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Original Article
Validity of Self-reported Smoking Using Urinary Cotinine among Vocational High School Students.
Soon Woo Park, Jong Yeon Kim
J Prev Med Public Health. 2009;42(4):223-230.
DOI: https://doi.org/10.3961/jpmph.2009.42.4.223
  • 5,293 View
  • 84 Download
  • 27 Crossref
AbstractAbstract PDF
OBJECTIVES
This study was conducted to validate self-reported smoking among high school students using urinary cotinine. METHODS: A self report of smoking behavior was collected together with urine sample for cotinine analysis from 130 male and female students in two vocational high school students in November, 2007. Validity and agreement between self-reported smoking and urinary cotinine was analyzed with STATA 9.0 for different definitions of current smokers, and frequent and daily smokers. Urinary cotinine concentration was measured by the DRI Cotinine Assay for urine (Microgenics Corp., Fremont, CA) on Toshiba 200FR. The cut-off point of urinary cotinine was 50 ng/dl. RESULTS: The concentrations of urinary cotinine were significantly different according to the frequency and amount of smoking. Sensitivity and specificity was 90.9% and 91.8% respectively, and the Cohen's kappa value was 0.787 among the current smokers who smoked at least one day during one month preceding the survey. The comparable high sensitivity, specificity, and kappa value were shown also among the other definitions of current smokers, that is, subjective smokers, and weekly smokers. CONCLUSIONS: The results showed the high validity of self-reported smoking among high school students. However, due to the small sample size and limitation of the participants, it is cautious to generalize the results to overall high school students.
Summary

Citations

Citations to this article as recorded by  
  • Effects of a Smoking Cessation Coaching Program to Improve Smoking Habits
    So-Hyeong Ryu, Jae-Hong Yoo, An-Na Choi, So-Ra Kim, Sang-Sinn Park, Jin-Kook Tak
    Journal of Social Science.2022; 33(2): 33.     CrossRef
  • Analysis of the Accuracy and Related Factors of Self-Reported Smoking Status according to Urinary Cotinine Concentration in Adolescents: The KoNEHS Cycle (2015~2017)
    Sunkyoung Jung, Sangshin Park
    Journal of Environmental Health Sciences.2022; 48(4): 216.     CrossRef
  • Smoking Susceptibility and Tobacco Media Engagement Among Youth Never Smokers
    Saida I. Coreas, Erik J. Rodriquez, Sana G. Rahman, Sherine El-Toukhy, Wilson M. Compton, Carlos Blanco, Heather L Kimmel, Eliseo J. Pérez-Stable
    Pediatrics.2021;[Epub]     CrossRef
  • A comparison of self-reported to cotinine-detected smoking status among adults in Georgia
    Julianne Williams, Ivo Rakovac, Enrique Loyola, Lela Sturua, Nino Maglakelidze, Amiran Gamkrelidze, Kristina Mauer-Stender, Bente Mikkelsen, João Breda
    European Journal of Public Health.2020; 30(5): 1007.     CrossRef
  • Clustering of chronic diseases risk factors among adolescents: a quasi-experimental study in Sousse, Tunisia
    Emna Dendana, Rim Ghammem, Jihene Sahli, Jihen Maatoug, Sihem Ben Fredj, Imed Harrabi, Molka Chaieb, Hassen Ghannem
    International Journal of Adolescent Medicine and Health.2019;[Epub]     CrossRef
  • Consistency and reliability of smoking-related variables: longitudinal study design in asthma and COPD
    Eveliina Hirvonen, Mikhail Stepanov, Maritta Kilpeläinen, Ari Lindqvist, Tarja Laitinen
    European Clinical Respiratory Journal.2019; 6(1): 1591842.     CrossRef
  • Underestimation of Self-Reported Smoking Prevalence in Korean Adolescents: Evidence from Gold Standard by Combined Method
    Jun Hwang, Jong Kim, Do Lee, Hye Jung, Soon-Woo Park
    International Journal of Environmental Research and Public Health.2018; 15(4): 689.     CrossRef
  • Tobacco smoking and the risk of atrial fibrillation: A systematic review and meta-analysis of prospective studies
    Dagfinn Aune, Sabrina Schlesinger, Teresa Norat, Elio Riboli
    European Journal of Preventive Cardiology.2018; 25(13): 1437.     CrossRef
  • Susceptibility to tobacco product use among youth in wave 1 of the population Assessment of tobacco and health (PATH) study
