的SLT使用情况与尼古丁代谢物可替宁的血清浓度。使用受试者工作特征分析来确定区分SLT使用者和非烟草使用者的最佳血清可替宁切点，并使用一致性分析来比较自我报告的SLT使用与可替宁水平。在2003-2010年期间完成NHANES的30,298名成年受访者中，418人报告在过去5天内只使用SLT而不使用其他类型的烟草（香烟，雪茄或烟斗），而23,457人报告不使用任何烟草。区分SLT使用者和非烟草使用者的最佳可替宁临界值为3.0 ng/mL（灵敏度= 97.0%，特异性= 93.0%），与推荐用于识别成年吸烟者的修订临界值相当。自我报告使用SLT和不使用烟草与可替宁的一致性分别为96.4%和93.7%。这些发现表明，成人自我报告的SLT使用情况与血清可替宁水平高度相关，最大限度地减少自我报告使用情况的错误分类的最佳临界值是血清可替宁浓度为3.0 ng/mL。
Although investigators have assessed the relationship between self-reported cigarette smoking and biomarker levels, the validity of self-reported information on smokeless tobacco (SLT) use is uncertain. We used aggregated data from the 2003-2004, 2005-2006, 2007-2008, and 2009-2010 administrations of the National Health and Nutrition Examination Survey (NHANES) to compare self-reported SLT use with serum concentrations of cotinine, a metabolite of nicotine, among US adults aged a parts per thousand yen18 years. Receiver operating characteristic analysis was used to determine the optimal serum cotinine cutpoint for discriminating SLT users from nonusers of tobacco, and concordance analysis was used to compare self-reported SLT use with cotinine levels. Among the 30,298 adult respondents who completed the NHANES during 2003-2010, 418 reported having exclusively used SLT and no other type of tobacco (cigarettes, cigars, or pipes) during the past 5 days, while 23,457 reported not using any tobacco. The optimal cotinine cutpoint for discriminating SLT users from non-tobacco users was 3.0 ng/mL (sensitivity = 97.0%, specificity = 93.0%), which was comparable to a revised cutpoint recommended for identifying adult cigarette smokers. Concordance with cotinine was 96.4% and 93.7% for self-reported SLT use and tobacco nonuse, respectively. These findings indicate that self-reported SLT use among adults correlates highly with serum cotinine levels and that the optimal cutpoint for minimizing misclassification of self-reported use is a serum cotinine concentration of 3.0 ng/mL.