Hovanec Jan, Weiß Tobias, Koch Holger M, Pesch Beate, Behrens Thomas, Kendzia Benjamin, Arendt Marina, Dragano Nico, Moebus Susanne, Schmidt Börge, Brüning Thomas, Jöckel Karl-Heinz
Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany.
Institute for Medical Informatics, Biometry and Epidemiology, Essen University Hospital, Essen, Germany.
BMC Public Health. 2022 Feb 14;22(1):302. doi: 10.1186/s12889-022-12609-y.
Smoking intensity, which is generally based on self-reported average cigarettes per day (CPD), is a major behavioural risk factor and strongly related to socioeconomic status (SES). To assess the validity of the CPD measure, correlations with objective markers of tobacco smoke exposure - such as urinary nicotine metabolites - were examined. Yet, it remains unclear, whether this correlation is affected by SES, which may indicate imprecise or biased self-reports of smoking intensity.
We investigated the role of SES in the association between CPD and nicotine metabolites in current smokers among the participants of the population-based, prospective Heinz Nixdorf Recall Study. We determined urinary cotinine and additionally trans-3'-hydroxy-cotinine. SES was assessed by the International Socio-Economic Index of occupational status, and education. We calculated correlations (Pearson's r) between logarithmised CPD and cotinine in subgroups of SES and analysed SES and further predictors of cotinine in multiple linear regression models separately by gender.
Median reported smoking intensity was 20 CPD in male and 19 CPD in female smokers. Men showed higher cotinine concentrations (median 3652 μg/L, interquartile range (IQR) 2279-5422 μg/L) than women (3127 μg/L, IQR 1692-4920 μg/L). Logarithmised CPD correlated moderately with cotinine in both, men and women (Pearson's r 0.4), but correlations were weaker in smokers with lower SES: Pearson's r for low, intermediate, and high occupational SES was 0.35, 0.39, and 0.48 in men, and 0.28, 0.43, and 0.47 in women, respectively. Logarithmised CPD and urinary creatinine were main predictors of cotinine in multiple regression models, whereas SES showed a weak negative association in women. Results were similar for trans-3'-hydroxy-cotinine.
Decreasing precision of self-reported CPD was indicated for low SES in men and women. We found no strong evidence for biased self-reports of smoking intensity by SES.
吸烟强度通常基于自我报告的每日平均吸烟量（CPD），是一个主要的行为风险因素，且与社会经济地位（SES）密切相关。为评估CPD测量方法的有效性，研究了其与烟草烟雾暴露客观标志物（如尿中尼古丁代谢物）的相关性。然而，尚不清楚这种相关性是否受SES影响，这可能表明吸烟强度的自我报告不准确或存在偏差。
在基于人群的前瞻性海因茨·尼克斯多夫召回研究的参与者中，我们调查了SES在当前吸烟者中CPD与尼古丁代谢物之间关联中的作用。我们测定了尿中可替宁，另外还测定了反式-3'-羟基可替宁。SES通过国际职业社会经济指数和教育程度进行评估。我们计算了SES亚组中对数转换后的CPD与可替宁之间的相关性（Pearson相关系数r），并在多元线性回归模型中按性别分别分析了SES及可替宁的其他预测因素。
男性吸烟者报告的吸烟强度中位数为20 CPD，女性为19 CPD。男性的可替宁浓度中位数（3652μg/L，四分位间距（IQR）2279 - 5422μg/L）高于女性（3127μg/L，IQR 1692 - 4920μg/L）。对数转换后的CPD在男性和女性中与可替宁均呈中度相关（Pearson相关系数r为0.4），但在SES较低的吸烟者中相关性较弱：低、中、高职业SES男性的Pearson相关系数分别为0.35、0.39和0.48，女性分别为0.28、0.43和0.47。在多元回归模型中，对数转换后的CPD和尿肌酐是可替宁的主要预测因素，而SES在女性中显示出较弱的负相关。反式-3'-羟基可替宁的结果相似。
男性和女性中低SES者自我报告的CPD准确性降低。我们没有发现SES导致吸烟强度自我报告存在偏差的有力证据。
Zotero 插件