Assessment of the Validity of Self-Report as a Measure of Smoking Status in Patients Post-Myocardial Infarction

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Sonia Grandi
André Gervais
Lawrence Joseph
Jennifer O'Loughlin
Gilles Paradis
Louise Pilote
Stephane Rinfret
Mark Eisenberg



Self-report is the standard method for assessment of smoking status in the outpatient setting for myocardial infarction (MI) patients. However, the validity of self-report in this patient population has not been previously investigated. Using data from a double-blind, placebocontrolled, randomized trial we examined the validity of self-report for assessment of smoking status in an outpatient setting for MI patients. Smoking was assessed by self-report and biochemical validation by expired carbon monoxide (CO). Abstinence was defined by a selfreport of no cigarettes smoked in the past week and a CO level of less than or equal to 10 parts per million (ppm). At 12 months, number of cigarettes smoked was positively correlated with CO level (r = 0.70). Results show that biochemical validation by CO does not substantially increase the likelihood of detecting smokers in MI patients. However, it may discourage patients from denying their smoking status and therefore should be considered for routine assessment of smoking status in the outpatient cardiac setting. Current clinical guidelines for secondary prevention in myocardial infarction (MI) patients recommend routine assessment of smoking status.1 In clinical trials, biochemical validation in conjunction with self-report is the conventional method for assessment of smoking status.2–4 In the outpatient
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