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Transplant Toxicities

Accuracy of self-reported tobacco use status among hematopoietic SCT patients

Bone Marrow Transplantation volume 49, pages 961–965 (2014)Cite this article

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Abstract

Tobacco use is a risk factor for adverse outcomes among hematopoietic SCT (HSCT) patients. Accurate identification of tobacco use offers a vital opportunity to treat this risk factor. The current study compared self-reported tobacco use status with serum cotinine levels among HSCT patients at the time of pre-transplant evaluation. A total of 444 participants completed both assessments; 44 participants (9.9%) were classified as tobacco users with serum cotinine concentrations >2 ng/mL vs 29 with self-reporting. Sensitivity and specificity of self-reporting were 65.9% and 100%, respectively. Positive and negative predictive values were 100% and 96.4%, respectively. Comparing tobacco use documented in the medical record with cotinine, sensitivity and specificity were 51.2% and 99.2%, respectively. Factors associated with tobacco use were male gender, single relationship status, less education and younger age. In summary, utilization of serum cotinine assays increased detection of tobacco use cases >50% over self-reporting. Results are discussed in the context of translation to care, including clinical and ethical implications, and current tobacco use treatment guidelines. When cotinine assays are not available, self-reporting of any tobacco use in the year before HSCT should trigger brief advice and cessation or relapse prevention counseling.

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Acknowledgements

This publication was made possible by a KL2 awarded to Dr Ehlers within CTSA grant number UL1 TR000135 from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health. Funding for cotinine assays made possible by a supplemental grant from The Fraternal Order of Eagles Cancer Research Fund.

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Authors and Affiliations

  1. Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, Rochester, MN, USA

    S L Ehlers, C A Bronars & C A Patten

  2. Behavioral Health Research Program, Mayo Clinic College of Medicine, Rochester, MN, USA

    S L Ehlers, C A Bronars, C A Patten, T Brockman & C Hughes

  3. Division of Biomedical Statistics and Informatics, Mayo Clinic College of Medicine, Rochester, MN, USA

    P A Decker

  4. Division of Epidemiology, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, MN, USA

    J R Cerhan

  5. Division of Hematology, Mayo Clinic College of Medicine, Rochester, MN, USA

    W Hogan, A Dispenzieri, S Ansell & D Gastineau

  6. Nicotine Dependence Center Research Program, Mayo Clinic College of Medicine, Rochester, MN, USA

    J Ebbert

  7. Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA

    J Ebbert

  8. Human Cellular Therapy Laboratory, Mayo Clinic College of Medicine, Rochester, MN, USA

    D Gastineau

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  1. S L Ehlers
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  2. C A Bronars
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Correspondence to S L Ehlers.

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Ehlers, S., Bronars, C., Patten, C. et al. Accuracy of self-reported tobacco use status among hematopoietic SCT patients. Bone Marrow Transplant 49, 961–965 (2014). https://doi.org/10.1038/bmt.2014.70

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  • DOI: https://doi.org/10.1038/bmt.2014.70

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