HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Submit a response Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Wagenknecht, L E Articles by Friedman, G D Search for Related Content PubMed PubMed Citation Articles by Wagenknecht, L E Articles by Friedman, G D

Misclassification of smoking status in the CARDIA study: a comparison of self-report with serum cotinine levels.

L E Wagenknecht, G L Burke, L L Perkins, N J Haley and G D Friedman

Department of Public Health Science, Bowman Gray School of Medicine in Winston-Salem, NC 27157-1063.

BACKGROUND. Although widely used in epidemiological studies, self-report has been shown to underestimate the prevalence of cigarette smoking in some populations. METHODS. In the CARDIA study, self-report of cigarette smoking was validated against a biochemical marker of nicotine uptake, serum cotinine. RESULTS. The prevalence of smoking was slightly lower when defined by self-report (30.9%) than when defined by cotinine levels equal to or greater than 14 ng/mL (32.2%, P less than .05). The misclassification rate (proportion of reported nonsmokers with cotinine levels of at least 14 ng/mL) was 4.2% and was significantly higher among subjects who were Black, had a high school education or less, or were reported former smokers. Possible reasons for misclassification include reporting error, environmental tobacco smoke, and an inappropriate cutoff point for delineation of smoking status. Using self-report as the gold standard, the cotinine cutoff points that maximized sensitivity and specificity were 14, 9, and 15 ng/mL for all, White, and Black subjects, respectively. The misclassification rate remained significantly higher in Black than in White subjects using these race-specific criteria. CONCLUSIONS. Misclassification of cigarette smoking by self-report was low in these young adults; however, within certain race/education groups, self-report may underestimate smoking prevalence by up to 4%.

This article has been cited by other articles:

				R.E. Nowjack-Raymer and A. Sheiham Numbers of Natural Teeth, Diet, and Nutritional Status in US Adults J. Dent. Res., December 1, 2007; 86(12): 1171 - 1175. [Abstract] [Full Text] [PDF]

				A. M. Rasmusson, M. R. Picciotto, and S. Krishnan-Sarin Smoking as a complex but critical covariate in neurobiological studies of posttraumatic stress disorders: a review J Psychopharmacol, September 1, 2006; 20(5): 693 - 707. [Abstract] [PDF]

				T. K Houston, S. D Person, M. J Pletcher, K. Liu, C. Iribarren, and C. I Kiefe Active and passive smoking and development of glucose intolerance among young adults in a prospective cohort: CARDIA study BMJ, May 6, 2006; 332(7549): 1064 - 1069. [Abstract] [Full Text] [PDF]

				M. Rasmussen, M. T. Damsgaard, B. E. Holstein, L. H. Poulsen, and P. Due School connectedness and daily smoking among boys and girls: the influence of parental smoking norms Eur J Public Health, December 1, 2005; 15(6): 607 - 612. [Abstract] [Full Text] [PDF]

				P. Tanuseputro, D. G. Manuel, S. E. Schultz, H. Johansen, and C. A. Mustard Improving Population Attributable Fraction Methods: Examining Smoking-attributable Mortality for 87 Geographic Regions in Canada Am. J. Epidemiol., April 15, 2005; 161(8): 787 - 798. [Abstract] [Full Text] [PDF]

				M Huisman, A E Kunst, and J P Mackenbach Educational inequalities in smoking among men and women aged 16 years and older in 11 European countries Tob. Control, April 1, 2005; 14(2): 106 - 113. [Abstract] [Full Text] [PDF]

				G. King, A. Polednak, R. B. Bendel, M. C. Vilsaint, and S. B. Nahata Disparities in Smoking Cessation Between African Americans and Whites: 1990-2000 Am J Public Health, November 1, 2004; 94(11): 1965 - 1971. [Abstract] [Full Text] [PDF]

				N. Seshadri, T. R. Gildea, K. McCarthy, C. Pothier, M. S. Kavuru, and M. S. Lauer Association of an Abnormal Exercise Heart Rate Recovery With Pulmonary Function Abnormalities Chest, April 1, 2004; 125(4): 1286 - 1291. [Abstract] [Full Text] [PDF]

				J H Zaccai How to assess epidemiological studies Postgrad. Med. J., March 1, 2004; 80(941): 140 - 147. [Abstract] [Full Text] [PDF]

				S E Gilman, D B Abrams, and S L Buka Socioeconomic status over the life course and stages of cigarette use: initiation, regular use, and cessation J. Epidemiol. Community Health, October 1, 2003; 57(10): 802 - 808. [Abstract] [Full Text] [PDF]

