• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of amjphAmerican Journal of Public Health Web SiteAmerican Public Health Association Web SiteSubmissionsSubscriptionsAbout Us
Am J Public Health. 1994 July; 84(7): 1086–1093.
PMCID: PMC1614767

The validity of self-reported smoking: a review and meta-analysis.

Abstract

OBJECTIVES. The purpose of this study was to identify circumstances in which biochemical assessments of smoking produce systematically higher or lower estimates of smoking than self-reports. A secondary aim was to evaluate different statistical approaches to analyzing variation in validity estimates. METHODS. Literature searches and personal inquiries identified 26 published reports containing 51 comparisons between self-reported behavior and biochemical measures. The sensitivity and specificity of self-reports of smoking were calculated for each study as measures of accuracy. RESULTS. Sensitivity ranged from 6% to 100% (mean = 87.5%), and specificity ranged from 33% to 100% (mean = 89.2%). Interviewer-administered questionnaires, observational studies, reports by adults, and biochemical validation with cotinine plasma were associated with higher estimates of sensitivity and specificity. CONCLUSIONS. Self-reports of smoking are accurate in most studies. To improve accuracy, biochemical assessment, preferably with cotinine plasma, should be considered in intervention studies and student populations.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.9M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Haley NJ, Hoffmann D. Analysis for nicotine and cotinine in hair to determine cigarette smoker status. Clin Chem. 1985 Oct;31(10):1598–1600. [PubMed]
  • Murray DM, O'Connell CM, Schmid LA, Perry CL. The validity of smoking self-reports by adolescents: a reexamination of the bogus pipeline procedure. Addict Behav. 1987;12(1):7–15. [PubMed]
  • Luepker RV, Pallonen UE, Murray DM, Pirie PL. Validity of telephone surveys in assessing cigarette smoking in young adults. Am J Public Health. 1989 Feb;79(2):202–204. [PMC free article] [PubMed]
  • Windsor R, Morris J, Cutter G, Lowe J, Higginbotham J, Perkins L, Konkol L. Sensitivity, specificity and predictive value of saliva thiocyanate among pregnant women. Addict Behav. 1989;14(4):447–452. [PubMed]
  • Gianrossi R, Detrano R, Mulvihill D, Lehmann K, Dubach P, Colombo A, McArthur D, Froelicher V. Exercise-induced ST depression in the diagnosis of coronary artery disease. A meta-analysis. Circulation. 1989 Jul;80(1):87–98. [PubMed]
  • Phillips KA. The use of meta-analysis in technology assessment: a meta-analysis of the enzyme immunosorbent assay human immunodeficiency virus antibody test. J Clin Epidemiol. 1991;44(9):925–931. [PubMed]
  • Bauman KE, Dent CW. Influence of an objective measure on self-reports of behavior. J Appl Psychol. 1982 Oct;67(5):623–628. [PubMed]
  • Bauman KE, Koch GG, Bryan ES. Validity of self-reports of adolescent cigarette smoking. Int J Addict. 1982 Oct;17(7):1131–1136. [PubMed]
  • Cohen JD, Bartsch GE. A comparison between carboxyhemoglobin and serum thiocyanate determinations as indicators of cigarette smoking. Am J Public Health. 1980 Mar;70(3):284–286. [PMC free article] [PubMed]
  • Fortmann SP, Rogers T, Vranizan K, Haskell WL, Solomon DS, Farquhar JW. Indirect measures of cigarette use: expired-air carbon monoxide versus plasma thiocyanate. Prev Med. 1984 Jan;13(1):127–135. [PubMed]
  • Gillies PA, Wilcox B, Coates C, Kristmundsdöttir F, Reid DJ. Use of objective measurement in the validation of self-reported smoking in children aged 10 and 11 years: saliva thiocyanate. J Epidemiol Community Health. 1982 Sep;36(3):205–208. [PMC free article] [PubMed]
  • Haddow JE, Palomaki GE, Knight GJ. Use of serum cotinine to assess the accuracy of self reported non-smoking. Br Med J (Clin Res Ed) 1986 Nov 15;293(6557):1306–1306. [PMC free article] [PubMed]
  • Luepker RV, Pechacek TF, Murray DM, Johnson CA, Hund F, Jacobs DR. Saliva thiocyanate: a chemical indicator of cigarette smoking in adolescents. Am J Public Health. 1981 Dec;71(12):1320–1324. [PMC free article] [PubMed]
  • McNeill AD, Jarvis MJ, West R, Russell MA, Bryant A. Saliva cotinine as an indicator of cigarette smoking in adolescents. Br J Addict. 1987 Dec;82(12):1355–1360. [PubMed]
