Published since 1884 by the Society for the Study of Addiction.
Editor-in-Chief, Robert West

Smokers in Clinical Studies Who Say They've Quit Often Haven't

A new US study published by the scientific journal Addiction has found that a high proportion of smokers enrolled in stop-smoking programs during a hospital stay report having quit when in fact they have not.  The findings mean that in these kinds of study it is vital to check claims of having quit using an objective measure.

This nationwide study followed five large smoking cessation clinical trials in the US that enrolled smokers at hospitalization.  At 6-month follow-up, 822 participants (out of 4,206 who completed the follow-up survey) reported they had not smoked in the past 7 days and provided a usable saliva sample for verification by testing for a chemical called ‘cotinine’. The liver converts nicotine in the body to cotinine and so this chemical is a very accurate measure of whether someone has smoked in the past few days. More than 40% of those 822 self-reported quitters failed the saliva test.

The misreporting rate may be even higher because, despite the offer of $50 to $100 for providing a sample 18.6% of people who had said they had quit smoking did not reply, even after multiple attempts. These participants were excluded from the study. The study also excluded anyone who said they were using another nicotine product such as smokeless tobacco, nicotine patches or e-cigarettes. Even very heavy exposure to other people smoking would not have raised cotinine levels to those found in this study.

Lead author Dr. Taneisha Scheuerman says “Our study shows that in studies where participants may feel pressure to say they have quit when they have not, it is essential to verify claims of quitting using an objective test such as cotinine to know true quit rates. For clinical researchers, another important finding is that misreporting rates were similar across intervention and control conditions, suggesting that the relative effectiveness of interventions tested was the same using self-report and cotinine levels.”

Professor Robert West, Editor-in-Chief of the journal, Addiction, that published the article comments, “Other research has shown very low misreporting rates in population surveys of smoking. Hospital patients and pregnant women would be likely to feel strong pressure to have stopped smoking.”

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For editors:

Scheuermann TS, Richter KP, Rigotti NA, Cummins SE, Harrington KF, Sherman SE, Zhu S-H, Tindle HA, Preacher KJ, and the Consortium of Hospitals Advancing Research on Tobacco (CHART) (2017) Accuracy of self-reported smoking abstinence in clinical trials of hospital-initiated smoking interventions. Addiction 112. doi:10.1111/add.13913

This paper is free to download for one month after publication from the Wiley Online Library or by contacting Jean O’Reilly, Editorial Manager, Addiction, jean@addictionjournal.org, tel +44 (0)20 7848 0853.

Media seeking interviews with lead author Dr Taneisha Scheuermann should contact her via the University of Kansas Medical Center by telephone (+1 913-588-2641) or email (tscheuermann@kumc.edu)

Addiction is a monthly international scientific journal publishing peer-reviewed research reports on alcohol, illicit drugs, tobacco, and gambling as well as editorials and other debate pieces. Owned by the Society for the Study of Addiction, it has been in continuous publication since 1884. Addiction is the number one journal in the 2016 ISI Journal Citation Reports ranking in the substance abuse category for both science and social science editions.