    Dennis R. Trinidad, John P. Pierce, James D. Sargent, Martha M. White, David R. Strong, David B. Portnoy, Victoria R. Green, Cassandra A. Stanton, Kelvin Choi, Maansi Bansal-Travers, Yuyan Shi, Jennifer L. Pearson, Annette R. Kaufman, Nicolette Borek, Bla
    Preventive Medicine.2017; 101: 8.     CrossRef
  • Lipid profiles and determinants of total cholesterol and hypercholesterolaemia among 25–74 year-old urban and rural citizens of the Yangon Region, Myanmar: a cross-sectional study
    Aung Soe Htet, Marte Karoline Kjøllesdal, Wai Phyo Aung, Aye Nyein Moe Myint, Win Thuzar Aye, Myint Myint Wai, Than Than Nu, Ei Mon Hla, Pyone Pyone Soe, Nan Wut Yi Tun, Naw Angela, Mya Mya Khaing, Aung Kyaw Htoo, Soe Tun, Pai Thitsar, Theeoo Lwin, San Sa
    BMJ Open.2017; 7(11): e017465.     CrossRef
  • Comparative analysis of two tobacco surveillance questionnaires used in NHANES: accuracy of self-reported smoking status
    Ram B. Jain
    Toxicological & Environmental Chemistry.2016; 98(1): 137.     CrossRef
  • Influence of Stress, Self-efficacy for Smoking Cessation, Smoking Temptation and Nicotine Dependency in Male College Students who Smoke
    Nam-Jo Kim, Hae-Sook Hong
    Journal of Korean Biological Nursing Science.2016; 18(1): 1.     CrossRef
  • Tobacco use and second-hand smoke exposure in young adolescents aged 12–15 years: data from 68 low-income and middle-income countries
    Bo Xi, Yajun Liang, Yunxia Liu, Yinkun Yan, Min Zhao, Chuanwei Ma, Pascal Bovet
    The Lancet Global Health.2016; 4(11): e795.     CrossRef
  • Association between Second-Hand Smoking and Laryngopathy in the General Population of South Korea
    Haewon Byeon, Dongwoo Lee, Sunghyoun Cho, Hiroyoshi Ariga
    PLOS ONE.2016; 11(11): e0165337.     CrossRef
  • Relationship between women's smoking and laryngeal disorders based on the urine cotinine test: results of a national population-based survey
    Haewon Byeon, Dongwoo Lee, Sunghyoun Cho
    BMJ Open.2016; 6(11): e012169.     CrossRef
  • Evaluating the validity of self-reported smoking in Mexican adolescents
    María del Carmen Valladolid-López, Tonatiuh Barrientos-Gutiérrez, Luz Myriam Reynales-Shigematsu, James F Thrasher, Ingris Peláez-Ballestas, Eduardo Lazcano-Ponce, Mauricio Hernández-Ávila
    BMJ Open.2015; 5(10): e007485.     CrossRef
  • The Correlation of Different Cotinine Levels With Questionnaire Results
    Myung Bae Park, Eun Woo Nam, Seon Kui Lee, Chun-Bae Kim, Chhabi Ranabhat
    Asia Pacific Journal of Public Health.2015; 27(5): 542.     CrossRef
  • The Relationship between Smoking and Personal Psychological Factors and Socioeconomic Status in 8th Grade Students from the 2010-2012 Online Survey of Adolescent Health Behaviors of Korea
    Cheol-Hwan Kim, Min-jung Jun, Sung-eun Kim
    Journal of the Korean Society for Research on Nicotine and Tobacco.2015; 6(1): 26.     CrossRef
  • Validation of Self-Reported Smokeless Tobacco Use by Measurement of Serum Cotinine Concentration Among US Adults
    I. T. Agaku, B. A. King
    American Journal of Epidemiology.2014; 180(7): 749.     CrossRef
  • Prevalence and validity of self-reported smoking in Indigenous and non-Indigenous young adults in the Australian Northern Territory
    Mark S Pearce, Kay D Mann, Gurmeet Singh, Belinda Davison, Susan M Sayers
    BMC Public Health.2014;[Epub]     CrossRef
  • Use of mobile phone text messaging to deliver an individualized smoking behaviour intervention in Chinese adolescents
    Hui-Jing Shi, Xiao-Xiao Jiang, Chun-Yan Yu, Yue Zhang
    Journal of Telemedicine and Telecare.2013; 19(5): 282.     CrossRef
  • Lifetime History of Cigarette Smoking Associated with Aggression and Impulsivity in Both Healthy and Personality Disorered Volunteers
    Elias Dakwar, Marias Popii, Emil F. Coccaro
    Journal of Personality Disorders.2011; 25(5): 645.     CrossRef
  • Earlier Age of Smoking Initiation May Not Predict Heavier Cigarette Consumption in Later Adolescence
    Holly E. R. Morrell, Anna V. Song, Bonnie L. Halpern-Felsher
    Prevention Science.2011; 12(3): 247.     CrossRef
  • Smoking-Induced Acute Eosinophilic Pneumonia in a 15-year-old Girl: A Case Report
    Ji-Seok Youn, Ji-Won Kwon, Byoung-Ju Kim, Soo-Jong Hong
    Allergy, Asthma and Immunology Research.2010; 2(2): 144.     CrossRef
  • Evaluating the impact of a school-based helmet promotion program on eligible adolescent drivers: different audiences, different needs?