  • Noland MP, Kryscio RJ, Riggs RS, Linville LH, Perritt LJ, Tucker TC. Saliva cotinine and thiocyanate: chemical indicators of smokeless tobacco and cigarette use in adolescents. J Behav Med. 1988 Oct;11(5):423–433. [PubMed]
  • Pechacek TF, Murray DM, Luepker RV, Mittelmark MB, Johnson CA, Shutz JM. Measurement of adolescent smoking behavior: rationale and methods. J Behav Med. 1984 Mar;7(1):123–140. [PubMed]
  • Petitti DB, Friedman GD, Kahn W. Accuracy of information on smoking habits provided on self-administered research questionnaires. Am J Public Health. 1981 Mar;71(3):308–311. [PMC free article] [PubMed]
  • Pierce JP, Dwyer T, DiGiusto E, Carpenter T, Hannam C, Amin A, Yong C, Sarfaty G, Shaw J, Burke N. Cotinine validation of self-reported smoking in commercially run community surveys. J Chronic Dis. 1987;40(7):689–695. [PubMed]
  • Pojer R, Whitfield JB, Poulos V, Eckhard IF, Richmond R, Hensley WJ. Carboxyhemoglobin, cotinine, and thiocyanate assay compared for distinguishing smokers from non-smokers. Clin Chem. 1984 Aug;30(8):1377–1380. [PubMed]
  • Prignot J. Quantification and chemical markers of tobacco-exposure. Eur J Respir Dis. 1987 Jan;70(1):1–7. [PubMed]
  • Saloojee Y, Vesey CJ, Cole PV, Russell MA. Carboxyhaemoglobin and plasma thiocyanate: complementary indicators of smoking behaviour? Thorax. 1982 Jul;37(7):521–525. [PMC free article] [PubMed]
  • Sillett RW, Wilson MB, Malcolm RE, Ball KP. Deception among smokers. Br Med J. 1978 Oct 28;2(6146):1185–1186. [PMC free article] [PubMed]
  • Slattery ML, Hunt SC, French TK, Ford MH, Williams RR. Validity of cigarette smoking habits in three epidemiologic studies in Utah. Prev Med. 1989 Jan;18(1):11–19. [PubMed]
  • Stookey GK, Katz BP, Olson BL, Drook CA, Cohen SJ. Evaluation of biochemical validation measures in determination of smoking status. J Dent Res. 1987 Oct;66(10):1597–1601. [PubMed]
  • van Vunakis H, Tashkin DP, Rigas B, Simmons M, Gjika HB, Clark VA. Relative sensitivity and specificity of salivary and serum cotinine in identifying tobacco-smoking status of self-reported nonsmokers and smokers of tobacco and/or marijuana. Arch Environ Health. 1989 Jan-Feb;44(1):53–58. [PubMed]
  • Vogt TM, Selvin S, Widdowson G, Hulley SB. Expired air carbon monoxide and serum thiocyanate as objective measures of cigarette exposure. Am J Public Health. 1977 Jun;67(6):545–549. [PMC free article] [PubMed]
  • Wagenknecht LE, Cutter GR, Haley NJ, Sidney S, Manolio TA, Hughes GH, Jacobs DR. Racial differences in serum cotinine levels among smokers in the Coronary Artery Risk Development in (Young) Adults study. Am J Public Health. 1990 Sep;80(9):1053–1056. [PMC free article] [PubMed]
  • Wald NJ, Idle M, Boreham J, Bailey A. Carbon monoxide in breath in relation to smoking and carboxyhaemoglobin levels. Thorax. 1981 May;36(5):366–369. [PMC free article] [PubMed]
  • Williams CL, Eng A, Botvin GJ, Hill P, Wynder EL. Validation of students' self-reported cigarette smoking status with plasma cotinine levels. Am J Public Health. 1979 Dec;69(12):1272–1274. [PMC free article] [PubMed]
  • Laird NM, Mosteller F. Some statistical methods for combining experimental results. Int J Technol Assess Health Care. 1990;6(1):5–30. [PubMed]
  • Curry S, Marlatt GA, Gordon JR. Abstinence violation effect: validation of an attributional construct with smoking cessation. J Consult Clin Psychol. 1987 Apr;55(2):145–149. [PubMed]
  • Murray RP, Connett JE, Lauger GG, Voelker HT. Error in smoking measures: effects of intervention on relations of cotinine and carbon monoxide to self-reported smoking. The Lung Health Study Research Group. Am J Public Health. 1993 Sep;83(9):1251–1257. [PMC free article] [PubMed]
  • Jenicek M. Meta-analysis in medicine. Where we are and where we want to go. J Clin Epidemiol. 1989;42(1):35–44. [PubMed]
  • Fleiss JL, Gross AJ. Meta-analysis in epidemiology, with special reference to studies of the association between exposure to environmental tobacco smoke and lung cancer: a critique. J Clin Epidemiol. 1991;44(2):127–139. [PubMed]

Articles from American Journal of Public Health are provided here courtesy of American Public Health Association

Formats:

Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...

Links

  • Cited in Books
    Cited in Books
    PubMed Central articles cited in books
  • PubMed
    PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...