THE VALIDITY OF SELF-REPORTED SMOKING - A REVIEW AND METAANALYSIS

Objectives. The purpose of this study was to identify circumstances in which biochemical assessments of smoking produce systematically highe r or lower estimates of smoking than self-reports. A secondary aim was to evaluate different statistical approaches to analyzing variation i n validity estimates. Methods. Literature searches and personal inquir ies identified 26 published reports containing 51 comparisons between self-reported behavior and biochemical measures. The sensitivity and:s pecificity of self-reports of smoking were calculated for each study a s measures of accuracy. Results. Sensitivity ranged from 6% to 100% (m ean = 87.5%), and specificity ranged from: 33% to 100% (mean = 89.2%). Interviewer-administered questionnaires, observational studies, repor ts by adults, and biochemical validation with cotinine-plasma were ass ociated with higher estimates of sensitivity and specificity. Conclusi ons. Self-reports of smoking are accurate in most studies. To improve accuracy, biochemical assessment, preferably with cotinine-plasma, sho uld be considered in intervention studies and student populations.