				N. Schmitz, J. Kruse, and J. Kugler Disabilities, Quality of Life, and Mental Disorders Associated With Smoking and Nicotine Dependence Am J Psychiatry, September 1, 2003; 160(9): 1670 - 1676. [Abstract] [Full Text] [PDF]

				G. King, R. K. Mallett, L. T. Kozlowski, and R. B. Bendel African Americans' Attitudes Toward Cigarette Excise Taxes Am J Public Health, May 1, 2003; 93(5): 828 - 834. [Abstract] [Full Text] [PDF]

				R. A. Silverman, E. D. Boudreaux, P. G. Woodruff, S. Clark, and C. A. Camargo Jr Cigarette Smoking Among Asthmatic Adults Presenting to 64 Emergency Departments Chest, May 1, 2003; 123(5): 1472 - 1479. [Abstract] [Full Text] [PDF]

				A. V. Diez Roux, S. S. Merkin, P. Hannan, D. R. Jacobs, and C. I. Kiefe Area Characteristics, Individual-Level Socioeconomic Indicators, and Smoking in Young Adults: The Coronary Artery Disease Risk Development in Young Adults Study Am. J. Epidemiol., February 15, 2003; 157(4): 315 - 326. [Abstract] [Full Text] [PDF]

				W. K. Al-Delaimy, G. N. Mahoney, F. E. Speizer, and W. C. Willett Toenail Nicotine Levels as a Biomarker of Tobacco Smoke Exposure Cancer Epidemiol. Biomarkers Prev., November 1, 2002; 11(11): 1400 - 1404. [Abstract] [Full Text] [PDF]

				W K Al-Delaimy Hair as a biomarker for exposure to tobacco smoke Tob. Control, September 1, 2002; 11(3): 176 - 182. [Abstract] [Full Text] [PDF]

				M. A. Whooley, A. L. Boyd, J. M. Gardin, and D. R. Williams Religious Involvement and Cigarette Smoking in Young Adults: The CARDIA Study Arch Intern Med, July 22, 2002; 162(14): 1604 - 1610. [Abstract] [Full Text] [PDF]

				S. A. Newell, R. W. Sanson-Fisher, and N. J. Savolainen Systematic Review of Psychological Therapies for Cancer Patients: Overview and Recommendations for Future Research J Natl Cancer Inst, April 17, 2002; 94(8): 558 - 584. [Abstract] [Full Text] [PDF]

				E Vartiainen, T Seppala, P Lillsunde, and P Puska Validation of self reported smoking by serum cotinine measurement in a community-based study J. Epidemiol. Community Health, March 1, 2002; 56(3): 167 - 170. [Abstract] [Full Text] [PDF]

				F. R. Khuri, E. S. Kim, J. J. Lee, R. J. Winn, S. E. Benner, S. M. Lippman, K. K. Fu, J. S. Cooper, E. E. Vokes, R. M. Chamberlain, et al. The Impact of Smoking Status, Disease Stage, and Index Tumor Site on Second Primary Tumor Incidence and Tumor Recurrence in the Head and Neck Retinoid Chemoprevention Trial Cancer Epidemiol. Biomarkers Prev., August 1, 2001; 10(8): 823 - 829. [Abstract] [Full Text] [PDF]

				J. A. Krishnan, G. B. Diette, E. A. Skinner, B. D. Clark, D. Steinwachs, and A. W. Wu Race and Sex Differences in Consistency of Care With National Asthma Guidelines in Managed Care Organizations Arch Intern Med, July 9, 2001; 161(13): 1660 - 1668. [Abstract] [Full Text] [PDF]

				R. S. Caraballo, G. A. Giovino, T. F. Pechacek, and P. D. Mowery Factors Associated with Discrepancies between Self-Reports on Cigarette Smoking and Measured Serum Cotinine Levels among Persons Aged 17 Years or Older : Third National Health and Nutrition Examination Survey, 1988-1994 Am. J. Epidemiol., April 15, 2001; 153(8): 807 - 814. [Abstract] [Full Text] [PDF]

				O. A. Ghosheh, L. P. Dwoskin, D. K. Miller, and P. A. Crooks Accumulation of Nicotine and Its Metabolites in Rat Brain After Intermittent or Continuous Peripheral Administration of [2'-14C]Nicotine Drug Metab. Dispos., April 13, 2001; 29(5): 645 - 651. [Abstract] [Full Text]

