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

S. L. Ehlers, C. A. Bronars, C. A. Patten, T. Brockman, C. Hughes, P. A. Decker, J. R. Cerhan, W. Hogan, A. Dispenzieri, S. Ansell, J. Ebbert, D. Gastineau

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)961-965
Number of pages5
JournalBone Marrow Transplantation
Issue number7
StatePublished - Jul 2014

ASJC Scopus subject areas

  • Hematology
  • Transplantation


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