title: Agreement between exhaled breath carbon monoxide threshold levels and self-reported cigarette smoking in a sample of male adolescents in Jordan.
abstract: This study aimed to measure the percent agreement between Exhaled Breath Carbon Monoxide (eBCO) measure using a piCO+ smokerlyzer® and self-reported cigarette smoking status and to determine the optimal thresholds for definite identification of cigarette smokers of male school students in Jordan. A descriptive, cross sectional, study of a random sample of male adolescents in grades 7 and 8 from four public high schools in Irbid, completed an adaptation of a standardized Arabic-language tobacco smoking questionnaire and an eBCO measure. Sensitivity and specificity of the eBCO were calculated against self-reported cigarette smoking. Participants (n = 439) had a mean age of 12.5 years (SD = 0.50) and 174 (39.9%) reported being an ever smoker of whom 59 (33.9%) reported being a recent (30-day) smoker. The optimal eBCO cut-off point for recent smoking was 4.5 ppm with a sensitivity of 84.7% and specificity of 65.5%. Overall, eBCO can accurately identify recent smokers and distinguish them from non-smokers. The eBCO use enables healthcare professionals and researchers to assess efficacy of smoking cessation and prevention programs without necessarily relying on self-report. Further research is indicated to validate our findings and should be expanded to include females, detailed characteristics of cigarette and waterpipe smoking.
authors.affiliation: Faculty of Nursing, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan. nasheyab@just.edu.jo.
authors.forename: Nihaya
authors.initials: N
authors.lastname: Al-Sheyab
authors.affiliation: Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan. Kkheiral@gmail.com.
authors.forename: Khalid A
authors.initials: KA
authors.lastname: Kheirallah
authors.affiliation: Charles Perkins Centre, Faculty of Nursing and Midwifery, the University of Sydney, Sydney 2007, Australia. Linda.tm@sah.org.au.
authors.forename: Linda J Thomson
authors.initials: LJ
authors.lastname: Mangnall
authors.affiliation: Faculty of Health, University of Technology, Sydney 2007, Australia. Linda.tm@sah.org.au.
authors.forename: Robyn
authors.initials: R
authors.lastname: Gallagher
mesh_terms: D000293:Adolescent; D002248:Carbon Monoxide / Q000032:analysis*; D003430:Cross-Sectional Studies; D045853:Exhalation / Q000502:physiology*; D006306:Health Surveys; D006801:Humans; D007597:Jordan; D008297:Male; D057566:Self Report; D012680:Sensitivity and Specificity; D012907:Smoking / Q000009:adverse effects*; D016540:Smoking Cessation; D013334:Students / Q000706:statistics & numerical data; D020711:Threshold Limit Values; D062789:Tobacco Products
chemical_list: D002248:Carbon Monoxide