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

Author

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  • Jun Hyun Hwang

    (Department of Preventive Medicine, Catholic University of Daegu School of Medicine, Daegu 42472, Korea)

  • Jong Yeon Kim

    (Department of Preventive Medicine, Catholic University of Daegu School of Medicine, Daegu 42472, Korea)

  • Do Hoon Lee

    (Department of Laboratory Medicine, Center for Diagnostic Oncology, National Cancer Center, Goyang-si 10408, Korea)

  • Hye Gyoun Jung

    (Department of Preventive Medicine, Catholic University of Daegu School of Medicine, Daegu 42472, Korea)

  • Soon-Woo Park

    (Department of Preventive Medicine, Catholic University of Daegu School of Medicine, Daegu 42472, Korea)

Abstract

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.

Suggested Citation

  • Jun Hyun Hwang & Jong Yeon Kim & Do Hoon Lee & Hye Gyoun Jung & Soon-Woo Park, 2018. "Underestimation of Self-Reported Smoking Prevalence in Korean Adolescents: Evidence from Gold Standard by Combined Method," IJERPH, MDPI, vol. 15(4), pages 1-10, April.
    • Handle: RePEc:gam:jijerp:v:15:y:2018:i:4:p:689-:d:139724
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    References listed on IDEAS

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    1. Waldron, Ingrid, 1991. "Patterns and causes of gender differences in smoking," Social Science & Medicine, Elsevier, vol. 32(9), pages 989-1005, January.
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    Cited by:

    1. Jun Hyun Hwang & Dong Hee Ryu & Inho Park & Soon-Woo Park, 2020. "Cigarette or E-Cigarette Use as Strong Risk Factors for Heated Tobacco Product Use among Korean Adolescents," IJERPH, MDPI, vol. 17(19), pages 1-11, September.
    2. Xia Xiao & Yan Li & Xiaoxiao Song & Qinghua Xu & Siwei Yang & Jie Wu & Edmund Seto, 2018. "Discrepancy between Self-Reported and Urine Cotinine-Verified Environmental Tobacco Smoke Exposure among Rural Pregnant Women in China," IJERPH, MDPI, vol. 15(7), pages 1-11, July.
    3. Thi Phuong Thao Tran & Jinju Park & Eunjung Park & Sang Hwa Shin & Yu-Jin Paek & Yun Hee Kim & Min Kyung Lim, 2020. "Effect of Additional Motivational Interviewing on Smoking Abstinence for 1-Year among Korean Adolescents: Results from A Comparative Retrospective Study in Quitline," IJERPH, MDPI, vol. 17(21), pages 1-17, October.

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