Misailidi Maria, Tzatzarakis Manolis N, Kavvalakis Mathaios P, Koutedakis Yiannis, Tsatsakis Aristidis M, Flouris Andreas D
FAME Laboratory, Centre for Research and Technology Hellas, Trikala, Greece ; Department of Exercise Sciences, University of Thessaly, Trikala, Greece ; Regional Directorate of Primary and Secondary Education of Western Greece, Patras, Greece.
Centre of Toxicology Science and Research, Medical School, University of Crete, Iraklio, Greece.
PLoS One. 2014 Jan 21;9(1):e85809. doi: 10.1371/journal.pone.0085809. eCollection 2014.
(i) to develop questionnaires that can identify never-smoking children and adults experiencing increased exposure to secondhand smoke (SHS+), (ii) to determine their validity against hair nicotine, and (iii) assess their reliability. A sample of 191 children (85 males; 106 females; 7-18 years) and 95 adult (23 males; 72 females; 18-62 years) never-smokers consented to hair nicotine analysis and answered a large number of questions assessing all sources of SHS. A randomly-selected 30% answered the questions again after 20-30 days. Prevalence of SHS+ in children and adults was 0.52±0.07 and 0.67±0.10, respectively (p<0.05). The Smoke Scale for Children (SS-C) and the Smoke Scale for Adults (SS-A) were developed via factor analysis and included nine questions each. Positivity criteria for SS-C and SS-A via receiver operating characteristics curve analysis were identified at >16.5 and >16, respectively. Significant Kappa agreement (p<0.05) was confirmed when comparing the SS-C and SS-A to hair nicotine concentration. Reliability analyses demonstrated that the SS-C and SS-A scores obtained on two different days are highly correlated (p<0.001) and not significantly different (p>0.05). Area under the curve and McNemar's Chi-square showed no pair-wise differences in sensitivity and specificity at the cutoff point between the two different days for SS-C and SS-A (p>0.05). We conclude that the SS-C and the SS-A represent valid, reliable, practical, and inexpensive instruments to identify children and adult never-smokers exposed to increased SHS. Future research should aim to further increase the validity of the two questionnaires.
(i) 编制能够识别接触二手烟增加的不吸烟儿童和成人（SHS+）的问卷，(ii) 确定问卷相对于头发尼古丁含量的有效性，以及(iii) 评估问卷的可靠性。选取191名儿童（85名男性；106名女性；7至18岁）和95名成人（23名男性；72名女性；18至62岁）不吸烟者作为样本，他们同意进行头发尼古丁分析，并回答了大量评估二手烟所有来源的问题。随机抽取30%的人在20至30天后再次回答这些问题。儿童和成人中SHS+的患病率分别为0.52±0.07和0.67±0.10（p<0.05）。通过因子分析编制了儿童吸烟量表（SS-C）和成人吸烟量表（SS-A），每个量表包含9个问题。通过受试者工作特征曲线分析确定，SS-C和SS-A的阳性标准分别为>16.5和>16。将SS-C和SS-A与头发尼古丁浓度进行比较时，证实了显著的Kappa一致性（p<0.05）。可靠性分析表明，在两天内获得的SS-C和SS-A分数高度相关（p<0.001），且无显著差异（p>0.05）。曲线下面积和McNemar卡方检验显示，SS-C和SS-A在两天不同时间点的截断点处，敏感性和特异性无两两差异（p>0.05）。我们得出结论，SS-C和SS-A是识别接触二手烟增加的不吸烟儿童和成人的有效、可靠、实用且廉价的工具。未来的研究应致力于进一步提高这两份问卷的有效性。
