NDLI: Using breath carbon monoxide to validate self-reported tobacco smoking in remote Australian Indigenous communities

Content Provider	Springer Nature : BioMed Central
Author	MacLaren, David J Conigrave, Katherine M Robertson, Jan A Ivers, Rowena G Eades, Sandra Clough, Alan R
Abstract	Background This paper examines the specificity and sensitivity of a breath carbon monoxide (BCO) test and optimum BCO cutoff level for validating self-reported tobacco smoking in Indigenous Australians in Arnhem Land, Northern Territory (NT). Methods In a sample of 400 people (≥16 years) interviewed about tobacco use in three communities, both self-reported smoking and BCO data were recorded for 309 study participants. Of these, 249 reported smoking tobacco within the preceding 24 hours, and 60 reported they had never smoked or had not smoked tobacco for ≥6 months. The sample was opportunistically recruited using quotas to reflect age and gender balances in the communities where the combined Indigenous populations comprised 1,104 males and 1,215 females (≥16 years). Local Indigenous research workers assisted researchers in interviewing participants and facilitating BCO tests using a portable hand-held analyzer. Results A BCO cutoff of ≥7 parts per million (ppm) provided good agreement between self-report and BCO (96.0% sensitivity, 93.3% specificity). An alternative cutoff of ≥5 ppm increased sensitivity from 96.0% to 99.6% with no change in specificity (93.3%). With data for two self-reported nonsmokers who also reported that they smoked cannabis removed from the analysis, specificity increased to 96.6%. Conclusion In these disadvantaged Indigenous populations, where data describing smoking are few, testing for BCO provides a practical, noninvasive, and immediate method to validate self-reported smoking. In further studies of tobacco smoking in these populations, cannabis use should be considered where self-reported nonsmokers show high BCO.
Related Links	https://pophealthmetrics.biomedcentral.com/counter/pdf/10.1186/1478-7954-8-2.pdf
Ending Page	7
Page Count	7
Starting Page	1
File Format	HTM / HTML
ISSN	14787954
DOI	10.1186/1478-7954-8-2
Journal	Population Health Metrics
Issue Number	1
Volume Number	8
Language	English
Publisher	BioMed Central
Publisher Date	2010-02-20
Access Restriction	Open
Subject Keyword	Public Health Epidemiology Research Methodology Health Services Research Cutoff Level Smoking Rate Cannabis User Northern Territory Secondhand Smoke
Content Type	Text
Resource Type	Article
Subject	Public Health, Environmental and Occupational Health Epidemiology
Journal Impact Factor	3.2/2023
5-Year Journal Impact Factor	3.3/2023

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1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
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3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
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