title: Analysis of self-reported versus biomarker based smoking prevalence: methodology to compute corrected smoking prevalence rates.
abstract: BACKGROUND
  Prevalence of smoking is needed to estimate the need for future public health resources.
  
  
  OBJECTIVE
  To compute and compare smoking prevalence rates by using self-reported smoking statuses, two serum cotinine (SCOT) based biomarker methods, and one urinary 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) based biomarker method. These estimates were then used to develop correction factors to be applicable to self-reported prevalences to arrive at corrected smoking prevalence rates.
  
  
  METHODS
  Data from National Health and Nutrition Examination Survey (NHANES) for 2007-2012 for those aged ≥20 years (N = 16826) were used.
  
  
  RESULTS
  Self-reported prevalence rate for the total population computed as the weighted number of self-reported smokers divided by weighted number of all participants was 21.6% and 24% when computed by weighted number of self-reported smokers divided by the weighted number of self-reported smokers and nonsmokers. The corrected prevalence rate was found to be 25.8%.
  
  
  CONCLUSIONS
  A 1% underestimate in smoking prevalence is equivalent to not being able to identify 2.2 million smokers in US in a given year. This underestimation, if not corrected, could lead to serious gap in the public health services available and needed to provide adequate preventive and corrective treatment to smokers.
authors.affiliation: a Private Consultant , Dacula , GA , USA.
authors.forename: Ram B
authors.initials: RB
authors.lastname: Jain
mesh_terms: D015415:Biomarkers / Q000097:blood / Q000652:urine; D006801:Humans; D008722:Methods; D015995:Prevalence; D057566:Self Report; D012907:Smoking; D014481:United States
chemical_list: D015415:Biomarkers
keywords: NHANES; Smoking; race/ethnicity; serum cotinine; tobacco biomarkers; urinary NNAL