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Manan NA, Nawi AM, Ahmad N, et al. Self-reported smoking among adolescents: How accurate is it with the urine cotinine strip test?. Int J Pediatr Adolesc Med. 2019;7(2):78-82doi: 10.1016/j.ijpam.2019.08.001.
Manan, N. A., Nawi, A. M., Ahmad, N., & Hassan, M. R. (2020). Self-reported smoking among adolescents: How accurate is it with the urine cotinine strip test?. International journal of pediatrics & adolescent medicine, 7(2), 78-82. https://doi.org/10.1016/j.ijpam.2019.08.001
Manan, Norfazillah Ab, et al. "Self-reported smoking among adolescents: How accurate is it with the urine cotinine strip test?." International journal of pediatrics & adolescent medicine vol. 7,2 (2020): 78-82. doi: https://doi.org/10.1016/j.ijpam.2019.08.001
Manan NA, Nawi AM, Ahmad N, Hassan MR. Self-reported smoking among adolescents: How accurate is it with the urine cotinine strip test?. Int J Pediatr Adolesc Med. 2020 Jun;7(2):78-82. doi: 10.1016/j.ijpam.2019.08.001. Epub 2019 Aug 10. PMID: 32642541; PMCID: PMC7335823.
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Int J Pediatr Adolesc Med. 2020 Jun;7(2):78-82. doi: 10.1016/j.ijpam.2019.08.001. Epub 2019 Aug 10.

Self-reported smoking among adolescents: How accurate is it with the urine cotinine strip test?.

International journal of pediatrics & adolescent medicine

Norfazillah Ab Manan, Azmawati Mohammed Nawi, Norfazilah Ahmad, Mohd Rohaizat Hassan

Affiliations

  1. Dept. of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.

PMID: 32642541 PMCID: PMC7335823 DOI: 10.1016/j.ijpam.2019.08.001

Abstract

BACKGROUND & OBJECTIVE: In the local setting, the prevalence of smoking among adolescents varies, as it is based only on self-reporting without biomarker validation. The objective of the present study was to determine the accuracy of self-reported smoking among adolescents as compared to that of the urine cotinine strip test.

METHODS: We performed a cross-sectional study of 314 adolescents aged 16 years from February 2015 to April 2015 in Putrajaya, Malaysia. The accuracy of self-reporting was assessed using a data collection sheet and was validated by the urine cotinine strip test. Three schools were chosen by the simple random method, where all Form 4 students constituted the sample unit. The kappa statistic was used for determining agreement between self-reporting and urine cotinine strip testing.

RESULTS: There was a substantial agreement between self-reporting and the urine cotinine strip test (kappa = 0.757, 95% confidence interval [CI]: 0.63, 0.88); there was 95.86% overall agreement. The prevalence of self-reported smoking was 8% (95% CI: 7.47, 8.53) and that of urine cotinine strip testing was 10.8% (95% CI: 10.20, 11.41). There was a discrepancy with the results of the urine cotinine strip test in 8% of self-reported smokers and 3.8% of self-reported nonsmokers. Self-reporting had 67.6% sensitivity and 99.3% specificity as compared to those of urine cotinine strip testing and had 92% positive predictive value and 96.2% negative predictive value.

CONCLUSION: Self-reporting can be used to assess smoking status but should be used with care among adolescents. Urine cotinine strip test validation of self-reporting enables the measurement of the true prevalence of smoking among adolescents.

© 2019 Publishing services provided by Elsevier B.V. on behalf of King Faisal Specialist Hospital & Research Centre (General Organization), Saudi Arabia.

Keywords: Accuracy; Adolescent; Discrepancy; Self-reported smoking; Urine cotinine; Validation

Conflict of interest statement

The authors declare that they have no competing interest.The authors declare that they have no competing interests.

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