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Underestimation of Self-Reported Smoking Prevalence in Korean Adolescents: Evidence from Gold Standard by Combined Method

1
Department of Preventive Medicine, Catholic University of Daegu School of Medicine, Daegu 42472, Korea
2
Department of Laboratory Medicine, Center for Diagnostic Oncology, National Cancer Center, Goyang-si 10408, Korea
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2018, 15(4), 689; https://doi.org/10.3390/ijerph15040689
Received: 2 March 2018 / Revised: 31 March 2018 / Accepted: 3 April 2018 / Published: 5 April 2018
The objective of this study was to evaluate the validity of self-reported smoking prevalence in Korean adolescents by using an improved gold standard by a combined method. Using a stratified sampling method, we selected 13 schools from among 397 high schools that participated in the 2015 Korean Youth Health Risk Behavior Web-Based Survey (KYRBS). A second survey (repeated self-reporting questionnaire and urinary cotinine test) was conducted on 1058 students who completed the KYRBS. The gold standard of current smoker was defined as those either self-reporting as a smoker in the second survey or having a urinary cotinine concentration ≥50 ng/mL. The current smoking prevalence in the first survey (KYRBS) was 7.9% (boys 16.5% and girls 1.8%), which was lower than the results based on gold standard (11.3% total, boys 21.9% and girls 3.7%). The sensitivity and specificity of self-reported smoking status was 62.5% and 99.0%, respectively. In particular, the sensitivity of girls (43.5%) was lower than that of boys (67.0%). The self-reported smoking prevalence in Korean adolescents was underestimated, particularly among girls. Careful attention should be paid to interpreting adolescents’ smoking prevalence, and supplementary surveys or periodic validity tests need to be considered in Asian countries. View Full-Text
Keywords: adolescents; cotinine; self-reported survey; smoking; validity adolescents; cotinine; self-reported survey; smoking; validity
MDPI and ACS Style

Hwang, J.H.; Kim, J.Y.; Lee, D.H.; Jung, H.G.; Park, S.-W. Underestimation of Self-Reported Smoking Prevalence in Korean Adolescents: Evidence from Gold Standard by Combined Method. Int. J. Environ. Res. Public Health 2018, 15, 689.

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