Validity assessment of self-reported smoking status to detection of urine cotinine levels among patients with tuberculosis undergoing tobacco cessation treatment

Jagannath Purushothama, Sanjeev Badiger, Nanjesh Kumar, Neevan D'souza, Mackwin Dmello, Jeby Jose Olickal, Nandakishore Baikunje
2022 Biomedicine  
Introduction and Aim: Tobacco cessation programs by and large use self-reporting as the gold standard for assessing tobacco use. However, self-reporting may be skewed due to the socio-demographic profile and the context in which the respondents share their tobacco history after undergoing tobacco cessation treatment. It is therefore, imperative to validate the respondents' self-reported smoking status in an effective manner. Hence, this study aimed in validating the self-reported smoking status
more » ... of study participants with their urine cotinine levels in a randomized controlled trial on smoking cessation. Materials and Methods: A cross-sectional study was conducted in Dakshina Kannada district of Karnataka to validate the self-reported smoking status of 300 participants. A seven-day point prevalence of smoking status was assessed based on a questionnaire and validated further using the semi-quantitative urine cotinine test at the end of a randomized smoking cessation study. Results: The sensitivity and specificity of self-reported smoking status was 73.17% and 95.79% respectively. Other validity indicators like positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, and accuracy were estimated to be 97.40%, 62.33%, 17.38%, 0.28%, and 80.33% respectively. Cohen's kappa statistics showed a substantial agreement (k=0.61; SE= 0.04) between the two test methods. Educational status and the level of motivation to quit showed a significant association between the test methods. Conclusion: Self-reported smoking status of participants is not sensitive in identifying smokers thus leading to under-reporting.
doi:10.51248/.v42i2.1412 fatcat:fmpg5yxd2jf5lpzma5yzc3q6xe