    E. Germeni, C. Lionis, V. Kalampoki, B. Davou, M. Belechri, E. Petridou
    Health Education Research.2010; 25(5): 865.     CrossRef
  • A novel C6-phenyl liquid chromatographic technique for rapid and simultaneous measurements of urinary cotinine and nicotine
    Bee Lan Lee, Yanhong Gao, Ai Li New, Xu Wang, Woon-Puay Koh, Choon Nam Ong
    Analytical Methods.2010; 2(7): 878.     CrossRef
  • Smoking and Risk for Diabetes Incidence and Mortality in Korean Men and Women
    Sun Ha Jee, Athena W. Foong, Nam Wook Hur, Jonathan M. Samet
    Diabetes Care.2010; 33(12): 2567.     CrossRef
Validation Studies
Validity of Expired Carbon Monoxide and Urine Cotinine Using Dipstick Method to Assess Smoking Status.
Su San Park, Ju Yul Lee, Sung Il Cho
J Prev Med Public Health. 2007;40(4):297-304.
DOI: https://doi.org/10.3961/jpmph.2007.40.4.297
  • 5,727 View
  • 53 Download
  • 14 Crossref
AbstractAbstract PDF
OBJECTIVES
We investigated the validity of the dipstick method (Mossman Associates Inc. USA) and the expired CO method to distinguish between smokers and nonsmokers. We also elucidated the related factors of the two methods. METHODS: This study included 244 smokers and 50 exsmokers, recruited from smoking cessation clinics at 4 local public health centers, who had quit for over 4 weeks. We calculated the sensitivity, specificity and Kappa coefficient of each method for validity. We obtained ROC curve, predictive value and agreement to determine the cutoff of expired air CO method. Finally, we elucidated the related factors and compared their effect powers using the standardized regression coefficient. RESULTS: The dipstick method showed a sensitivity of 92.6%, specificity of 96.0% and Kappa coefficient of 0.79. The best cutoff value to distinguish smokers was 5-6ppm. At 5 ppm, the expired CO method showed a sensitivity of 94.3%, specificity of 82.0% and Kappa coefficient of 0.73. And at 6 ppm, sensitivity, specificity and Kappa coefficient were 88.5%, 86.0% and 0.64, respectively. Therefore, the dipstick method had higher sensitivity and specificity than the expired CO method. The dipstick and expired CO methods were significantly increased with increasing smoking amount. With longer time since the last smoking, expired CO showed a rapid decrease after 4 hours, whereas the dipstick method showed relatively stable levels for more than 4 hours. CONCLUSIONS: The dipstick and expired CO methods were both good indicators for assessing smoking status. However, the former showed higher sensitivity and specificity and stable levels over longer hours after smoking, compared to the expired CO method.
