School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Cairns, Queensland, Australia.
Popul Health Metr. 2010 Feb 20;8(1):2. doi: 10.1186/1478-7954-8-2.
This paper examines the specificity and sensitivity of a breath carbon monoxide (BCO) test and optimum BCO cutoff level for validating self-reported tobacco smoking in Indigenous Australians in Arnhem Land, Northern Territory (NT).
In a sample of 400 people (>/=16 years) interviewed about tobacco use in three communities, both self-reported smoking and BCO data were recorded for 309 study participants. Of these, 249 reported smoking tobacco within the preceding 24 hours, and 60 reported they had never smoked or had not smoked tobacco for >/=6 months. The sample was opportunistically recruited using quotas to reflect age and gender balances in the communities where the combined Indigenous populations comprised 1,104 males and 1,215 females (>/=16 years). Local Indigenous research workers assisted researchers in interviewing participants and facilitating BCO tests using a portable hand-held analyzer.
A BCO cutoff of >/=7 parts per million (ppm) provided good agreement between self-report and BCO (96.0% sensitivity, 93.3% specificity). An alternative cutoff of >/=5 ppm increased sensitivity from 96.0% to 99.6% with no change in specificity (93.3%). With data for two self-reported nonsmokers who also reported that they smoked cannabis removed from the analysis, specificity increased to 96.6%.
In these disadvantaged Indigenous populations, where data describing smoking are few, testing for BCO provides a practical, noninvasive, and immediate method to validate self-reported smoking. In further studies of tobacco smoking in these populations, cannabis use should be considered where self-reported nonsmokers show high BCO.
本研究旨在检验呼出气一氧化碳（BCO）测试的特异性和敏感性，并确定最佳 BCO 截断值，以验证北领地阿纳姆地的澳大利亚原住民自我报告的吸烟情况。
在对三个社区的 400 人进行的关于烟草使用情况的访谈中，记录了 309 名研究参与者的自我报告吸烟情况和 BCO 数据。其中，249 人报告在过去 24 小时内吸烟，60 人报告从未吸烟或已经戒烟>6 个月。该样本是通过配额机会招募的，以反映社区中年龄和性别平衡，其中合并的原住民人口包括 1104 名男性和 1215 名女性（>/=16 岁）。当地的原住民研究人员协助研究人员进行访谈，并使用便携式手持分析仪为参与者进行 BCO 测试。
BCO 截断值>=/7ppm 可提供自我报告和 BCO 之间的良好一致性（96.0%的敏感性，93.3%的特异性）。替代截断值>=/5ppm 可将敏感性从 96.0%提高到 99.6%，而特异性无变化（93.3%）。从分析中去除了两名自我报告的不吸烟者的数据，他们也报告说自己吸食了大麻，特异性增加到 96.6%。
在这些弱势群体的原住民中，有关吸烟的数据很少，BCO 测试提供了一种实用、非侵入性和即时的方法来验证自我报告的吸烟情况。在这些人群中进一步研究吸烟情况时，如果自我报告的不吸烟者的 BCO 较高，应考虑大麻的使用。
