Park Soon Woo, Kim Jong Yeon
Department of Preventive Medicine, Catholic University of Daegu School of Medicine, Korea.
J Prev Med Public Health. 2009 Jul;42(4):223-30. doi: 10.3961/jpmph.2009.42.4.223.
This study was conducted to validate self-reported smoking among high school students using urinary cotinine.
A self report of smoking behavior was collected together with urine sample for cotinine analysis from 130 male and female students in two vocational high school students in November, 2007. Validity and agreement between self-reported smoking and urinary cotinine was analyzed with STATA 9.0 for different definitions of current smokers, and frequent and daily smokers. Urinary cotinine concentration was measured by the DRI Cotinine Assay for urine (Microgenics Corp., Fremont, CA) on Toshiba 200FR. The cut-off point of urinary cotinine was 50 ng/dl.
The concentrations of urinary cotinine were significantly different according to the frequency and amount of smoking. Sensitivity and specificity was 90.9% and 91.8% respectively, and the Cohen's kappa value was 0.787 among the current smokers who smoked at least one day during one month preceding the survey. The comparable high sensitivity, specificity, and kappa value were shown also among the other definitions of current smokers, that is, subjective smokers, and weekly smokers.
The results showed the high validity of self-reported smoking among high school students. However, due to the small sample size and limitation of the participants, it is cautious to generalize the results to overall high school students.
本研究旨在通过尿可替宁验证高中生自我报告的吸烟情况。
2007年11月，从两所职业高中的130名男女学生中收集吸烟行为的自我报告以及用于可替宁分析的尿液样本。使用STATA 9.0针对当前吸烟者、频繁吸烟者和每日吸烟者的不同定义，分析自我报告吸烟与尿可替宁之间的有效性和一致性。尿可替宁浓度通过用于尿液的DRI可替宁测定法（Microgenics公司，弗里蒙特，加利福尼亚州）在东芝200FR上进行测量。尿可替宁的临界值为50 ng/dl。
根据吸烟频率和吸烟量，尿可替宁浓度存在显著差异。在调查前一个月内至少吸烟一天的当前吸烟者中，敏感性和特异性分别为90.9%和91.8%，Cohen's kappa值为0.787。在当前吸烟者的其他定义中，即主观吸烟者和每周吸烟者中，也显示出相当高的敏感性、特异性和kappa值。
结果表明高中生自我报告吸烟具有较高的有效性。然而，由于样本量小和参与者的局限性，将结果推广到全体高中生时需谨慎。
