title: Validity of self-reported adult secondhand smoke exposure.
abstract: OBJECTIVE
  Exposure of adults to secondhand smoke (SHS) has immediate adverse effects on the cardiovascular system and causes coronary heart disease. The current study evaluated brief self-report screening measures for accurately identifying adult cardiology patients with clinically significant levels of SHS exposure in need of intervention.
  
  
  METHODS
  A cross-sectional study conducted in a university-affiliated cardiology clinic and cardiology inpatient service.
  
  
  METHODS
  Participants were 118 non-smoking patients (59% male, mean age=63.6 years, SD=16.8) seeking cardiology services.
  
  
  METHODS
  Serum cotinine levels and self-reported SHS exposure in the past 24 h and 7 days on 13 adult secondhand exposure to smoke (ASHES) items.
  
  
  RESULTS
  A single item assessment of SHS exposure in one's own home in the past 7 days was significantly correlated with serum cotinine levels (r=0.41, p<0.001) with sensitivity ≥75%, specificity >85% and correct classification rates >85% at cotinine cut-off points of >0.215 and >0.80 ng/mL. The item outperformed multi-item scales, an assessment of home smoking rules, and SHS exposure assessed in other residential areas, automobiles and public settings. The sample was less accurate at self-reporting lower levels of SHS exposure (cotinine 0.05-0.215 ng/mL).
  
  
  CONCLUSIONS
  The single item ASHES-7d Home screener is brief, assesses recent SHS exposure over a week's time, and yielded the optimal balance of sensitivity and specificity. The current findings support use of the ASHES-7d Home screener to detect SHS exposure and can be easily incorporated into assessment of other major vital signs in cardiology.
authors.affiliation: Department of Medicine, Stanford University, Stanford Prevention Research Center, Stanford, California, USA.
authors.forename: Judith J
authors.initials: JJ
authors.lastname: Prochaska
authors.affiliation: Department of Medicine, Division of Cardiology, University of California, San Francisco, San Francisco, California, USA.
authors.forename: William
authors.initials: W
authors.lastname: Grossman
authors.affiliation: Department of Medicine, Stanford University, Stanford Prevention Research Center, Stanford, California, USA.
authors.forename: Kelly C
authors.initials: KC
authors.lastname: Young-Wolff
authors.affiliation: Departments of Medicine and Bioengineering and Therapeutic Sciences, Division of Clinical Pharmacology and Experimental Therapeutics, University of California, San Francisco, San Francisco, California, USA.
authors.forename: Neal L
authors.initials: NL
authors.lastname: Benowitz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001336:Automobiles; D003367:Cotinine / Q000097:blood*; D003430:Cross-Sectional Studies; D004781:Environmental Exposure / Q000032:analysis*; D005260:Female; D006331:Heart Diseases / Q000628:therapy; D006798:Housing; D006801:Humans; D008297:Male; D008875:Middle Aged; D057566:Self Report; D012907:Smoking; D011795:Surveys and Questionnaires; D014028:Tobacco Smoke Pollution / Q000032:analysis*; D055815:Young Adult
chemical_list: D014028:Tobacco Smoke Pollution; D003367:Cotinine
keywords: Primary Health Care; Priority/special Populations; Secondhand Smoke; Surveillance and Monitoring