Summary

Citations

Citations to this article as recorded by  
  • Effects of a supportive workplace environment on the success rate for smoking cessation camp
    Woojin Kim, A Ram Kim, Minsu Ock, Young-Jee Jeon, Heun Lee, Daehwan Kim, Minjun Kim, Cheolin Yoo
    Annals of Occupational and Environmental Medicine.2023;[Epub]     CrossRef
  • Health and economic impact of a smoking cessation program in Korean workplaces
    Soo Kyoung Kim, Jeongeun Lee, Jaeun Lee, Jeonghoon Ahn, Hyekyeong Kim
    Health Promotion International.2022;[Epub]     CrossRef
  • Pilot Study on the Determination of Volatile Organic Compounds (VOCs) in Exhaled Breath of Each Cigarette Type
    Young Hwan Cho, Hyoung Yong Kim, Jeom Kyu Lee, Seung Hyun Kim
    Journal of the Korean Society for Research on Nicotine and Tobacco.2021; 12(1): 24.     CrossRef
  • Short-Term Success Rates of Smoking Cessation Support Programs and Factors Predicting Smoking Relapse: Using Data from a Smoking Cessation Clinic in a Hospital
    Seung-Hyun Yu, Myeong-Jun Kim, Jin Jeon, Hoon-Ki Park, Hwan-Sik Hwang, Kye-Yeung Park
    Korean Journal of Family Medicine.2019; 40(6): 373.     CrossRef
  • Risk factors for hepatocellular carcinoma by age, sex, and liver disorder status: A prospective cohort study in Korea
    Sang‐Wook Yi, Ja‐Sung Choi, Jee‐Jeon Yi, Yong‐ho Lee, Ki Jun Han
    Cancer.2018; 124(13): 2748.     CrossRef
  • Factors Affecting Smoking Cessation Success during 4-week Smoking Cessation Program for University Students
    Sang Mee Koo, Jeong Hee Kang
    Journal of Korean Academy of Community Health Nursing.2017; 28(2): 165.     CrossRef
  • Tuberculosis, smoking and risk for lung cancer incidence and mortality
    Seri Hong, Yejin Mok, Christina Jeon, Sun Ha Jee, Jonathan M. Samet
    International Journal of Cancer.2016; 139(11): 2447.     CrossRef
  • Relationship between women's smoking and laryngeal disorders based on the urine cotinine test: results of a national population-based survey
    Haewon Byeon, Dongwoo Lee, Sunghyoun Cho
    BMJ Open.2016; 6(11): e012169.     CrossRef
  • Effects of a Smoking Cessation Program including Telephone Counseling and Text Messaging using Stages of Change for Outpatients after a Myocardial Infarction
    Jung-Hyeon Kong, Yeongmi Ha
    Journal of Korean Academy of Nursing.2013; 43(4): 557.     CrossRef
  • Cost and effectiveness of the nationwide government-supported Smoking Cessation Clinics in the Republic of Korea
    Jin-Kyoung Oh, Min Kyung Lim, E Hwa Yun, Sang Hwa Shin, Eun Young Park, Eun-Cheol Park
    Tobacco Control.2013; 22(e1): e73.     CrossRef
  • The National "Smoking Cessation Clinics" Program in the Republic of Korea: Socioeconomic Status and Age Matter
    Hyoshin Kim, Jin-Kyoung Oh, Min Kyung Lim, Bo Yoon Jeong, E Hwa Yun, Eun Young Park
    Asian Pacific Journal of Cancer Prevention.2013; 14(11): 6919.     CrossRef
  • A Retrospective Comparison of Varenicline Monotherapy Versus the Combination of Varenicline and Bupropion or Bupropion and Nicotine Patches in a VA Tobacco Cessation Clinic
    Dane Shiltz, Angie Paniagua, James E. Hastings
    Journal of Smoking Cessation.2011; 6(1): 65.     CrossRef
  • Effects of a Smoking Cessation Program using Self-regulated Learning Strategy for Middle School Boys
    Young-Ju Jee, Haejung Lee, Yeonjung Lim
    Journal of Korean Academy of Psychiatric and Mental Health Nursing.2011; 20(1): 1.     CrossRef
  • Smoking and Risk of Tuberculosis Incidence, Mortality, and Recurrence in South Korean Men and Women
    Sun Ha Jee, Jonathan E. Golub, Jaeseong Jo, Il Su Park, Heechoul Ohrr, Jonathan M. Samet
    American Journal of Epidemiology.2009; 170(12): 1478.     CrossRef
Original Articles
Concentration of Urinary Cotinine and Frequency of Sister Chromatid Exchange in Lymphocytes among Male Adolescents.
Dong Ki Paek, Seong Sil Chang, Tae Yong Lee, Young Man Roh, Yeonkyeng Lee, Young Chae Cho, Dong Bae Lee
Korean J Prev Med. 2001;34(3):269-276.
