Confirmation of self-reported non-smoking status by salivary cotinine among diabetes patients in Kerala, India
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Date
2014-05
Journal Title
Journal ISSN
Volume Title
Publisher
Clinical Epidemiology and Global Health
Abstract
Problem considered: There are no studies of tobacco cessation reported from low and middle
income countries that have tested cotinine against self report in a patient population. We
confirmed the accuracy of self report of smoking cessation by matching self reports against
salivary cotinine test in diabetes patients.
Methods: The study was part of a randomized controlled trial among 224 diabetes patients
in Kerala. Salivary cotinine level was measured among 35 diabetes patients who claimed to
have not smoked even a single cigarette/bidi in the last 30 days before the test. Biochemical
analysis of salivary cotinine was done using the Enzyme-Linked Immunosorbent Assay kit
from Salimetrics. Cotinine value of >15 ng/ml was used as the cut-off point.
Results: Among the 35 patients, 26 (74%) were found to have a saliva cotinine level 15 ng/
ml confirming self reports of non smoking status. Among the remaining nine patients,
four reported being routinely exposed to secondhand smoke in their household or work
place prior to cotinine testing. Interviews revealed that 12% of the variance between self
report and the cotinine test results was attributable to routine exposure to second hand
smoke.
Conclusion: Self report of non-smoking by diabetes patients in India was fairly reliable when
validated against a cotinine test. Larger clinical trials are warranted to further evaluate the
validity of self reported non-smoking status in different patient populations having
different education levels.
Description
Keywords
Saliva cotinine Diabetes Kerala India Smoking
Citation
Clinical Epidemiology and Global Health. 2014