Quality of measurement of smoking status by self-report and saliva cotinine among pregnant women

Boyd, Neal Richard, Windsor, Richard A., Perkins, Laura L. and Lowe, John B. (1998) Quality of measurement of smoking status by self-report and saliva cotinine among pregnant women. Maternal and Child Health Journal, 2 2: 77-83. doi:10.1023/A:1022936705438

Author Boyd, Neal Richard
Windsor, Richard A.
Perkins, Laura L.
Lowe, John B.
Title Quality of measurement of smoking status by self-report and saliva cotinine among pregnant women
Journal name Maternal and Child Health Journal   Check publisher's open access policy
ISSN 1092-7875
Publication date 1998-06-01
Sub-type Article (original research)
DOI 10.1023/A:1022936705438
Volume 2
Issue 2
Start page 77
End page 83
Total pages 7
Editor Milton Kotelchuck
Place of publication New York
Publisher Plenum Publishing Corporation
Collection year 1999
Language eng
Subject C1
321216 Health Promotion
730201 Women's health
Formatted abstract
Objective. The objectives of this paper were to determine the rate of misclassification of smoking and nonsmoking status by self-reports and saliva cotinine of pregnant women participating in a smoking cessation trial, determine the relationship of the number of cigarettes smoked per day and saliva cotinine, and examine whether misclassification was due to an inappropriate saliva cotinine cutoff point.

Methods. End of pregnancy self-reports of smoking status and saliva cotinine were used to calculate misclassification rates.

Results. The findings revealed that 61 of 441 self-reported smokers had biochemical values inconsistent with smoking status for a smoking misclassification rate of 13.8%. The results also revealed that 28 of 107 self-reported quitters had cotinine values consistent with smoking status for a nonsmoking misclassification rate of 26.2%. Receiver Operating Characteristic (ROC) curves were then plotted to determine whether misclassification resulted from an inappropriate cutoff point. The cotinine cutoff point that maximized sensitivity and specificity for all women was 24 ng/ml. Racial ROC comparisons indicated a higher cutoff point for blacks than whites. Use of any of the ROC indicated cutoff points would not change the misclassification rates.

Conclusions. These findings suggest that underreporting of smoking status during pregnancy is high and that social desirability of nonsmoking status may have contributed to the lack of precision in saliva cotinine to distinguish smoking status in this study.
© 1998 Plenum Publishing Corporation
Q-Index Code C1

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Public Health Publications
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Created: Tue, 10 Jun 2008, 23:26:18 EST