Manan Norfazillah Ab, Nawi Azmawati Mohammed, Ahmad Norfazilah, Hassan Mohd Rohaizat
Dept. of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Int J Pediatr Adolesc Med. 2020 Jun;7(2):78-82. doi: 10.1016/j.ijpam.2019.08.001. Epub 2019 Aug 10.
BACKGROUND & OBJECTIVE: In the local setting, the prevalence of smoking among adolescents varies, as it is based only on self-reporting without biomarker validation. The objective of the present study was to determine the accuracy of self-reported smoking among adolescents as compared to that of the urine cotinine strip test.
We performed a cross-sectional study of 314 adolescents aged 16 years from February 2015 to April 2015 in Putrajaya, Malaysia. The accuracy of self-reporting was assessed using a data collection sheet and was validated by the urine cotinine strip test. Three schools were chosen by the simple random method, where all Form 4 students constituted the sample unit. The kappa statistic was used for determining agreement between self-reporting and urine cotinine strip testing.
There was a substantial agreement between self-reporting and the urine cotinine strip test (kappa = 0.757, 95% confidence interval [CI]: 0.63, 0.88); there was 95.86% overall agreement. The prevalence of self-reported smoking was 8% (95% CI: 7.47, 8.53) and that of urine cotinine strip testing was 10.8% (95% CI: 10.20, 11.41). There was a discrepancy with the results of the urine cotinine strip test in 8% of self-reported smokers and 3.8% of self-reported nonsmokers. Self-reporting had 67.6% sensitivity and 99.3% specificity as compared to those of urine cotinine strip testing and had 92% positive predictive value and 96.2% negative predictive value.
Self-reporting can be used to assess smoking status but should be used with care among adolescents. Urine cotinine strip test validation of self-reporting enables the measurement of the true prevalence of smoking among adolescents.
在当地环境中，青少年吸烟率因仅基于自我报告而缺乏生物标志物验证而有所不同。本研究的目的是确定青少年自我报告吸烟情况与尿可替宁试纸检测结果相比的准确性。
2015年2月至2015年4月，我们在马来西亚布城对314名16岁青少年进行了一项横断面研究。使用数据收集表评估自我报告的准确性，并通过尿可替宁试纸检测进行验证。通过简单随机方法选择了三所学校，所有四年级学生构成样本单位。kappa统计量用于确定自我报告与尿可替宁试纸检测之间的一致性。
自我报告与尿可替宁试纸检测之间存在高度一致性（kappa = 0.757，95%置信区间[CI]：0.63，0.88）；总体一致性为95.86%。自我报告的吸烟率为8%（95%CI：7.47，8.53），尿可替宁试纸检测的吸烟率为10.8%（95%CI：10.20，11.41）。8%的自我报告吸烟者和3.8%的自我报告非吸烟者的尿可替宁试纸检测结果存在差异。与尿可替宁试纸检测相比，自我报告的敏感性为67.6%，特异性为99.3%，阳性预测值为92%，阴性预测值为96.2%。
自我报告可用于评估吸烟状况，但在青少年中应谨慎使用。通过尿可替宁试纸检测对自我报告进行验证能够测量青少年吸烟的真实患病率。
