DOI: https://doi.org/10.14710/jbtr.v5i1.3971

Validation of Self-Reported Smoker and Second Hand Smoke Exposure by Urinary Cotinine within The Malaysian Cohort Project

1Faculty of Medicine, University Kebangsaan Malaysia, Malaysia

2Taylor’s University Lakeside, Malaysia

Received: 20 Dec 2018; Accepted: 17 May 2019; Available online: 27 Jul 2019; Published: 31 Jul 2019.
Open Access Copyright (c) 2019 Journal of Biomedicine and Translational Research

Citation Format:
Abstract

Background: Validation of self-reported questionnaire is very crucial in ensuring the quality and reliability of data collection. 

Objective: The aim of this study were i) to validate the questionnaire on tobacco smoke intake and second hand smoke exposure among The Malaysian Cohort (TMC) subjects through the determination of urinary cotinine levels, ii) to determine the optimal cut-off point of urine cotinine that discriminates smokers from non-smokers and iii) to estimate misclassification rate between self-reported smoking and urinary cotinine level.

Methods: Urine samples from a total of 775 The Malaysian Cohort subjects (104 smokers, 102 former smokers and 569 non-smokers) were obtained and urinary cotinine levels were determined by high-performance liquid chromatography (HPLC). Differences between groups were compared using Kruskal Wallis and Mann-Whitney tests. The Receiver Operating Characteristic (ROC) curved was performed to define the optimal urinary cotinine cut-off point.

Results: Urinary cotinine concentration significantly (p<0.001) correlated with smoking status (r=0.46), the average number of cigarettes smoked per day (r=0.53), duration of smoking (r=0.33) and number of cigarettes packed per year (r=0.47). Smokers and second hand smokers have significantly higher median cotinine levels (978.40 and 21.31 respectively) compared to non-smokers (15.52) and non-exposed (13.60) subjects. Cotinine level at cut-off value of 1.51 ng/mg creatinine is able to distinguish smokers and non-smokers with a sensitivity of 84.62% and specificity of 81.97%.

Conclusion: The Malaysian Cohort self-reported smoking questionnaire is a reliable tool in assessing the use of tobacco and second hand smoke exposure among the subjects.

Note: This article has supplementary file(s).

Fulltext View|Download |  Research Instrument
Data Supplementntitled
Subject Urine Cotinine, Self-reported Tobacco intake, second hand smoke
Type Research Instrument
  Download (182KB)    Indexing metadata
Keywords: Urine Cotinine; Self-reported Tobacco intake; second hand smoke
Funding: The Malaysian Cohort Study is funded by a top-down grant from the National Biotechnology Division, Ministry of Science, Technology and Innovation (MOSTI), Malaysia (ER-05-01-02-MEB001 from 2005-2014).

Article Metrics:

