Agreement between Self-Report on Smoking Cessation and Urinary Cotinine Test

Kim, Jeong Yu; Kwon, Min; Joe, Keun Ho; Chai, Suk Hi; Won, Wang Youn; Kim, Dai Jin

Abstract

OBJECTIVE
Self-report is being used in most of studies investigating the therapeutic effect of smoking cessation clinics of public health centers in Korea instead of cotinine or other chemical markers of nicotine exposure. This study was conducted to evaluate the agreement between self-report and urinary cotinine test after smoking cessation program.
METHODS
The study subjects were 333 adult male who visited public health center and participated in 12-week scheduled smoking cessation program. Questionnaires including demographic data and information about cigarette use, blood test, and urinary cotinine test were performed to all subjects during initial evaluation. At the end of the program, smoking status of subjects was assessed by an oral self-report and additional blood and urinary cotinine tests were done to the subjects who agreed.
RESULTS
52 participants who gave both self-report on smoking status and urine sample were included in the final analysis. The overall percentage agreement was 67.3%, and the overall Kappa index was 0.367. The sensitivity, specificity, positive predictive value, and negative predictive value of self-report in detecting smoking state were 46.43%, 91.67%, 86.67%, and 59.46%, respectively.
CONCLUSION
The agreement between self-report and urinary cotinine test in detecting smoking status after smoking cessation program was relatively low on account of participants who failed to quit smoking but reported their smoking status incorrectly. Therefore, the use of objective measures such as urine cotinine should be considered in evaluation of successful smoking cessation.