title: Urinary point-of-care test for smoking in the pre-operative assessment of patients undergoing elective plastic surgery.
abstract: Self-reported information about smoking habit and cigarette consumption can be inaccurate and subject to bias in the clinical setting. Accurate assessment of a given smoking history at point-of-care is valuable. We describe the use of a comprehensive smoking questionnaire and the use of a disposable biomarker test to verify and quantify the exposure to tobacco smoke. This point-of-care test (SmokeScreen) is a 6-min, easy-to-use urine test that measures nicotine and its breakdown products. One hundred consecutive patients attending plastic surgery pre-assessment clinic filled in the questionnaire and gave a consented urine sample. Qualitative and semi-quantitative assessment of tobacco consumption was observed by a simple sample colour change set against a standardised colorimetric chart for nicotine metabolite containing urine. The questionnaire self-reported smoking prevalence was 30% with 98% test specificity. The cotinine validated smoking prevalence was 54% with a 26% self-denial rate. Half the patients (n = 15) who admitted smoking on the questionnaire underreported the amount they smoked daily, as quantified by biochemical measurement. Objective biochemical assessment shows that 26% of self-reporting non-smokers via self-completed questionnaire studies are actual smokers attending this pre-assessment clinic. When patients did report smoking there was consistent underreporting of cigarette consumption.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Pinderfields Hospital, Aberford Road, Wakefield WF1 4DG, UK. carolinep@doctors.org.uk
authors.forename: C E
authors.initials: CE
authors.lastname: Payne
authors.forename: S J
authors.initials: SJ
authors.lastname: Southern
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000652:urine; D003124:Colorimetry; D003367:Cotinine / Q000652:urine*; D017558:Elective Surgical Procedures; D004781:Environmental Exposure / Q000032:analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019095:Point-of-Care Systems; D011300:Preoperative Care / Q000379:methods*; D019651:Plastic Surgery Procedures; D015203:Reproducibility of Results; D012907:Smoking / Q000652:urine*; D011795:Surveys and Questionnaires; D014028:Tobacco Smoke Pollution / Q000032:analysis; D014342:Truth Disclosure
chemical_list: D015415:Biomarkers; D014028:Tobacco Smoke Pollution; D003367:Cotinine