title: Alcohol, caffeine, and nicotine consumption in adolescents: hair analysis versus self-report.
abstract: Clinical reliability of self-reported data for alcohol, caffeine, and nicotine consumptions is lacking, particularly in adolescents.
  
  
  
  To compare a self-report questionnaire and hair analysis to assess the reliability and effectiveness of the self-report.
  
  
  
  A cross-sectional study on 14-15-year-old Italian students (n = 874, 38% males, 62% females) was performed comparing self-reported data to hair analysis. The latter quantified hair concentrations of caffeine, nicotine, cotinine, ethyl glucuronide (EtG), and fatty acid ethyl esters (FAEEs) using mass spectrometry.
  
  
  
  Concordance between self-report and hair testing ranged from good to poor across substances and levels of use: poor for heavy alcohol intake (EtG: k = 0.36, 20 positive cases by hair analysis, false negative by self-report, 2.3% of total sample; FAEE k = 0.31, 25 positive cases, 2.9% of total sample); fair to poor for active smokers (k = 0.40, 125 positive cases, 14.3% of total sample); and moderate for caffeine (k = 0.57, 56 positive cases, 6.4% of total sample).
  
  
  
  Epidemiological studies on alcohol, caffeine, and nicotine consumption in adolescents may benefit from the inclusion of toxicological analysis on hair samples to overcome the under-reporting phenomenon of questionnaires and detect more cases of problematic substance use.
authors: a Department of Health Science , University of Florence , Florence , Italy.
authors: Elisabetta
authors: E
authors: Bertol
authors: a Department of Health Science , University of Florence , Florence , Italy.
authors: Fabio
authors: F
authors: Vaiano
authors: b Forensic Toxicology and Antidoping , University Hospital of Padova , Padova , Italy.
authors: Rafael
authors: R
authors: Boscolo-Berto
authors: a Department of Health Science , University of Florence , Florence , Italy.
authors: Alessia
authors: A
authors: Fioravanti
authors: a Department of Health Science , University of Florence , Florence , Italy.
authors: Diego
authors: D
authors: Palumbo
authors: a Department of Health Science , University of Florence , Florence , Italy.
authors: Valeria
authors: V
authors: Catalani
authors: a Department of Health Science , University of Florence , Florence , Italy.
authors: Francesco
authors: F
authors: Mari
authors: c Regional Alcoholic Center, Toscana Region, Alcohol Unit, AOU Careggi , Florence , Italy.
authors: Valentino
authors: V
authors: Patussi
authors: d University of Florence, Unit of Research and Innovation in Forensic Toxicology and Neuroscience of Addiction , Florence , Italy.
authors: Giovanni
authors: G
authors: Serpelloni
mesh_terms: D000293:Adolescent; D000428:Alcohol Drinking / Q000378:metabolism; D002110:Caffeine / Q000008:administration & dosage / Q000032:analysis*; D003367:Cotinine / Q000032:analysis; D003430:Cross-Sectional Studies; D005188:False Negative Reactions; D005260:Female; D005965:Glucuronates / Q000032:analysis; D006197:Hair / Q000737:chemistry*; D006801:Humans; D007558:Italy; D008297:Male; D013058:Mass Spectrometry / Q000379:methods; D009538:Nicotine / Q000008:administration & dosage / Q000032:analysis*; D015203:Reproducibility of Results; D057566:Self Report; D012907:Smoking / Q000378:metabolism; D015813:Substance Abuse Detection / Q000379:methods*; D011795:Surveys and Questionnaires
chemical_list: D005965:Glucuronates; C093924:ethyl glucuronide; D002110:Caffeine; D009538:Nicotine; D003367:Cotinine
keywords: Alcohol; adolescents; caffeine; hair analysis; nicotine; questionnaire