The accuracy of self-reported smoking status assessed by cotinine test strips

Parker, David; Lasater, Thomas M.; Windsor, Richard A.; Wilkins, Jeff; Upegui, David; Heimdal, James

doi:10.1080/14622200210142715

Cited by 60 publications

(38 citation statements)

References 31 publications

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“…Tobacco history and smoking status were obtained with items from the Behavioral Risk Factor Survey, 43 and reliability of the self-report was established by biochemical verification of the presence (current smoking) or absence (not smoking) of the nicotine metabolite, cotinine, using a cotinine dipstick in a sample of the patient's urine. 44 If the patient did not self-report current smoking but the cotinine test was positive, they were reclassified as current smokers.…”

Section: Health Status Factorsmentioning

confidence: 99%

Women With Lung Cancer: Quality of Life After Thoracotomy

et al. 2010

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Section: Health Status Factorsmentioning

confidence: 99%

Women With Lung Cancer: Quality of Life After Thoracotomy

et al. 2010

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“…An immunochromatographic test strip in ''dipstick'' format (saliva NicAlertR) was used to measure cotinine levels in saliva samples. The sensitivity and specificity of the urine dipstick NicAlertR method was previously independently validated by several groups with urine NicAlertR results being found to compare favorably to the ELISA laboratory method and to the mass spectrometry method (23)(24)(25). The ease and convenience of providing a saliva sample may make a saliva-based test more preferable in a clinical setting than a urine-based test.…”

Section: Introductionmentioning

confidence: 99%

Validation of Self-Reported Smoking Status Using Saliva Cotinine: A Rapid Semiquantitative Dipstick Method

Montalto

Wells

2007

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Purpose: This study evaluated the performance characteristics of a novel rapid method for verifying smoking status in individuals by measurement of cotinine, the primary metabolite of nicotine, in saliva samples using an immunochromatographic strip in a ''dipstick'' format compared with liquid chromatography/mass spectrometry (LC/MS). Materials and Methods: A prospective comparison was made of smoking status as determined by measurement of cotinine in urine by LC/MS (the gold standard) and in saliva using a semiquantitative dipstick assay that uses cotinine-specific monoclonal antibodies attached to gold particles and a series of avidity traps to measure cotinine levels (saliva NicAlertR). One hundred seventy-two individuals from a family practice/general medical setting agreed to participate after informed consent and institutional review board approval. Saliva NicAlertR tests were done by untrained operators who followed written directions. Results: Comparison of smoking status as determined by urine cotinine measurement by LC/MS (50 ng/mL cutoff) with the saliva strip test results, averaged over the two operators, indicated that the saliva test strip results had a sensitivity of 99% and a specificity of 96%. Saliva NicAlertR also identified four smokers who reported being nonsmokers but were confirmed to be smokers by LC/MS. Conclusions: The saliva NicAlertR assay seems to be a valid, highly sensitive, and specific method for validating self-reported smoking status and may have clinical applications in selected medical settings. (Cancer Epidemiol Biomarkers Prev 2007;16(9):1858 -62)

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“…One inexpensive, reliable, and valid measurement tool for cotinine is the urinary cotinine test strip. Test strips have been shown to compare favorably to gas chromatography/mass spectrometry testing for cotinine (18,25), with sensitivity and specificity of urinary cotinine test strips ranging from 90% to 97% in identifying smokers when used with a 100 ng/mL threshold. …”

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Validity of Self-reported Smoking Status among Participants in a Lung Cancer Screening Trial

Studts

Ghate

Gill

et al. 2006

Cancer Epidemiology, Biomarkers &Amp; Prevention

126

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Lung cancer remains a devastating disease associated with substantial morbidity and mortality. Recent research has suggested that lung cancer screening with spiral computed tomography scans might reduce lung cancer mortality. Studies of lung cancer screening have also suggested that significant numbers of participants quit smoking after screening. However, most have relied solely on selfreported smoking behavior, which may be less accurate among participants in lung cancer screening. To assess the validity of self-reported smoking status among participants in a lung cancer screening trial, this study compared selfreported smoking status against urinary cotinine levels. The sample included 55 consecutive participants enrolled in a randomized clinical trial comparing annual spiral computed tomography and chest X-ray for lung cancer screening. Participants were a mean of 59 years of age and predominantly Caucasian (96%) and male (55%). Self-reported smoking status was assessed before and after participants learned of the purpose of the biochemical verification study. Using urinary cotinine as the ''gold standard,'' the sensitivity and specificity of self-reported smoking status were 91% and 95%, respectively (k = 0.85, P < 0.001, 95% confidence interval = 0.71-0.99). Total misclassification rate was 7%. However, three of the four misclassified participants reported concurrent use of nicotine replacement strategies. Eliminating these cases from the analysis revealed sensitivity of 100% and specificity of 95% (k = 0.96, P < 0.001, 95% confidence interval = 0.88-1.00). In conclusion, self-reported smoking status among participants in a lung cancer screening trial was highly consistent with urinary cotinine test results. Validity of Self-reported Smoking Status among Participants in a Lung Cancer Screening TrialLung cancer is a devastating illness associated with substantial morbidity and mortality. In 2006, f174,470 Americans will be diagnosed with lung cancer, and another 162,460 will die from the disease (1). Improved survival with early diagnosis has prompted exploration of lung cancer screening technologies (2-5). In addition to the medical implications of early detection, participation in screening programs may be associated with decreased smoking rates (6-9), although some have suggested that negative screening results may actually lead to continuation of or return to smoking (6).Most studies exploring changes in smoking status associated with screening have relied solely on participant self-report of smoking status. The veracity of self-reports is often questionable in situations involving social pressure or medical disapproval (10-13). In these high-demand situations, studies have consistently suggested that smoking behavior is underreported (12-18). Although inaccurate self-reported smoking status in the general population occurs relatively infrequently (15,19), the lung cancer screening context may constitute a high-demand situation, a condition under which biochemical verification is recommended (1...

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The accuracy of self-reported smoking status assessed by cotinine test strips

Cited by 60 publications

References 31 publications

Women With Lung Cancer: Quality of Life After Thoracotomy

Women With Lung Cancer: Quality of Life After Thoracotomy

Validation of Self-Reported Smoking Status Using Saliva Cotinine: A Rapid Semiquantitative Dipstick Method

Validity of Self-reported Smoking Status among Participants in a Lung Cancer Screening Trial

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