Consistency of daily cigarette smoking amount in dependent adults.

Abstract

Self-reported cigarettes per day (CPD) is a very common screening, as well as dependent or independent, measure in clinical and non-clinical research on smoking, but consistency of CPD across days in dependent smokers is uncertain. Adult dependent smokers (N=357; 170 men, 187 women) retrospectively reported “usual” CPD at screening and then prospectively self-monitored CPD on 3 consecutive days of one week during an ad libitum baseline period. Participants were those recruited for later tests of brief medication effects in those with high (n=170) versus low (n=187) interest in quitting smoking soon (within 3 months). Consistency was determined by intraclass correlation (ICC). Prospective daily CPD was generally consistent (ICC = 0.78, 95% CI of 0.74–0.81), but CPD changed (increase or decrease) by 5 cigarettes/day or more in 40% of participants and by at least 10/day in 10%. Consistency in CPD was greater in higher dependent smokers and in women with low (vs. high) quit interest, but consistency tended to be greater in men with high (vs. low) quit interest. Although retrospectively reported CPD at screening was consistent with the overall mean for prospectively monitored daily CPD, 15% of participants differed by at least 5/day between methods, and digit bias was twice as likely with retrospective versus prospective CPD, which was at chance levels. Understanding variability in CPD may improve knowledge of dependence and factors that foster or discourage daily smoking amount, but precise assessment of daily CPD likely requires prospective monitoring.

Analysis of Agreement between Expired-Air Carbon Monoxide Monitors

“…Using Bedfont monitors, Erb, Raiff, Meredith, and Dallery (2014) identified CO values <8 ppm as maximizing both sensitivity and specificity for classifying smokers from nonsmokers. By contrast, Perkins et al (2013) found < 5 ppm to be the optimal cutoff for 24 hour abstinence when using the Vitalograph BreathCO monitor, similar to <4 ppm found by Javors, Hatch, and Lamb (2005), Cropsey et al (2014) and Emery and Levine (2015) when also using the Vitalograph monitor. This discrepancy suggests there may be variation between these brands of CO monitors in validating abstinence and raises concern over whether they can be used interchangeably.…”

“…Javors et al 2005; Perkins et al 2013), the Vitalograph monitors agreed with the Bedfont classifications 87.8% of the time. However, when the same criterion was met using the Vitalograph monitors, the Bedfont monitors agreed less than half of the time (48.5%), indicating reported results for abstinence rates in clinical trials could be influenced by the monitor used.…”

“…All were healthy adults (44 M, 34 F) who met inclusion criteria for each study, both involving smoking ≥ 10 cigarettes per day for ≥ 1 year and meeting DSM-IV nicotine dependence criteria (American Psychiatric Association, 1994), those very typically recruited for studies of smoking behavior and abstinence (e.g. Addicott et al, 2012; Benowitz et al 2002, Perkins, Jao, & Karelitz, 2013; Perkins, Karelitz, Conklin, Sayette, & Giedgowd, 2010). Mean (SD) sample characteristics were 16.2 (5.3) cigarettes per day, 28.8 (8.9) years old, and 5.1 (1.8) Fagerström Test of Cigarette Dependence score (previously known as Fagerström Test of Nicotine Dependence, Fagerström, 2012; Heatherton, Kozlowski, Frecker, & Fagerström, 1991).…”

“…Clinical research uses CO values as a method to confirm abstinence in treatment studies (typically for >24 hrs) or brief deprivation (e.g. overnight) prior to laboratory testing of symptoms such as craving or withdrawal (Addicott et al, 2012; Perkins, Jao, & Karelitz, 2013; Perkins, Karelitz, Conklin, Sayette, & Giedgowd, 2010). Still others have used CO level as an inclusion criterion to ensure current status as a smoker (Froeliger, Modlin, Wang, Kozink, & McClernon, 2012; VanderVeen, Cohen, Cukrowica, & Trotter, 2008) or to assess current amount of smoke exposure (Perkins, Karelitz, & Jao, 2013).…”

Correlates of Digit Bias in Self-reporting of Cigarette per Day (CPD) Frequency: Results from Global Adult Tobacco Survey (GATS), India and its Implications

“…Former two methods show four to six time higher incidence of digit bias than latter one . Also prospective CPD data collection (Perkins et al, 2012) has twice less digit bias than retrospective CPD data collection technique. These methods are time consuming and resource intensive.…”