Heller W D, Scherer G, Sennewald E, Adlkofer F
Analytisch-Biologisches Forschungslabor Prof Adlkofer, Munich, Germany.
J Clin Epidemiol. 1998 Mar;51(3):211-8. doi: 10.1016/s0895-4356(97)00279-5.
Smoking prevalence in southern Germany was studied in 1984-1985 using a representative cohort of 4022 subjects aged 25 to 64 years, with 3753 reinterviewed in 1987-1988. Data were available for analysis from interviews on self-reported smoking behavior and from serum cotinine measurements in both investigations. More men than women reported current smoking, and particularly heavy smoking. Serum cotinine levels increased steadily with the daily number and nicotine yield of cigarettes smoked. Mean cotinine levels in ex-smokers were higher than those in never smokers, suggesting that a higher percentage of current smokers are misclassified as ex-smokers than never smokers. Using cotinine rather than self-reported smoking data increased the proportion of true smokers in the subgroup of self-reported smokers by about 3% in males and by about 1% in females. Data from the reinterviews revealed that reported smoking status confirmed by cotinine measurement in 1987-1988 conflicted in a number of cases with the data obtained in 1984-1985 using the same procedure. For example, 0.1% of those who stated they were current regular smokers, 4.3% of those who stated they were current occasional smokers, and 17.6% of those who stated they were ex-smokers in 1984-1985 claimed in 1987-1988 to have never smoked. This misclassification of ex-smokers was higher in women. Altogether the true proportion of ex-smokers among self-reported never smokers was about 9.7% (17.8% in men and 6.7% in women). The widely variable uptake of tobacco smoke by smokers, as well as the misclassification of true smokers and ex-smokers as never smokers, needs to be considered in epidemiological studies evaluating the health risks from both active and passive smoking.
1984 - 1985年，利用一个由4022名年龄在25至64岁之间的受试者组成的代表性队列，对德国南部的吸烟率进行了研究，1987 - 1988年对其中3753人进行了再次访谈。在这两项调查中，均有关于自我报告吸烟行为的访谈数据以及血清可替宁测量数据可供分析。报告当前吸烟尤其是重度吸烟的男性多于女性。血清可替宁水平随着每日吸烟数量和所吸香烟的尼古丁含量稳步上升。已戒烟者的平均可替宁水平高于从不吸烟者，这表明与从不吸烟者相比，当前吸烟者中被误分类为已戒烟者的比例更高。使用可替宁而非自我报告的吸烟数据，在自我报告吸烟者亚组中，男性真正吸烟者的比例增加了约3%，女性增加了约1%。再次访谈的数据显示，1987 - 1988年通过可替宁测量确认的报告吸烟状况在一些情况下与1984 - 1985年采用相同程序获得的数据相冲突。例如，1984 - 1985年称自己是当前经常吸烟者的人中，有0.1%在1987 - 1988年声称从未吸烟；称自己是当前偶尔吸烟者的人中，有4.3%在1987 - 1988年声称从未吸烟；称自己是已戒烟者的人中，有17.6%在1987 - 1988年声称从未吸烟。这种已戒烟者的误分类在女性中更高。总体而言，在自我报告的从不吸烟者中，真正已戒烟者的比例约为9.7%（男性为17.8%，女性为6.7%）。在评估主动吸烟和被动吸烟的健康风险的流行病学研究中，需要考虑吸烟者对烟草烟雾的广泛不同的摄入量，以及真正吸烟者和已戒烟者被误分类为从不吸烟者的情况。
