Key result
Self-reported number of cigarettes smoked was positively correlated with expired carbon monoxide levels (r = 0.70) at 12 months, indicating biochemical validation adds little to detecting smokers.
Why the study?
Does self-report accurately reflect smoking status compared to biochemical validation by expired carbon monoxide in post-MI patients?
RCT
double-blind
randomized
Does self-report accurately reflect smoking status compared to biochemical validation by expired carbon monoxide in post-MI patients?
Effect estimate: r = 0.70
Self-reported smoking status is a valid measure in post-MI patients, as biochemical validation with expired carbon monoxide does not substantially increase the detection of smokers.
Self-report may suffice for smoking assessment in post-MI cohorts; leaves open whether biochemical validation improves trial accuracy.
Summary Self-report is the standard method for assessment of smoking status in the outpatient setting for myocardial infarction (MI) patients. However, the validity of self-report in this patient population has not been previously investigated. Using data from a double-blind, placebo-controlled, randomized trial we examined the validity of self-report for assessment of smoking status in an outpatient setting for MI patients. Smoking was assessed by self-report and biochemical validation by expired carbon monoxide (CO). Abstinence was defined by a self-report of no cigarettes smoked in the past week and a CO level of less than or equal to 10 parts per million (ppm). At 12 months, number of cigarettes smoked was positively correlated with CO level ( r = 0.70). Results show that biochemical validation by CO does not substantially increase the likelihood of detecting smokers in MI patients. However, it may discourage patients from denying their smoking status and therefore should be considered for routine assessment of smoking status in the outpatient cardiac setting. Current clinical guidelines for secondary prevention in myocardial infarction (MI) patients recommend routine assessment of smoking status. 1 In clinical trials, biochemical validation in conjunction with self-report is the conventional method for assessment of smoking status. 2 – 4 In the outpatient cardiac setting, self-report alone is used for routine assessment of smoking status.
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Grandi et al. (2014) conducted an RCT in myocardial infarction. Self-report of smoking status vs. Biochemical validation by expired carbon monoxide (CO) was evaluated on Correlation between number of cigarettes smoked and CO level (r = 0.70). Self-reported number of cigarettes smoked was positively correlated with expired carbon monoxide levels (r = 0.70) at 12 months, indicating biochemical validation adds little to detecting smokers.
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