				J.P. Mackenbach, A.E.J.M. Cavelaars, A.E. Kunst, and F. Groenhof Socioeconomic inequalities in cardiovascular disease mortality. An international study Eur. Heart J., July 2, 2000; 21(14): 1141 - 1151. [Abstract] [PDF]

				A E J M Cavelaars, A E Kunst, J J M Geurts, R Crialesi, L Grötvedt, U Helmert, E Lahelma, O Lundberg, J Matheson, A Mielck, et al. Educational differences in smoking: international comparison BMJ, April 22, 2000; 320(7242): 1102 - 1107. [Abstract] [Full Text]

				C. J. Smith, T. H. Fischer, and S. B. Sears Environmental Tobacco Smoke, Cardiovascular Disease, and the Nonlinear Dose-Response Hypothesis Toxicol. Sci., April 1, 2000; 54(2): 462 - 472. [Abstract] [Full Text] [PDF]

				F. Mathews, P. Yudkin, R. F Smith, and A. Neil Nutrient intakes during pregnancy: the influence of smoking status and age J. Epidemiol. Community Health, January 1, 2000; 54(1): 17 - 23. [Abstract] [Full Text]

				D. Tang, D. Warburton, S. R. Tannenbaum, P. Skipper, R. M. Santella, G. S. Cereijido, F. G. Crawford, and F. P. Perera Molecular and Genetic Damage from Environmental Tobacco Smoke in Young Children Cancer Epidemiol. Biomarkers Prev., May 1, 1999; 8(5): 427 - 431. [Abstract] [Full Text]

				R. S. Caraballo, G. A. Giovino, T. F. Pechacek, P. D. Mowery, P. A. Richter, W. J. Strauss, D. J. Sharp, M. P. Eriksen, J. L. Pirkle, and K. R. Maurer Racial and Ethnic Differences in Serum Cotinine Levels of Cigarette Smokers: Third National Health and Nutrition Examination Survey, 1988-1991 JAMA, July 8, 1998; 280(2): 135 - 139. [Abstract] [Full Text] [PDF]

				M. R. Duenas, C. J. Smith, M. W. Ogden, E. Schultz Jr, G. Howard, L. E. Wagenknecht, G. L. Burke, and F. J. Nieto Tobacco Smoke and Atherosclerosis Progression JAMA, July 1, 1998; 280(1): 32 - 33. [Full Text] [PDF]

				K. Phillips, D.A. Howard, M.C. Bentley, and G. Alvan Assessment by Personal Monitoring of Respirable Suspended Particles and Environmental Tobacco Smoke Exposure for Non-Smokers in Sydney, Australia Indoor and Built Environment, July 1, 1998; 7(4): 188 - 203. [Abstract] [PDF]

				K. E. Lund, A. Skrondal, H. Vertio, and A. R. Helgason Children's residential exposure to environmental tobacco smoke varies greatly between the Nordic countries Scand J Public Health, April 1, 1998; 26(2): 115 - 120. [Abstract] [PDF]

				K. E. Lund, A. Skrondal, H. Vertio, and A. R Helgason To what extent do parents strive to protect their children from environmental tobacco smoke in the Nordic countries? A population-based study Tob. Control, March 1, 1998; 7(1): 56 - 60. [Abstract] [Full Text]

				D. L. Faulkner and R. K. Merritt Race and Cigarette Smoking Among United States Adolescents: The Role of Lifestyle Behaviors and Demographic Factors Pediatrics, February 1, 1998; 101 (2): e4 - e4. [Abstract] [Full Text] [PDF]

				G. Howard, L. E. Wagenknecht, G. L. Burke, A. Diez-Roux, G. W. Evans, P. McGovern, F. J. Nieto, G. S. Tell, and for the ARIC Investigators Cigarette Smoking and Progression of Atherosclerosis: The Atherosclerosis Risk in Communities (ARIC) Study JAMA, January 14, 1998; 279(2): 119 - 124. [Abstract] [Full Text] [PDF]

				F. P. Perera Environment and Cancer: Who Are Susceptible? Science, November 7, 1997; 278(5340): 1068 - 1073. [Abstract] [Full Text]

				K. Resnicow, R. Vaughan, R. Futterman, R. E. Weston, J. Royce, C. Parms, M. D. Hearn, M. Smith, H. P. Freeman, and M. A. Orlandi A Self-Help Smoking Cessation Program for Inner-City African Americans: Results from the Harlem Health Connection Project Health Educ Behav, April 1, 1997; 24(2): 201 - 217. [Abstract] [PDF]