Korean J Fam Pract.  2022 Dec;12(5):375-383. 10.21215/kjfp.2022.12.5.375.

Smoking Prevalence and Factors Associated with False Reporting in Korean Adolescents: The Korea National Health and Nutrition Examination Survey (2016–2020)

• Park SJ
• Seo YB
• Lee J
• Kim SH
• Kim CH

• KMID: 2536834
• DOI: http://doi.org/10.21215/kjfp.2022.12.5.375

Abstract

Background
The smoking rate of domestic adolescents is typically determined using the self-questionnaire method. However, use of the urinary cotinine test can more accurately confirm the actual smoking rate. Here we used the self-questionnaire method and the urinary cotinine test to confirm smoking prevalence among adolescents and attempted to investigate factors associated with false responses among smokers.
Methods
This study utilized the Korea National Health and Nutrition Examination Survey data collected in 2016–2020. Among 1,258 adolescents, the actual smoking rate was analyzed based on self-reported smoking and urinary cotinine level (≥50 ng/mL). Demographic factors, physical measurements, and health behavioral factors, mental health factors, and smoking-related variables were set; factors related to false responses were identified through logistic regression analysis.
Results
Among the total subjects, 94 adolescents (8.2%) reported being current smokers, while 142 adolescents (13.8%) were identified as actual smokers by the urine cotinine test. The self-reported and actual smoking rates were higher among male patients, older patients, secondhand smoke exposure groups, and those with drinking experience. Sex, household income, and depression were factors related to false responses.
Conclusion
In determining smoking rates among adolescents, use of the self-questionnaire method may give inaccurate results. Various factors can influence false responses, so caution is required in interpretation. The use of additional tests, such as the urine cotinine test, will help accurately determine the smoking rate among adolescents.

Keyword

Smoking; Adolescents; Self-Report; Cotinine; False Responses