title: Validity of Self-Reported Tobacco Smoke Exposure among Non-Smoking Adult Public Housing Residents.
abstract: Tobacco smoke exposure (TSE) in public multi-unit housing (MUH) is of concern. However, the validity of self-reports for determining TSE among non-smoking residents in such housing is unclear.
  
  
  
  We analyzed data from 285 non-smoking public MUH residents living in non-smoking households in the Boston area. Participants were interviewed about personal TSE in various locations in the past 7 days and completed a diary of home TSE for 7 days. Self-reported TSE was validated against measurable saliva cotinine (lower limit of detection (LOD) 0.02 ng/ml) and airborne apartment nicotine (LOD 5 ng). Correlations, estimates of inter-measure agreement, and logistic regression assessed associations between self-reported TSE items and measurable cotinine and nicotine.
  
  
  
  Cotinine and nicotine levels were low in this sample (median = 0.026 ng/ml and 0.022 μg/m(3), respectively). Prevalence of detectable personal TSE was 66.3% via self-report and 57.0% via measurable cotinine (median concentration among those with cotinine>LOD: 0.057 ng/ml), with poor agreement (kappa = 0.06; sensitivity = 68.9%; specificity = 37.1%). TSE in the home, car, and other peoples' homes was weakly associated with cotinine levels (Spearman correlations rs = 0.15-0.25), while TSE in public places was not associated with cotinine. Among those with airborne nicotine and daily diary data (n = 161), a smaller proportion had household TSE via self-report (41.6%) compared with measurable airborne nicotine (53.4%) (median concentration among those with nicotine>LOD: 0.04 μg/m(3)) (kappa = 0.09, sensitivity = 46.5%, specificity = 62.7%).
  
  
  
  Self-report alone was not adequate to identify individuals with TSE, as 31% with measurable cotinine and 53% with measurable nicotine did not report TSE. Self-report of TSE in private indoor spaces outside the home was most associated with measurable cotinine in this low-income non-smoking population.
authors.affiliation: New England Research Institutes, Inc., Watertown, MA, United States of America.
authors.forename: Shona C
authors.initials: SC
authors.lastname: Fang
authors.affiliation: New England Research Institutes, Inc., Watertown, MA, United States of America.
authors.forename: Shan
authors.initials: S
authors.lastname: Chen
authors.affiliation: New England Research Institutes, Inc., Watertown, MA, United States of America.
authors.forename: Felicia
authors.initials: F
authors.lastname: Trachtenberg
authors.affiliation: Interfaculty Initiative in Health Policy, Harvard University, Cambridge, MA, United States of America.
authors.forename: Slawa
authors.initials: S
authors.lastname: Rokicki
authors.affiliation: Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America.
authors.forename: Gary
authors.initials: G
authors.lastname: Adamkiewicz
authors.affiliation: Mongan Institute for Health Policy, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States of America.|Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, MA, United States of America.
authors.forename: Douglas E
authors.initials: DE
authors.lastname: Levy
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000397:Air Pollution / Q000032:analysis; D001900:Boston / Q000453:epidemiology; D003367:Cotinine / Q000032:analysis; D005191:Family Characteristics; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009538:Nicotine / Q000032:analysis; D011638:Public Housing / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012463:Saliva / Q000737:chemistry; D057566:Self Report; D012907:Smoking / Q000453:epidemiology*; D014028:Tobacco Smoke Pollution / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D014028:Tobacco Smoke Pollution; D009538:Nicotine; D003367:Cotinine