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BACKGROUND: The low smoking prevalence in Asian women may be due to under-reporting. We therefore investigated gender difference in self-reported and cotinine-verified smoking prevalence rates in Korea METHODS: We analysed data from 5455 individuals (2387 men and 3068 women) in the 2008 Korean National Health and Nutrition Examination Survey. A urinary cotinine concentration of 50 ng/ml was the cut-off distinguishing smokers from non-smokers. Sensitivity analysis was done using different cut-offs of 25, 75 and 100 ng/ml. RESULTS: Cotinine-verified smoking rates were 50.0% for men and 13.9% for women, or 5.3% point and 8.0% point higher in absolute terms, respectively, than the self-reported rates for men and women. Ratios of cotinine-verified to self-reported smoking rates were 2.36 for women and 1.12 for men. Of the 1620 cotinine-verified smokers, 12.1% of men and 58.9% of women classified themselves as non-smokers. Women who live with a spouse or parents tend to under-report their smoking more than those who live alone or with others. CONCLUSION: Since the number of self-reported female smokers was less than half of cotinine-verified smokers, current anti-smoking policies based on self-reported smoking prevalence rates in Korea should be further directed towards hidden female smokers. Also, biochemical verification needs to be considered with national tobacco surveys in Asian countries.
Jung‐Choi et al. (2011) studied this question.