http://nova.newcastle.edu.au/vital/access/services/Feed ${session.getAttribute("locale")} 5 Assessing the accuracy of self-reported smoking status and impact of passive smoke exposure among pregnant Aboriginal and Torres Strait Islander women using cotinine biochemical validation http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:10664 Introduction and Aims: A significant level of misreport or error occurs during questionnaire-based assessment of smoking behaviour. Failure to measure environmental tobacco smoke, and participant’s inclination to under-report their smoking raise questions as to the accuracy of assessment. In order to establish an estimation of the possible error associated with such assessment, the accuracy of self-reported smoking status among a group of pregnant Aboriginal and Torres Strait Islander women was examined. Design and Methods: Women attending two Aboriginal Medical services in Far North Queensland for antenatal care were invited to participate. Women completed an interviewer assisted questionnaire relating to their smoking status and a 24 h diary of their exposure to nicotine and consumption of alcohol. Urine samples were analysed for cotinine using an Enzyme Linked Immunosorbent Assay. Results: Cotinine analysis indicated that 17% of women who reported that they were non-smokers were likely to have misreported this status, or be exposed to high levels of passive smoke. The only significant predictors of cotinine level were self-reported nicotine exposure (including passive smoke) and number of cigarettes smoked in the previous 24 h. Other individual and environmental variables had no significant influence on cotinine level using this analysis technique. Discussion and Conclusions: The level of potential error in smoking assessment among this group was substantial. Exposure to environmental tobacco smoke might explain part of this error, but the reasons for misreport can only be speculated. This rate of misclassification should be taken into consideration in routine screening of antenatal women in primary health care. 2012-04-17T05:26:48.069Z ]]> Tobacco use and measuring nicotine dependence among urban indigenous pregnant women http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:7845 Objectives: To examine patterns of nicotine dependence, the value of the Fagerström Test for Nicotine Dependence (FTND) and its correlation with self-reported tobacco use and urinary cotinine concentrations among pregnant Indigenous women in Townsville. Design, participants and setting: Cross-sectional study of 201 consecutive women who self-reported tobacco use at their first antenatal visit to Townsville Aboriginal and Islander Health Service (TAIHS) between 1 November 2005 and 31 October 2007. All smokers were to be assessed by FTND, and 108 women participating in the Tilly’s Tracks project (a randomised trial of an intervention to reduce smoking in pregnant Aboriginal and Torres Strait Islander women) were to have a comprehensive smoking history taken and urinary cotinine samples collected. Main outcome measures: Self-reported smoking status, FTND scores and urinary cotinine concentrations. Results: Of 302 Indigenous women presenting to TAIHS, 201 (66.6%) identified as current tobacco users at their first antenatal visit; this proportion rose to 79.6% in women aged <20 years. An FTND was completed for 152 women (75.6%), with a median score of 4, and 40.1% scoring 3 or less, indicating low levels of nicotine dependence. There were significant correlations between the FTND and number of cigarettes smoked (ρ=0.56; P<0.001) and urinary cotinine concentrations (ρ=0.25; P=0.030). Of those who provided comprehensive smoking histories, the median age of starting smoking was 15 years, with a median of two previous quit attempts; 71.4% reported partners who smoked and 27.3% reported smoking occurred inside the house. Conclusion: The use of the FTND in Indigenous pregnant women may assess physical nicotine dependence, thus providing information that will help in preparing quit-smoking plans, including tailoring of pharmacological support to individual need. Quit-smoking programs that better address the behavioural and psychological aspects of smoking within the Indigenous community in Australia are needed. 2011-06-06T01:30:06.347Z ]]>