Analysis of self-reported versus biomarker based smoking prevalence: methodology to compute corrected smoking prevalence rates.

CONTEXT

Prevalence of smoking is needed to estimate the need for future public health resources.

OBJECTIVE

To compute and compare smoking prevalence rates by using self-reported smoking statuses, two serum cotinine (SCOT) based biomarker methods, and one urinary 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) based biomarker method. These estimates were then used to develop correction factors to be applicable to self-reported prevalences to arrive at corrected smoking prevalence rates.

MATERIALS AND METHODS

Data from National Health and Nutrition Examination Survey (NHANES) for 2007-2012 for those aged ≥20 years (N = 16826) were used.

RESULTS

Self-reported prevalence rate for the total population computed as the weighted number of self-reported smokers divided by weighted number of all participants was 21.6% and 24% when computed by weighted number of self-reported smokers divided by the weighted number of self-reported smokers and nonsmokers. The corrected prevalence rate was found to be 25.8%.

DISCUSSION AND CONCLUSIONS

A 1% underestimate in smoking prevalence is equivalent to not being able to identify 2.2 million smokers in US in a given year. This underestimation, if not corrected, could lead to serious gap in the public health services available and needed to provide adequate preventive and corrective treatment to smokers.