Efficient screening of current smoking status in recruitment of smokers for population-based research

Ontario Tobacco Research Unit, Toronto, ON, Canada M4S 2S1.
Nicotine & Tobacco Research (Impact Factor: 3.3). 12/2008; 10(11):1663-7. DOI: 10.1080/14622200802326152
Source: PubMed


Population-based samples of smokers are necessary for tobacco behavior monitoring and surveillance and for evaluating tobacco
control programs and policies. We evaluated the sensitivity and specificity of a simple, onequestion screener as a tool to
maximize efficiency of obtaining a population representative sample of current smokers. This analysis was based on 5,002 respondents
from the Ontario Tobacco Survey (OTS), a regionally stratified longitudinal survey of adult smokers and cross-sectional survey
of nonsmokers in Ontario, Canada. Overall, the question “Have you smoked one or more cigarettes in the past six months?” achieved
at least 99.7% sensitivity and 87.1% specificity when compared with several standard definitions of current smoking status.
The brief screening question minimized respondent burden and data collection costs, and may have had a positive influence
on response rate. Having a more conservative measure of smoking status permitted atypical smokers to be included in the survey
which will allow us to track their behavior change and evaluate the performance of accepted smoking status definitions. We
recommend that studies, which specifically sample smokers, utilize any past 6-month smoking as a brief screener for smoking

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    ABSTRACT: Occasional smokers represent an important segment of all smokers and have been described to be a heterogeneous group in terms of past experience and likelihood of maintaining nondaily smoking behavior. In the prospective Ontario Tobacco Survey, 408 occasional smokers were followed for a year. Characteristics of subgroups of occasional smokers, as suggested by previous literature, were studied for personal and smoking behavior group differences. Agglomerative hierarchical clustering was also used to empirically identify subgroups of occasional smokers using average linkage. Smoking status at 1-year follow-up was examined overall and by the identified subgroups to determine if any were useful predictors of persistent status as nondaily smoking and likelihood of smoking cessation. Significant differences were seen among the subgroups of occasional smokers suggested in previous studies including the number of quit attempts, setting a firm quit date, and whether or not participants cared others knew they smoked in descriptive analyses. Exploratory cluster analysis suggested 4 clusters of occasional smokers based on differences in age, perceived addiction, and history of daily smoking. Subgroups based on participants' history of smoking, self-reported addiction level, and empirically identified cluster subgroups resulted in significant differences of smoking status at 1-year follow-up. This study suggests that occasional smokers may be a heterogeneous group with different subgroups characterized by age, accumulated smoking experience and smoking pattern, as well as factors associated with the likelihood of quitting altogether, over time, and perceived addiction.
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