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Misclassification of self‐reported smoking in adult survivors of childhood cancer
Author(s) -
Huang IChan,
Klosky James L.,
Young Chelsea M.,
Murphy Sharon E.,
Krull Kevin K.,
Srivastava DeoKumar,
Hudson Melissa M.,
Robison Leslie L.
Publication year - 2018
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.27240
Subject(s) - medicine , cotinine , nicotine , young adult , cigarette smoking , epidemiology , nicotine dependence , demography , sociology
We investigated misclassification rates, sensitivity, and specificity of self‐reported cigarette smoking through serum cotinine concentration (liquid chromatography tandem mass spectrometry) among 287 adult survivors of childhood cancer. Overall, 2.5–6.7% and 19.7–36.9% of the self‐reported never and past smokers had cotinine levels indicative of active smoking. Sensitivity and specificity of self‐reported smoking were 57.5–67.1% and 96.6–99.2%. Misclassification was associated with younger age (OR = 3.2; 95% CI = 1.4–7.4), male (OR = 2.1; 95% CI = 1.1–4.0), and past (OR = 2.7; 95% CI = 1.3–5.8) or current (OR = 2.6; 95% CI = 1.0–6.6) marijuana use. After adjusting for tobacco‐related variables, current marijuana use remained a significant risk for misclassification. Clinicians/researchers should consider bio‐verification to measure smoking status among survivors.