Article Info
Section: Original Research Articles
Language : EN
Recent articles
Validation of Self-Reported Smoker and Second Hand Smoke Exposure by Urinary Cotinine within The Malaysian Cohort Project Prevalence of Malaria Parasites among Pregnant Women and Children under Five years in Ekiti State, Southwest Nigeria. A long-term follow-up of Sex Chromosomal Mosaicism Disorders of Sex Development Fragile X syndrome, the search for a targeted treatment Seroprevalence of Hepatitis B and C in Healthy Malaysian Adults: A Preliminary Report More recent articles
  1. Institute of Public Health (IPH). National Health & Morbidity Survey (NHMS 2015). In: Ministry of Health Malaysia, editor. 2015. p. 315
  2. Syed Junid S. Health Care Cost Of Smoking In Malaysia In: National University of Malaysia, editor. Kuala Lumpur: UKM; 2007
  3. Park MB, Kim CB, Nam EW, Hong KS. Does South Korea have hidden female smokers: discrepancies in smoking rates between self-reports and urinary cotinine level. BMC women's health. 2014;14:156
  4. Jung-Choi KH, Khang YH, Cho HJ. Hidden female smokers in Asia: a comparison of self-reported with cotinine-verified smoking prevalence rates in representative national data from an Asian population. Tobacco control. 2012;21(6):536-42
  5. Rebagliato M. Validation of self reported smoking. Journal of epidemiology and community health. 2002;56(3):163-4
  6. Caraballo RS, Giovino GA, Pechacek TF, Mowery PD. Factors associated with discrepancies between self-reports on cigarette smoking and measured serum cotinine levels among persons aged 17 years or older: Third National Health and Nutrition Examination Survey, 1988-1994. American journal of epidemiology. 2001;153(8):807-14
  7. Ozoh OB, Dania MG, Irusen EM. The Prevalence of Self-Reported Smoking and Validation with Urinary Cotinine Among Commercial Drivers in Major Parks in Lagos, Nigeria. Journal of public health in Africa. 2014;5(1):316
  8. Pearce MS, Hayes L, Newcastle Heart P, Newcastle Thousand Families S. Self-reported smoking status and exhaled carbon monoxide: results from two population-based epidemiologic studies in the North of England. Chest. 2005;128(3):1233-8
  9. Morabia A, Bernstein MS, Curtin F, Berode M. Validation of self-reported smoking status by simultaneous measurement of carbon monoxide and salivary thiocyanate. Preventive medicine. 2001;32(1):82-8
  10. Maclaren DJ, Conigrave KM, Robertson JA, Ivers RG, Eades S, Clough AR. Using breath carbon monoxide to validate self-reported tobacco smoking in remote Australian Indigenous communities. Population health metrics. 2010;8(1):2
  11. Man CN, Fathelrahman AI, Harn GL, Lajis R, Samin AS, Omar M, et al. Correlation between urinary nicotine, cotinine and self-reported smoking status among educated young adults. Environmental toxicology and pharmacology. 2009;28(1):92-6
  12. Jarvis MJ, Tunstall-Pedoe H, Feyerabend C, Vesey C, Saloojee Y. Comparison of tests used to distinguish smokers from nonsmokers. Am J Public Health. 1987;77(11):1435-8
  13. Verification SSoB. Biochemical verification of tobacco use and cessation. Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco. 2002;4(2):149-59
  14. Benowitz NL. Cotinine as a biomarker of environmental tobacco smoke exposure. Epidemiologic reviews. 1996;18(2):188-204
  15. Smoking and Tobacco Used [Internet]. National Center for Chronic Disease Prevention and Health Promotion,. 2016 [cited 31 July 2017]
  16. Prevention CfDCa. Adult Tobacco Use Questions on the National Health Interview Survey 1997 -Forward. In: Prevention CfDCa, editor. Atlanta, USA: Centres for Disease Control and Prevention; 1997
  17. Kim S. Overview of Cotinine Cutoff Values for Smoking Status Classification. International journal of environmental research and public health. 2016;13(12)
  18. Jamal R, Syed Zakaria SZ, Kamaruddin MA, Abd Jalal N, Ismail N, Mohd Kamil N, et al. Cohort Profile: The Malaysian Cohort (TMC) project: a prospective study of non-communicable diseases in a multi-ethnic population. Int J Epidemiol. 2015;44(2):423-31
  19. Cattaneoa R, Alegretti, A.P., Sagebin, F.R., Abreu, C.M.D., Petersen, G.O. & Chatkin, J.M. Validation of a high-performance liquid chromatography method for the determination of cotinine in urine. Revista Brasileira de Toxicologia 2006;19(1):25-31
  20. Hukkanen J, Jacob P, 3rd, Benowitz NL. Metabolism and disposition kinetics of nicotine. Pharmacol Rev. 2005;57(1):79-115
  21. Tricker AR. Nicotine metabolism, human drug metabolism polymorphisms, and smoking behaviour. Toxicology. 2003;183(1-3):151-73
  22. Gilligan C, Sanson-Fisher R, Eades S, Wenitong M, Panaretto K, D'Este C. Assessing the accuracy of self-reported smoking status and impact of passive smoke exposure among pregnant Aboriginal and Torres Strait Islander women using cotinine biochemical validation. Drug Alcohol Rev. 2010;29(1):35-40
  23. Pearce MS, Mann KD, Singh G, Davison B, Sayers SM. Prevalence and validity of self-reported smoking in Indigenous and non-Indigenous young adults in the Australian Northern Territory. BMC Public Health. 2014;14:861
  24. Jeemon P, Agarwal S, Ramakrishnan L, Gupta R, Snehi U, Chaturvedi V, et al. Validation of self-reported smoking status by measuring serum cotinine levels: an Indian perspective. Natl Med J India. 2010;23(3):134-6

Last update:

No citation recorded.

Last update:

No citation recorded.