Validation of Self-Reported Smokeless Tobacco Use by Measurement of Serum Cotinine Concentration Among US Adults

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• Alternative Title:
  Am J Epidemiol
• Personal Author:
  Agaku, Israel T. ; King, Brian A.
• Description:
  Although investigators have assessed the relationship between self-reported cigarette smoking and biomarker levels, the validity of self-reported information on smokeless tobacco (SLT) use is uncertain. We used aggregated data from the 2003-2004, 2005-2006, 2007-2008, and 2009-2010 administrations of the National Health and Nutrition Examination Survey (NHANES) to compare self-reported SLT use with serum concentrations of cotinine, a metabolite of nicotine, among US adults aged ≥18 years. Receiver operating characteristic analysis was used to determine the optimal serum cotinine cutpoint for discriminating SLT users from nonusers of tobacco, and concordance analysis was used to compare self-reported SLT use with cotinine levels. Among the 30,298 adult respondents who completed the NHANES during 2003-2010, 418 reported having exclusively used SLT and no other type of tobacco (cigarettes, cigars, or pipes) during the past 5 days, while 23,457 reported not using any tobacco. The optimal cotinine cutpoint for discriminating SLT users from non-tobacco users was 3.0 ng/mL (sensitivity=97.0%, specificity=93.0%), which was comparable to a revised cutpoint recommended for identifying adult cigarette smokers. Concordance with cotinine was 96.4% and 93.7% for self-reported SLT use and tobacco nonuse, respectively. These findings indicate that self-reported SLT use among adults correlates highly with serum cotinine levels and that the optimal cutpoint for minimizing misclassification of self-reported use is a serum cotinine concentration of 3.0 ng/mL.
• Subjects:
  Adult Aged Aged, 80 And Over Biomarkers Cotinine Epidemiologic Research Design Female Humans Male Middle Aged Nutrition Surveys ROC Curve Self Report Sensitivity And Specificity Tobacco, Smokeless Tobacco Use Young Adult

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• Source:
  Am J Epidemiol. 180(7):749-754.
• Pubmed ID:
  25125690
• Pubmed Central ID:
  PMC4519345
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHS/United States
• Volume:
  180
• Issue:
  7
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:bfdbf130e85787985f8bf4d6766c2c255ead7ae1c3ac217e65f15d07f75b0c8a
• Download URL:
  https://stacks.cdc.gov/view/cdc/32544/cdc_32544_DS1.pdf
• File Type:
  [PDF - 186.51 KB ]