The Reliability of Self-Reported Cigarette Consumption in the United States

Office on Smoking and Health, Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control, Rockville, MD 20857.
American Journal of Public Health (Impact Factor: 4.55). 09/1989; 79(8):1020-3. DOI: 10.2105/AJPH.79.8.1020
Source: PubMed


To investigate the possibility that self-reported smoking is not a valid measure for assessing trends in smoking prevalence, we compared total self-reported cigarette consumption with the adjusted consumption data from cigarette excise taxes as reported by the US Department of Agriculture (USDA) for the period 1974 through 1985. Self-reported consumption was calculated by using data from the National Health Interview Surveys (NHIS) for adults and from the National Household Surveys on Drug Abuse for adolescents. For this period, the average ratio of self-reported cigarette consumption to the USDA estimate of consumption was 0.72 (range = 0.69 to 0.78). There was no statistical difference in this consumption ratio from year to year, indicating no apparent increase in the underreporting of cigarette smoking in these surveys. We conclude that cross-sectional surveys of self-reported smoking status remain a reliable surveillance tool for monitoring changes in population smoking behavior.

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    • "Finally, the study relied on selfreported smoking status without biochemical verification, and hence the information is subject to a potential reporting bias. Nonetheless, previous reports have underlined the accuracy of self-reported measurements (Hatziandreu et al., 1989). Strengths of our survey include the representativeness of the adult population of 18 strategically selected European countries, the same questionnaire agreed by a core of tobacco control experts and administered face to face in the 18 countries , the standardized use of a single definition of current smokers, and the use of the HSI, a validated score of dependence widely used for clinical and epidemiological purposes (Pérez-Ríos et al., 2009). "
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    ABSTRACT: Objective: When the prevalence of smoking decreases in a population there is a hypothesis -the so-called "hardening hypothesis"- that the remaining smokers form a subgroup of "hardcore smokers". Our aims were to test the hardening hypothesis, and to analyze the determinants of high dependence taking into account both individual and country-level characteristics. Method: Within the Pricing Policies and Control of Tobacco in Europe (PPACTE) project, we conducted a face-to-face survey on smoking between January and July 2010 in 18 European countries, including 2,882 male and 2,254 female smokers with complete information on smoking dependence. The Heaviness of Smoking Index (HIS) was used as a measure of tobacco dependence. We correlated smoking prevalence and dependence using the country as unit of analysis. Moreover, we fitted multilevel logistic regression models in an individual-level analysis. Results: Country-specific prevalence of smoking was positively, although not significantly, correlated with the proportion of highly tobacco dependent smokers (overall rsp=0.203, p=0.419), both in men (rsp=0.235, p=0.347) and women (rsp=0.455, p=0.058). Using individual-level analysis, high dependence was positively related to age, and, although not significantly, to smoking prevalence, and inversely related to level of education. The lack of a smoking ban at home was positively related to smoking dependence. Conclusions: Using both ecological and individual-level analyses, the relations between smoking prevalence and HSI were not significant, but in the opposite direction as compared to that assumed by the "hardening hypothesis". Therefore, our data provide empirical evidence against this theory, thus supporting the feasibility of an endgame strategy.
    Preventive Medicine 10/2015; 81. DOI:10.1016/j.ypmed.2015.09.023 · 3.09 Impact Factor
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    • "Second, self-reported income and cocaine purchasing/use may not reflect actual levels. However , studies on cigarettes, alcohol, and other drug use (Hatziandreu et al., 1989; Smith et al., 1990; Darke, 1998) suggest that self-report is highly correlated with variables such as state per capita sales and biomarkers, thus these may be reliable estimates of actual use. This semi-structured interview approach used careful probing to ensure that participants were internally consistent when responding, and a few subjects' data were excluded for unreliability . "
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    ABSTRACT: Background: We previously observed that behavioral economic factors predict naturalistic heroin seeking behavior that correlates with opioid seeking in the experimental laboratory. The present study sought to replicate and extend these prior findings with regular cocaine users. Methods: Participants (N=83) completed a semi-structured interview to establish income-generating and cocaine-purchasing/use repertoire during the past month. Questions addressed sources/amounts of income and expenditures; price (money and time) per purchase; and frequency/amounts of cocaine purchased and consumed. Naturalistic cocaine purchasing and use patterns were: (1) analyzed as a function of income quartile, (2) perturbed by hypothetical changes in cost factors to assess changes in purchasing/use habits, and (3) correlated with experimental cocaine seeking. Results: Income was positively related to naturalistic cocaine seeking/use pattern (i.e., income elastic), and behaviors were cost-efficient and sensitive to supply chain. Income was unrelated to proportional expenditure on cocaine (≈55%) but inversely related to food expenditure. In all hypothetical scenarios (changes in income or dealer, loss of income assistance from government or family/friends, and increasing arrest risk when purchasing), the high-income group reported they would continue to use more cocaine daily than other groups. Number of laboratory cocaine choices significantly correlated with cocaine purchase time (positively) and purity of cocaine (negatively) in the naturalistic setting. Conclusions: These results replicate and extend findings with regular heroin users, demonstrate the importance of income, cost-efficiency and supply-mindedness in cocaine seeking/use, and suggest that this interview-based approach has good external validity.
    Drug and Alcohol Dependence 08/2014; 141. DOI:10.1016/j.drugalcdep.2014.04.028 · 3.42 Impact Factor
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    • "The rates range from 22% to 31% in the United States between 1974 and 1985, respectively [16], from 28% to 30% in New Zealand in the period of 1976 and 1981 [17], and from 25% to 35% in Italy in the period of 2001 and 2008 [18], where social acceptability of smoking is less than it is in many developing countries. Given the continued high prevalence of smoking in Vietnam, the social acceptability of smoking is assumed to be equal or less than those of industrialized countries thirty years ago, and therefore three magnitudes of under-reporting, 10, 20 and 30% were applied to sensitivity analysis [16]. "
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    ABSTRACT: Illicit trade carries the potential to magnify existing tobacco-related health care costs through increased availability of untaxed and inexpensive cigarettes. What is known with respect to the magnitude of illicit trade for Vietnam is produced primarily by the industry, and methodologies are typically opaque. Independent assessment of the illicit cigarette trade in Vietnam is vital to tobacco control policy. This paper measures the magnitude of illicit cigarette trade for Vietnam between 1998 and 2010 using two methods, discrepancies between legitimate domestic cigarette sales and domestic tobacco consumption estimated from surveys, and trade discrepancies as recorded by Vietnam and trade partners. The results indicate that Vietnam likely experienced net smuggling in during the period studied. With the inclusion of adjustments for survey respondent under-reporting, inward illicit trade likely occurred in three of the four years for which surveys were available. Discrepancies in trade records indicate that the value of smuggled cigarettes into Vietnam ranges from $100 million to $300 million between 2000 and 2010 and that these cigarettes primarily originate in Singapore, Hong Kong, Macao, Malaysia, and Australia. Notable differences in trends over time exist between the two methods, but by comparison, the industry estimates consistently place the magnitude of illicit trade at the upper bounds of what this study shows. The unavailability of annual, survey-based estimates of consumption may obscure the true, annual trend over time. Second, as surveys changed over time, estimates relying on them may be inconsistent with one another. Finally, these two methods measure different components of illicit trade, specifically consumption of illicit cigarettes regardless of origin and smuggling of cigarettes into a particular market. However, absent a gold standard, comparisons of different approaches to illicit trade measurement serve efforts to refine and improve measurement approaches and estimates.
    PLoS ONE 01/2014; 9(1):e87272. DOI:10.1371/journal.pone.0087272 · 3.23 Impact Factor
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