title: Self-Reporting of Smoking Cessation in Cardiac Patients: How Reliable Is It and Is Reliability Associated With Patient Characteristics?
abstract: OBJECTIVE
  The objectives of this study were to determine the accuracy of smoking cessation self-reports by cardiac patients who participated in a smoking cessation program, and to determine which patient characteristics are associated with an inaccurate self-report during a follow-up interview 12 months after the start of the program.
  
  
  METHODS
  Smoking cessation self-reports (point prevalence abstinence) were validated against salivary cotinine levels. Using χ analyses, patients who reported accurately being a nonsmoker were compared with those who reported inaccurately being a nonsmoker (biochemically verified as smokers) on factors the literature has indicated to be associated with inaccurate self-report in smoking. Potential predictors of inaccurate self-report of smoking (P ≤ 0.20 in univariate analyses) were subsequently tested in a multivariate logistic regression analysis.
  
  
  RESULTS
  Of the 95 patients tested, almost 25% inaccurately reported having quit smoking at a cutoff of 10-ng/mL cotinine in saliva. The data show more underreporting of smoking among patients who received a face-to-face counseling intervention and among patients with an intermediate education level. There was significantly less underreporting among patients characterized as having a Type D personality.
  
  
  CONCLUSIONS
  These findings suggest that underreporting of smoking status in cardiac patients who participate in a smoking cessation program is high, especially in those who receive intensive face-to-face counseling. Having a Type D personality seems to be a protective factor, whereas having an intermediate level of education is a risk factor for inaccurate reporting. Biochemical validation in high-risk populations is highly needed, ideally accompanied by alternative forms of verification. Optimal validation testing in smoking cessation studies of cardiac patients is difficult because of high refusal rates, no-show, and organizational difficulties.
authors.affiliation: From Auti-Uniek (MG), Oosterbeek, the Netherlands; Faculty of Psychology and Educational Sciences (NB, LL, AM, CB), Open University of the Netherlands, Heerlen, the Netherlands; Cellule d'Expertise Médicale (NB), Inspection Générale de la Sécurité Sociale, Luxembourg; and Department of Health Promotion (HV), School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands.
authors.forename: Mariëlle
authors.initials: M
authors.lastname: Gerritsen
authors.forename: Nadine
authors.initials: N
authors.lastname: Berndt
authors.forename: Lilian
authors.initials: L
authors.lastname: Lechner
authors.forename: Hein
authors.initials: H
authors.lastname: de Vries
authors.forename: Aart
authors.initials: A
authors.lastname: Mudde
authors.forename: Catherine
authors.initials: C
authors.lastname: Bolman
mesh_terms: D000368:Aged; D003367:Cotinine / Q000032:analysis*; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D012306:Risk; D012463:Saliva / Q000737:chemistry; D057566:Self Report / Q000592:standards*; D012907:Smoking / Q000523:psychology*; D016540:Smoking Cessation / Q000523:psychology*; D064415:Type D Personality
chemical_list: D003367:Cotinine