Verifying the accuracy of self-reported smoking behavior in female volunteer soldiers

Abstract

Smoking rates in the military are evaluated through questionnaire surveying. Because the accurate identification of smokers facilitates the provision of smoking cessation services, this study conducted urine cotinine concentration testing to verify the accuracy of self-reported smoking behavior by female volunteer soldiers and analyzed the effects of second-hand smoking on urine cotinine concentrations. This study is a cross-sectional study conducted using purposive sampling on female volunteer soldiers receiving training at the Taichung Recruit Training Center in May 2014. This study simultaneously collected questionnaires and urine samples, and urine samples were analyzed with an enzyme-linked immunosorbent assay. The self-reported smoking rate of female volunteer soldiers was 19.3%, whereas the smoking rate as determined by urine cotinine concentration testing was 26.3%, indicating an overall underestimation of 7.0%. Chi-square (χ2) goodness of fit test results indicated that the distribution of self-reported smoking behaviors and that verified from urine cotinine concentration testing were significantly different. The sensitivity of self-reported smoking behavior was 66.7% with a specificity of 97.6%. There was no significant association between second-hand smoking and urine cotinine concentrations. Questionnaire survey self-reporting methods could underestimate the smoking behavior of female volunteer soldiers and routine testing with biochemical verification is necessary.

The mutagenic forces shaping the genomic landscape of lung cancer in never smokers

“…Indeed, such events have been previously reported, for example, SBS4 was found in the lung cancers of never-smoking Chinese women that often cook with smoky coal in poorly ventilated houses 47 , and it is likely that severe levels of pollution are more common in countries with overall higher air pollution levels. Lastly, it is also possible that the self-reported smoking status was inaccurate, as previously shown in other cohorts after biochemical verification 52 , and that some SBS4 cases from smokers were misannotated as never smokers, albeit it is unlikely that such misannotation will exhibit any correlation with air pollution. Notwithstanding, the reported associations between air pollution and somatic mutations remained unaffected when all SBS4 mutations were excluded from our analysis ( Extended Data Fig.…”