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Instruments to assess secondhand smoke exposure in large cohorts of never smokers: The smoke scales
Misailidi, M Tzatzarakis, MN Kavvalakis, MP Koutedakis, Y Tsatsakis, AM Flouris, AD
Misailidi, M
Tzatzarakis, MN
Kavvalakis, MP
Koutedakis, Y
Tsatsakis, AM
Flouris, AD
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2014-01-21
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Abstract
The objectives of this study were to: (i) to develop questionnaires that can identify never-smoking children and adults experiencing increased exposure to secondhand smoke (SHS+), (ii) to determine their validity against hair nicotine, and (iii) assess their reliability. A sample of 191 children (85 males; 106 females; 7-18 years) and 95 adult (23 males; 72 females; 18- 62 years) never-smokers consented to hair nicotine analysis and answered a large number of questions assessing all sources of SHS. A randomly-selected 30% answered the questions again after 20-30 days. Prevalence of SHS+ in children and adults was 0.52±0.07 and 0.67±0.10, respectively (p<0.05). The Smoke Scale for Children (SS-C) and the Smoke Scale for Adults (SS-A) were developed via factor analysis and included nine questions each. Positivity criteria for SS-C and SS-A via receiver operating characteristics curve analysis were identified at >16.5 and >16, respectively. Significant Kappa agreement (p<0.05) was confirmed when comparing the SS-C and SS-A to hair nicotine concentration. Reliability analyses demonstrated that the SS-C and SS-A scores obtained on two different days are highly correlated (p<0.001) and not significantly different (p>0.05). Area under the curve and McNemar's Chi-square showed no pair-wise differences in sensitivity and specificity at the cutoff point between the two different days for SS-C and SS-A (p>0.05). We conclude that the SS-C and the SS-A represent valid, reliable, practical, and inexpensive instruments to identify children and adult never-smokers exposed to increased SHS. Future research should aim to further increase the validity of the two questionnaires. © 2014 Misailidi et al.
Citation
Misailidi M, Tzatzarakis MN, Kavvalakis MP, Koutedakis Y, Tsatsakis AM, Flouris AD (2014) Instruments to Assess Secondhand Smoke Exposure in Large Cohorts of Never Smokers: The Smoke Scales. PLoS ONE 9(1): e85809. https://doi.org/10.1371/journal.pone.0085809
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24465719 (pubmed)
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Journal article
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en
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© 2014 The Authors. Published by PLOS. This is an open access article available under a Creative Commons licence.
The published version can be accessed at the following link on the publisher’s website: https://doi.org/10.1371/journal.pone.0085809
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1932-6203
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1932-6203
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Licence for published version: Creative Commons Attribution 4.0 International