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Background
Keywords
Findings
Authors
What is already known on this subject?
What does this study add?

Text begins

Background

Cigarette smoking is associated with adverse health effects, including cancer, respiratory illness, heart disease and stroke.  National data on smoking prevalence often rely on self-reports.  This study assesses the validity of self-reported cigarette smoking status among Canadians. 

Data and methods

Data are from the 2007 to 2009 Canadian Health Measures Survey, a nationally representative cross-sectional survey of 4,530 Canadians aged 12 to 79.  The survey included self-reported smoking status and a measure of urinary cotinine, a biomarker of exposure to tobacco smoke.  The prevalence of cigarette smoking was calculated based on self-reports and also on urinary cotinine concentrations.  

Results

Compared with estimates based on urinary cotinine concentration, smoking prevalence based on self-report was 0.3 percentage points lower.  Sensitivity estimates (the percentage of respondents who reported being smokers among those classified as smokers based on cotinine concentrations) were similar for males and females (more than 90%).  Although sensitivity tended to be lower for respondents aged 12 to 19 than for those aged 20 to 79, the difference did not attain statistical significance.

Interpretation

Accurate estimates of the prevalence of cigarette smoking among Canadians can be derived from self-reported smoking status data. 

Keywords

Biological specimens, cotinine, data collection, direct measures, health surveys, reproducibility of results, urine specimen collection

Findings

The health risks associated with cigarette smoking are well-documented and widely recognized— cancer, respiratory illness, heart disease, and stroke. In Canada, smoking contributes to more than 37,000 deaths a year. Tobacco-related health care expenditures amount to billions of dollars annually, with additional indirect costs such as lost productivity, longer-term disability and premature death. [Full Text]

Authors

Suzy L. Wong (613-951-4774; suzy.wong@statcan.gc.ca) and Margot Shields (613-951-4177; margot.shields@statcan.gc.ca) are with the Health Analysis Division at Statistics Canada, Ottawa, Ontario, K1A 0T6.  Scott Leatherdale and David Hammond are with the University of Waterloo, Waterloo, Ontario.  Eric Malaison is with Health Canada.

What is already known on this subject?

  • Cigarette smoking is associated with adverse health effects, including cancer, respiratory illness, heart disease and stroke. 
  • National data on smoking prevalence data often rely on self-reports. 
  • The urinary concentration of cotinine is an objective measure of exposure to tobacco smoke.

What does this study add?

  • Accurate estimates of the prevalence of cigarette smoking among Canadians can be derived from self-reported data on smoking status.