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Tob Control. 2015 Jan;24(1):48-53. doi: 10.1136/tobaccocontrol-2013-051174. Epub 2013 Aug 30.

Validity of self-reported adult secondhand smoke exposure.

Author information

1
Department of Medicine, Stanford University, Stanford Prevention Research Center, Stanford, California, USA.
2
Department of Medicine, Division of Cardiology, University of California, San Francisco, San Francisco, California, USA.
3
Departments of Medicine and Bioengineering and Therapeutic Sciences, Division of Clinical Pharmacology and Experimental Therapeutics, University of California, San Francisco, San Francisco, California, USA.

Abstract

OBJECTIVES:

Exposure of adults to secondhand smoke (SHS) has immediate adverse effects on the cardiovascular system and causes coronary heart disease. The current study evaluated brief self-report screening measures for accurately identifying adult cardiology patients with clinically significant levels of SHS exposure in need of intervention.

DESIGN AND SETTING:

A cross-sectional study conducted in a university-affiliated cardiology clinic and cardiology inpatient service.

PATIENTS:

Participants were 118 non-smoking patients (59% male, mean age=63.6 years, SD=16.8) seeking cardiology services.

MAIN OUTCOME MEASURES:

Serum cotinine levels and self-reported SHS exposure in the past 24 h and 7 days on 13 adult secondhand exposure to smoke (ASHES) items.

RESULTS:

A single item assessment of SHS exposure in one's own home in the past 7 days was significantly correlated with serum cotinine levels (r=0.41, p<0.001) with sensitivity ≥75%, specificity >85% and correct classification rates >85% at cotinine cut-off points of >0.215 and >0.80 ng/mL. The item outperformed multi-item scales, an assessment of home smoking rules, and SHS exposure assessed in other residential areas, automobiles and public settings. The sample was less accurate at self-reporting lower levels of SHS exposure (cotinine 0.05-0.215 ng/mL).

CONCLUSIONS:

The single item ASHES-7d Home screener is brief, assesses recent SHS exposure over a week's time, and yielded the optimal balance of sensitivity and specificity. The current findings support use of the ASHES-7d Home screener to detect SHS exposure and can be easily incorporated into assessment of other major vital signs in cardiology.

KEYWORDS:

Primary Health Care; Priority/special Populations; Secondhand Smoke; Surveillance and Monitoring

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