Assessment of validity of self-reported smoking status

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.