The 13th World Conference on Tobacco OR Health

Objective: The validity of self reported smoking in population surveys remains an important question .This has been of particular concern in a situation where there is a strong social pressure against smoking like in hospital staff in particular among women in Tunisian socio-cultural context. An associated question is what would be the value of measuring urinary cotinine concentrations in such surveys to obtain validated smoking data.

Methods: Cross sectional analysis of data on self reported smoking and urinary cotinine among a sample of 809 women Charles Nicolles hospital, who participated in the hospital staff tobacco use survey. We used quantitative colorimetric urine test based on the könig reaction, in which pink-red chromophores formed from nicotine and its metabolites condensation with barbituric acid were extracted into acetate buffer.

Results: Among self reported women hospital staff regular smokers, 72.7% had a cotinine concentration of cutt off 7,6 micromol/ml or higher in urine. Of those participants who reported to smoked occasionally 14,3% of women had a cotinine concentration in urine at least 7,6 micromol/ml. Among reported ex- smokers and never smoking, respectively 10,9% and 14,8% of women had cotinine in their urine at cutt-off level. The validity of self reporting was similar among subjects from different areas, ages, and professional categories groups. Conclusions: These results substantiate the unreliability of self-report on smoking status in women hospital staff in Tunisia and have implications for clinical and education practice