Bernstein Steven L, Rosner June, Toll Benjamin
a Department of Emergency Medicine , Yale School of Medicine , New Haven , Connecticut , USA.
b Yale Cancer Center, Yale School of Medicine , New Haven , Connecticut , USA.
Subst Abus. 2016 Jul-Sep;37(3):398-401. doi: 10.1080/08897077.2016.1154494.
Smoking cessation clinical trials assess tobacco abstinence using self-report and biomarkers. Optimum methods for each are unclear; a common question assesses smoking in the prior 7 days. In contrast, timeline follow-back (TLFB) is another technique often used to assess use of alcohol in treatment trials; it is used less frequently in studies of smoking cessation. The goal of this study was to assess concordance between the 7-day smoking question and a 7-day TLFB.
Secondary analysis of data from a randomized clinical trial of smoking cessation was conducted at a busy, urban hospital emergency department (ED) from October 2010 to December 2012. At 1, 3, and 12 months, subjects were contacted by phone to assess smoking status. Those reporting abstinence at 3 months were asked to return for an in-person measurement of exhaled carbon monoxide. For this analysis, smoking status at 1 month was compared for subjects in response to 2 questions asked concurrently, addressing 7-day point prevalence tobacco use and a 7-day TLFB.
Of 780 subjects, 666 (85.4%) were available for 1-month follow-up. Of these, 99 (14.9%) reported no smoking in response to the 7-day question, and 96 (14.4%) reported no smoking in response to the 7-day TLFB. The overall proportionate agreement between the 2 methods was 98.6%, with a kappa of 0.95 (95% confidence interval [CI]: 0.91-0.98).
A single question that assesses smoking at 7 days provides excellent concordance with the more detailed TLFB. The single question appears adequate to assess self-reported tobacco use in clinical trials of smoking cessation.
戒烟临床试验使用自我报告和生物标志物来评估烟草戒断情况。每种方法的最佳方式尚不清楚；一个常见问题是评估过去7天内的吸烟情况。相比之下，时间线追溯法（TLFB）是另一种常用于治疗试验中评估酒精使用情况的技术；在戒烟研究中使用频率较低。本研究的目的是评估7天吸烟问题与7天时间线追溯法之间的一致性。
对2010年10月至2012年12月在一家繁忙的城市医院急诊科进行的戒烟随机临床试验数据进行二次分析。在1个月、3个月和12个月时，通过电话联系受试者以评估吸烟状况。那些报告在3个月时已戒烟的受试者被要求返回进行呼出一氧化碳的现场测量。对于本分析，比较了受试者在同时回答两个问题时1个月时的吸烟状况，这两个问题分别涉及7天时间点流行率的烟草使用情况和7天时间线追溯法。
780名受试者中，666名（85.4%）可进行1个月的随访。其中有99名（14.9%）在回答7天问题时报告未吸烟，96名（14.4%）在回答7天时间线追溯法问题时报告未吸烟。两种方法之间的总体比例一致性为98.6%，kappa值为0.95（95%置信区间[CI]：0.91 - 0.98）。
一个评估7天内吸烟情况的单一问题与更详细的时间线追溯法具有极好的一致性。这个单一问题似乎足以在戒烟临床试验中评估自我报告的烟草使用情况。
