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. 1994 Jul;84(7):1086–1093. doi: 10.2105/ajph.84.7.1086

The validity of self-reported smoking: a review and meta-analysis.

D L Patrick 1, A Cheadle 1, D C Thompson 1, P Diehr 1, T Koepsell 1, S Kinne 1
PMCID: PMC1614767  PMID: 8017530

Abstract

OBJECTIVES. The purpose of this study was to identify circumstances in which biochemical assessments of smoking produce systematically higher or lower estimates of smoking than self-reports. A secondary aim was to evaluate different statistical approaches to analyzing variation in validity estimates. METHODS. Literature searches and personal inquiries identified 26 published reports containing 51 comparisons between self-reported behavior and biochemical measures. The sensitivity and specificity of self-reports of smoking were calculated for each study as measures of accuracy. RESULTS. Sensitivity ranged from 6% to 100% (mean = 87.5%), and specificity ranged from 33% to 100% (mean = 89.2%). Interviewer-administered questionnaires, observational studies, reports by adults, and biochemical validation with cotinine plasma were associated with higher estimates of sensitivity and specificity. CONCLUSIONS. Self-reports of smoking are accurate in most studies. To improve accuracy, biochemical assessment, preferably with cotinine plasma, should be considered in intervention studies and student populations.

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Selected References

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