Kang Hyun Goo, Kwon Kyoung Hyun, Lee In Wook, Jung Boyoung, Park Eun-Cheol, Jang Sung-In
Yonsei University College of Medicine, Seoul, Korea E-mail :
Asian Pac J Cancer Prev. 2013;14(11):6807-12. doi: 10.7314/apjcp.2013.14.11.6807.
Lung cancer is a major cause of Korean female mortality and is clearly associated with smoking. The Korean National Health and Nutrition Examination Survey (KNHANES IV-2,3), which included both self-reports of smoking and urinary cotinine data, revealed a significant discrepancy between the prevalence of self-reported and biochemically-verified female smokers. The factors associated with accurate self-reporting of current smoking status remain poorly understood, however.
We assessed the prevalence of smoking in KNHANES using both self-report and urinary cotinine data. Subsequently, using univariate and multivariate tests, we assessed whether age, intensity of smoking, marital status, relationship with cohabitants, education, occupation, residential area, or annual household income were associated with inaccurate self- reporting in Korean females. We also investigated whether the prevalence of inaccurate self-reports changed over the survey period, 2008-2009.
The prevalence of self-reported smoking was 47.8% in males and 6.6% in females. By contrast, the prevalence of smoking as assessed by urinary cotinine levels was 52.2% in males and 14.5% in females. Of the 746 females with urinary cotinine levels >50 ng/ml, 407 (56.0%) provided inaccurate self-reports. In a multivariate model, age group(40-49: OR 3.54, 95%CI 1.42-8.86, p=0.007; ref :20- 29), cotinine intensity(OR 0.999, 95%CI 0.998-0.999, p<0.001), marital status (married but without spouse: OR 0.37, 95%CI 0.15-0.94, p=0.037; ref :never married), relationship with cohabitants (living with a spouse and unmarried child: OR 2.63, 95%CI 1.44-4.80, p=0.002; living with 2 generations except unmarried child: OR 2.53, 95%CI 1.09-5.87, p=0.030; living with ≥ 3 generations: OR 3.25, 95%CI 1.48-7.10, p=0.003; ref :spouse only) and education(college or higher: OR 2.73, 95%CI 1.04-7.18, p=0.042; ref :elementary or less) were independently associated with inaccurate self-reports.
The trend of smoking prevalence of Korean females is likely to decrease. However, an elevated prevalence of inaccurate self-reports by females remains. Factors related to the intensity of smoking and family status appear to influence whether a Korean female provides an accurate self-report when asked about smoking behavior.
肺癌是韩国女性死亡的主要原因，且与吸烟明显相关。韩国国家健康与营养检查调查（KNHANES IV-2,3）包括吸烟的自我报告和尿可替宁数据，结果显示自我报告的女性吸烟者患病率与经生化验证的女性吸烟者患病率之间存在显著差异。然而，目前对于与准确自我报告当前吸烟状况相关的因素仍知之甚少。
我们使用自我报告和尿可替宁数据评估了KNHANES中的吸烟患病率。随后，通过单因素和多因素检验，我们评估了年龄、吸烟强度、婚姻状况、与同居者的关系、教育程度、职业、居住地区或家庭年收入是否与韩国女性自我报告不准确有关。我们还调查了2008 - 2009年调查期间自我报告不准确的患病率是否发生了变化。
自我报告的吸烟患病率男性为47.8%，女性为6.6%。相比之下，根据尿可替宁水平评估的吸烟患病率男性为52.2%，女性为14.5%。在746名尿可替宁水平>50 ng/ml的女性中，407名（56.0%）提供了不准确的自我报告。在多因素模型中，年龄组（40 - 49岁：比值比3.54，95%置信区间1.42 - 8.86，p = 0.007；对照：20 - 29岁）、可替宁强度（比值比0.999，95%置信区间0.998 - 0.999，p < 0.001）、婚姻状况（已婚但无配偶：比值比0.37，95%置信区间0.15 - 0.94，p = 0.037；对照：未婚）、与同居者的关系（与配偶和未婚子女同住：比值比2.63，95%置信区间1.44 - 4.80，p = 0.002；与除未婚子女外的两代人同住：比值比2.53，95%置信区间1.09 - 5.87，p = 0.030；与三代及以上同住：比值比3.25，95%置信区间1.48 - 7.10，p = 0.003；对照：仅与配偶同住）和教育程度（大专及以上：比值比2.73，95%置信区间1.04 - 7.18，p = 0.042；对照：小学及以下）与自我报告不准确独立相关。
韩国女性吸烟患病率呈下降趋势。然而，女性自我报告不准确的患病率仍然较高。与吸烟强度和家庭状况相关的因素似乎会影响韩国女性在被问及吸烟行为时是否能提供准确的自我报告。
