Trends in the accuracy of self-reported cigarette smoking in Canada
Year: 2026
Type: article
Study design: Observational Study
Abstract: Introduction Self-reported data are commonly utilized to track trends in tobacco use and assess the impact of policy changes. Estimates derived from self-reported measures, especially for behaviors considered socially undesirable, can be influenced by reporting biases. Enhanced tobacco control measures may have exacerbated social desirability bias, resulting in increased underreporting of tobacco use. Our aim was to assess the accuracy of self-reported cigarette smoking. Methods Using repeated cross-sectional data from 6 cycles of the Canadian Health Measures Survey conducted between 2007 and 2019, we first compared cigarette use prevalence (daily and occasional) based on self-reports and urinary cotinine concentrations and calculated sensitivity and specificity using urinary cotinine concentrations with a cut-point of 50 ng/ml as a measure of true cigarette use. Second, we used logistic regressions to examine if sensitivity and specificity varied by individual/household characteristics and time. Results Over the 12-year study period, the average sensitivity for self-reported smoking status was 89.8% (95% CI, 85.5, 92.9) and ranged from 86.0% (95% CI, 79.0, 91.0) to 92.7% (95% CI, 89.1, 95.2). The average specificity was 97.5% (95% CI, 96.0, 98.4) and ranged from 97.1 (95% CI, 93.3, 98.8) to 98.6 (95% CI, 97.6, 99.2). Sensitivity and specificity estimates did not vary appreciably by sex or household income, with 1 exception. Sensitivity estimates among younger respondents (12-19 years) were generally lower, not precisely estimated, and varied substantially between cycles. Conclusions Self-reported responses from survey data can be used to provide accurate point estimates and trends in cigarette smoking prevalence in Canada. Implications The sensitivity (ie, correctly identifying respondents who smoked cigarettes) and specificity (ie, correctly identifying respondents who did not smoke cigarettes) of self-reported smoking status between 2007 and 2019 in Canada were high and did not vary in time or by sex and household income. Self-reported responses from survey data can be used to provide accurate point estimates and trends in cigarette smoking prevalence in Canada.
Source: Nicotine & Tobacco Research
DOI: 10.1093/ntr/ntag172
Institution: McMaster University
Language: English
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $5,392
Award: G4156051371
OpenAlex ID: W7171982971
