BACKGROUND: There is limited validation of self-reported measures for secondhand smoke (SHS) exposure in low- and middle-income countries. We evaluated the validity of standard self-reported measures among women and children in urban India. METHODS: Structured questionnaires were administered, and household air and hair samples were analyzed for nicotine concentration. RESULTS: In total, 141 households of 70 child and 71 adult participants were included. Air nicotine was detected in 72 (51%) homes, and 35 (75%) child and 12 (56%) adult participants had detectable hair nicotine. Correlation between air and hair nicotine was significant in children (r = 0.5; P = .0002) but not in adults (r = -0.1; P = .57). Poor correlation was found between self-reported measures of exposure and both air and hair nicotine. No questions were significantly correlated with hair nicotine, and the highest-magnitude correlation with air nicotine was for how often someone smoked inside for adults (r = 0.4; P = .10) and for home preparation of mishri (a smokeless tobacco product prepared for consumption by roasting) for children (r = 0.4; P = .39). The highest value for sensitivity by using air nicotine as the gold standard was for whether people smelled other families preparing mishri (47%; 95% confidence interval: 31-62) and prepared mishri in their own homes (50%; 95% confidence interval: 19-81). CONCLUSIONS: These results raise caution in using or evaluating self-reported SHS exposure in these communities. More appropriate questions for this population are needed, including mishri preparation as a source of SHS exposure.
BACKGROUND: There is limited validation of self-reported measures for secondhand smoke (SHS) exposure in low- and middle-income countries. We evaluated the validity of standard self-reported measures among women and children in urban India. METHODS: Structured questionnaires were administered, and household air and hair samples were analyzed for nicotine concentration. RESULTS: In total, 141 households of 70 child and 71 adult participants were included. Air nicotine was detected in 72 (51%) homes, and 35 (75%) child and 12 (56%) adult participants had detectable hair nicotine. Correlation between air and hair nicotine was significant in children (r = 0.5; P = .0002) but not in adults (r = -0.1; P = .57). Poor correlation was found between self-reported measures of exposure and both air and hair nicotine. No questions were significantly correlated with hair nicotine, and the highest-magnitude correlation with air nicotine was for how often someone smoked inside for adults (r = 0.4; P = .10) and for home preparation of mishri (a smokeless tobacco product prepared for consumption by roasting) for children (r = 0.4; P = .39). The highest value for sensitivity by using air nicotine as the gold standard was for whether people smelled other families preparing mishri (47%; 95% confidence interval: 31-62) and prepared mishri in their own homes (50%; 95% confidence interval: 19-81). CONCLUSIONS: These results raise caution in using or evaluating self-reported SHS exposure in these communities. More appropriate questions for this population are needed, including mishri preparation as a source of SHS exposure.
Authors: P Jeemon; S Agarwal; L Ramakrishnan; R Gupta; U Snehi; V Chaturvedi; K S Reddy; D Prabhakaran Journal: Natl Med J India Date: 2010 May-Jun Impact factor: 0.537
Authors: Charles W Warren; Juliette Lee; Veronica Lea; Ann Goding; Brandon O'Hara; Michelle Carlberg; Samira Asma; Matthew McKenna Journal: Glob Health Promot Date: 2009-09
Authors: J A Emerson; M F Hovell; S B Meltzer; J M Zakarian; C R Hofstetter; D R Wahlgren; B P Leaderer; E O Meltzer Journal: J Clin Epidemiol Date: 1995-10 Impact factor: 6.437
Authors: Sreenivas P Veeranki; Hadii M Mamudu; Shimin Zheng; Rijo M John; Yan Cao; David Kioko; James Anderson; Ahmed E O Ouma Journal: J Adolesc Health Date: 2014-12-16 Impact factor: 5.012
Authors: Erika Avila-Tang; Wael K Al-Delaimy; David L Ashley; Neal Benowitz; John T Bernert; Sungroul Kim; Jonathan M Samet; Stephen S Hecht Journal: Tob Control Date: 2012-09-02 Impact factor: 7.552
Authors: Erika Avila-Tang; Jessica L Elf; K Michael Cummings; Geoffrey T Fong; Melbourne F Hovell; Jonathan D Klein; Robert McMillen; Jonathan P Winickoff; Jonathan M Samet Journal: Tob Control Date: 2012-09-04 Impact factor: 7.552
Authors: Benjamin J Apelberg; Lisa M Hepp; Erika Avila-Tang; Lara Gundel; S Katharine Hammond; Melbourne F Hovell; Andrew Hyland; Neil E Klepeis; Camille C Madsen; Ana Navas-Acien; James Repace; Jonathan M Samet; Patrick N Breysse Journal: Tob Control Date: 2012-09-04 Impact factor: 7.552
Authors: Michal Bitan; David M Steinberg; Sandra R Wilson; Amy E Kalkbrenner; Bruce Lanphear; Melbourne F Hovell; Vicki Myers Gamliel; Laura J Rosen Journal: Tob Induc Dis Date: 2022-06-29 Impact factor: 5.163