  • 1,948 View
  • 19 Download
AbstractAbstract PDF
OBJECTIVES
To evaluate the internal burden and hazardous effects associated with smoking in middle and high school students. METHODS: We analysed urinary cotinine (U-cotinine) concentrations and the frequency of Sister Chromatid Exchanges (SCE). A comparison was done of U-cotinine concentrations and the frequency of SCE in peripheral lymphocytes across school levels (middle vs. high) and smoking types (direct: daily & occasional smoking, indirect: usual indirect & non-smoking), in 122 males. RESULTS: The middle school student group comprised 6.8% daily smokers, 15.9% occasional smokers, 40.9% daily indirect smokers, and 35.4% nonsmokers, while the high school student group comprised 18.0%, 20.5%,39.7%, and 21.8%, respectively. The U-cotinine concentration and the frequency of SCE among the middle school students were 79.11 microgram/literand 2.0 per cell, respectively, which were significantly lower than the 146.85 microgram/liter (p=0.078) and 2.6 per cell (p=0.005) of the high school students. Among the 40 direct smokers, these two biomarkers were 235.66 microgram/literand 2.59 per cell, significantly higher than the 67.33 microgram/liter (p=0.0001) and2.1 per cell (p=0.003) among indirect smoking groups. The variation in individual U-cotinine concentration ranged widely in both the indirect and direct smoking groups. CONCLUSION: Urinary cotinine concentrations and the frequency of Sister Chromatid Exchange seem to objectively and effectively evaluate student exposure whether it was direct or indirect smoking. Consequently, these biomarkers may be useful in monitoring the objective efficacy of anti-smoking programs in adolescent populations.
Summary
Influence of Smoking on Blood Cadmium Concentration in University Students.
Joo Youn Shin, Jong Han Lim, Sin Goo Park, Jee Na Lee, Mi Jang, Chung Song Huh, Dae Hee Kang, Yun Chul Hong
J Prev Med Public Health. 2004;37(3):225-231.
  • 2,130 View
  • 36 Download
AbstractAbstract PDF
OBJECTIVES
This study was performed to examine the influence of smoking on the blood cadmium concentration in university students. METHODS: The study included 300 university students. A questionnaire interview was used to collect data. The urine cotinine and blood cadmium levels were measured as biological exposure indices. The data were analyzed using t-tests ANOVA and ANCOVA. RESULTS: The median value of blood cadmium concentration was equal in both males and females (0.8microgram/liter). This level was relatively low in comparison with the reference value suggested by WHO (2001). ANCOVA showed that smoking related variables, urine cotinine and smoking amount, were significantly associated with the blood cadmium level (P=0.004, 0.015). However, the values with regard to traffic related air pollution were not significantly associated with the blood cadmium level. CONCLUSIONS: Smoking is an important source of nonoccupational cadmium exposure in young people. The Blood cadmium level is at least 10% higher in active smokers than in passive or nonsmokers. The level of urine cotinine can be used as an indicator of non-occupational exposure of respirable cadmium due to smoking, as there is a good correlation bestween smoking amount and the urine cotinine level.
Summary
Agreement between Smoking Self-report and Urine Cotinine among Adolescents.
Ihn Sook Jeong, No Rai Park, Jinkyung Ham
J Prev Med Public Health. 2004;37(2):127-132.
  • 2,323 View
  • 45 Download
AbstractAbstract PDF
OBJECTIONS: Cotinine, the major metabolite of nicotine, is a useful marker of exposure to tobacco smoke and self-reporting of smoking status is thought not to be reliable. This study aimed to evaluate the agreement between the smoking self-report among adolescents and the urinary cotinine test. METHODS: The study subjects were 1226 middle and high school students in Hanam city, who were selected by stratified random sampling. The self-report about smoking behavior was compared with urine cotinine value measured with PBM AccuSignRfi Nicotine (Princeton BioMeditech Corporation, USA). The percentage agreement, kappa and 95% confidence interval (CI) were calculated. RESULTS: The overall percentage agreement was 88.6%, and those for boys, girls, middle school, general school and vocational school students were 87.3%, 90.1%, 93.7%, 85, 5%, 90.7%, and 78.4%, respectively. The overall kappa index was 0.46 (95% CI=0.39-0.54) for overall, and those for boys, girls, middle school, general school and vocational school students were 0.56 (95% CI=0.48-0.65), 0.20 (95% CI=0.07-0.32), 0.21 (95% CI=0.09-0.34), 0.55 (95% CI=0.47-0.64), 0.42 (95% CI=0.33-0.52), and 0.48 (95% CI=0.36-0.60), respectively. CONCLUSION: The percentage agreement was relatively high but the kappa values very low for girls, and middle school students. Though the prevalence bias can be influenced by these results, the selfreport was not a sufficient tool for the evaluation of adolescents' smoking status, especially in girls or middle school students.
Summary

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