Jarvis M J, Tunstall-Pedoe H, Feyerabend C, Vesey C, Saloojee Y
Addiction Research Unit, Institute of Psychiatry, London, England.
Am J Public Health. 1987 Nov;77(11):1435-8. doi: 10.2105/ajph.77.11.1435.
Questionnaire and biochemical measures of smoking were studied in 211 hospital outpatients. Eleven different tests of smoke intake were compared for their ability to categorize smokers and nonsmokers correctly. The concentration of cotinine, whether measured in plasma, saliva, or urine, was the best indicator of smoking, with sensitivity of 96-97 per cent and specificity of 99-100 per cent. Thiocyanate provided the poorest discrimination. Carbon monoxide measured as blood carboxyhaemoglobin or in expired air gave sensitivity and specificity of about 90 per cent. Sensitivities of the tests were little affected by the presence among the claimed nonsmokers of a group of 21 "deceivers" who concealed their smoking. It is concluded that cotinine is the measure of choice, but for most clinical applications carbon monoxide provides an acceptable degree of discrimination and is considerably cheaper and simpler to apply.
对211名医院门诊患者进行了吸烟问卷调查和生化检测。比较了11种不同的吸烟量测试方法对吸烟者和非吸烟者进行正确分类的能力。无论在血浆、唾液还是尿液中测量，可替宁浓度都是吸烟的最佳指标，敏感性为96 - 97%，特异性为99 - 100%。硫氰酸盐的鉴别能力最差。以血液中碳氧血红蛋白或呼出气体测量的一氧化碳的敏感性和特异性约为90%。在声称不吸烟的人群中有21名“隐瞒者”隐瞒了他们的吸烟情况，但这些测试的敏感性几乎没有受到影响。结论是可替宁是首选的检测指标，但对于大多数临床应用来说，一氧化碳提供了可接受的鉴别程度，而且应用起来要便宜得多且更简单。
