Assessment of smoking behaviour in the dental setting. A study comparing self-reported questionnaire data and exhaled carbon monoxide levels

Abstract

The present study validated the accuracy of data from a self-reported questionnaire on smoking behaviour with the use of exhaled carbon monoxide (CO) level measurements in two groups of patients. Group 1 included patients referred to an oral medicine unit, whereas group 2 was recruited from the daily outpatient service. All patients filled in a standardized questionnaire regarding their current and former smoking habits. Additionally, exhaled CO levels were measured using a monitor. A total of 121 patients were included in group 1, and 116 patients were included in group 2. The mean value of exhaled CO was 7.6 ppm in the first group and 9.2 ppm in the second group. The mean CO values did not statistically significantly differ between the two groups. The two exhaled CO level measurements taken for each patient exhibited very good correlation (Spearman's coefficient of 0.9857). Smokers had a mean difference of exhaled CO values of 13.95 ppm (p < 0.001) compared to non-smokers adjusted for the first or second group. The consumption of one additional pack year resulted in an increase in CO values of 0.16 ppm (p = 0.003). The consumption of one additional cigarette per day elevated the CO measurements by 0.88 ppm (p < 0.001). Based on these results, the correlations between the self-reported smoking habits and exhaled CO values are robust and highly reproducible. CO monitors may offer a non-invasive method to objectively assess current smoking behaviour and to monitor tobacco use cessation attempts in the dental setting.

Assessment of smoking behaviour in a dental setting: a 1-year follow-up study using self-reported questionnaire data and exhaled carbon monoxide levels

“…The results of the present study show a strong association between self-reported smoking habits and the measurement of exhaled CO levels (Tables 3 and 4). The present study corroborates data from a previous study [12], assessing exhaled CO levels of patients from an oral medicine unit and daily outpatient service upon initial presentation. Nevertheless, exhaled CO levels were not yet analysed over a defined period of time in a dental setting, thus also exhibiting the dynamic changes of measured CO levels within the same patients.…”

“…The secondary outcome parameters included dynamic changes in questionnaire data analysis such as number of cigarettes consumed per day or the mean packyear value. A previous paper compares the initial data of this group to results of a group of patients recruited from daily outpatient service [12]. All patients examined in the oral medicine unit for the first study were scheduled for a followup visit to reassess their smoking habits 1 year later.…”

Relevance of smoking interventions for dental clinic patients with smoking‐related disease

“…Limitations of this study include its convenience sampling from one clinic. Smoking rates may have been under reported, although the validity of self‐reported smoking in a sample of clinic patients in a dental school was confirmed when compared with exhaled carbon monoxide levels .…”

Impact of a standardized referral to a community pharmacist-led smoking cessation program before elective joint replacement surgery

“…The ‘intention-to-treat’ analysis assumed that all participants lost to follow-up continued to smoke, so our results are more likely to under-report versus over-report program impact. We only used self-reported abstinence; however others have shown that self-report can produce results similar to CO monitoring 27,28 . We were unable to re-assess smoking cessation preoperatively because time to surgery was shorter than anticipated, but any tobacco reduction or cessation likely carries health benefits, even when not directly related to reducing postoperative complications 29,30 .…”