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      Population Assessment of Tobacco and Health (PATH) reliability and validity study: selected reliability and validity estimates

      , , , ,
      Tobacco Control
      BMJ

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          Abstract

          Introduction

          This paper reports a study done to estimate the reliability and validity of answers to the Youth and Adult questionnaires of the Population Assessment of Tobacco and Health (PATH) Study.

          Methods

          407 adults and 117 youth respondents completed the wave 4 (2016–2017) PATH Study interview twice, 6–24 days apart. The reinterview data were used to estimate the reliability of answers to the questionnaire. Kappa statistics, gross discrepancy rates and correlations between answers to the initial interview and the reinterview were used to measure reliability. We examined every item in the questionnaire for which there were at least 100 observations. After the reinterview, most respondents provided a saliva sample that allowed us to assess the accuracy of their answers to the tobacco use questions.

          Results

          There was generally a very high level of agreement between answers in the interview and reinterview. On the key current tobacco use items, the average kappa (the agreement rate adjusted for chance agreement) was 0.79 for adult respondents (age 18 or older). Youth respondents exhibited equally high levels of agreement across interviews. The items on current tobacco use also exhibited high levels of agreement with saliva test results (kappa=0.72). Rating scale items showed lower levels of exact agreement across interviews but the answers were generally within one scale point or category.

          Conclusions

          The PATH Study questions were developed using a careful protocol and the results indicate the answers provide reliable and valid information about tobacco use.

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          Most cited references11

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          The Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV (AUDADIS-IV): reliability of alcohol consumption, tobacco use, family history of depression and psychiatric diagnostic modules in a general population sample.

          the purpose of this study was to assess the test-retest reliability of newly introduced or revised modules of the Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV (AUDADIS-IV), including alcohol consumption, tobacco use, family history of depression, and selected DSM-IV axis I and II psychiatric disorders. kappa and intraclass correlation coefficients were calculated for the AUDADIS-IV modules using a test-retest design among a total of 2657 respondents, in subsets of approximately 400, randomly drawn from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). reliabilities for alcohol consumption, tobacco use and family history of major depression measures were good to excellent, while reliabilities for selected DSM-IV axis I and II disorders were fair to good. The reliabilities of dimensional symptom scales of DSM-IV axis I and axis II disorders exceeded those of their dichotomous diagnostic counterparts and were generally in the good to excellent range. the high reliability of alcohol consumption, tobacco use, family history of depression and psychiatric disorder modules found in this study suggests that the AUDADIS-IV can be a useful tool in various research settings, particularly in studies of the general population, the target population for which it was designed.
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            Can we trust national smoking prevalence figures? Discrepancies between biochemically assessed and self-reported smoking rates in three countries.

            National smoking prevalence estimates are the primary basis for assessing progress in tobacco control across the world. They are based on surveys of self-reported cigarette smoking. It has been assumed that this is sufficiently accurate for policy purposes, but this assumption has not been adequately tested. We report data from the 2003 Health Survey for England, the U.S. National Health and Nutrition Examination Survey for 2001-2002, and the 2004 national smoking behaviors survey in Poland as examples of countries at different stages in the "tobacco epidemic." Self-reported cigarette and total tobacco smoking prevalence were assessed by means of the standard questions used in each country. In subsamples, specimens were collected for analysis of cotinine (saliva, N = 1,613 in England; serum, N = 4,687 in the United States; and saliva, N = 388 in Poland) providing an objective means of determining active smoking. A cut point of 15 ng/mL was used to discriminate active smoking from passive smoke exposure. Self-reported cigarette smoking prevalence using the standard methods underestimated true tobacco smoking prevalence by an estimated 2.8% in England, 0.6% in the United States, and 4.4% in Poland. Cotinine concentrations in those misclassified as nonsmokers were indicative of high levels of smoke intake. Underestimation of smoking prevalence was minimal in the United States but significant in England and Poland. A review of methodologies for assessing tobacco smoking prevalence worldwide is urgently needed.
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              The validity of self-reported nicotine product use in the 2001-2008 National Health and Nutrition Examination Survey.

              Many researchers rely on high-quality face-to-face national surveys conducted by the federal government to estimate the prevalence of nicotine product use, but some scholars have suggested that adults' self-reports in such surveys are intentionally distorted by social desirability response bias, thus raising questions about the validity of those data. To assess the validity of face-to-face survey self-reports by comparing them with physiological tests. Respondents in the National Health and Nutrition Examination Survey provided self-reports of nicotine product use and gave blood samples that were analyzed for levels of serum cotinine, an indicator of nicotine exposure. Nationally representative samples of thousands of American adults in National Health and Nutrition Examination Survey surveys conducted in 2001-2002, 2003-2004, 2005-2006, and 2007-2008. Serum cotinine levels and self-reports of nicotine product use. On average, only 1.17% to 1.25% of adult respondents said that they did not use a product containing nicotine, but had elevated cotinine levels. After eliminating the potential influence of passive smoking, these figures dropped to 0.89% to 0.94%. This small discrepancy between the 2 assessments could be due to measurement error in the cotinine test results or to recent use of cotinine-elevating medication. These data do not support the claim that a substantial number of adult respondents intentionally under-report nicotine consumption in face-to-face interviews. The remarkable accuracy of self-reports of nicotine consumption seen here justifies confidence in self-reports of this behavior in such surveys.
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                Author and article information

                Journal
                Tobacco Control
                Tob Control
                BMJ
                0964-4563
                1468-3318
                October 28 2019
                November 2019
                November 2019
                October 08 2018
                : 28
                : 6
                : 663-668
                Article
                10.1136/tobaccocontrol-2018-054561
                30297373
                91930d3e-a854-4831-9be7-c66eea7a89cc
                © 2018
                History

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