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Published on: February 12, 2015
Dose-related effect of urinary cotinine levels on pulmonary function among Korean women
Setting:
Country-wide general population in South Korea.
Background:
The dose-response relationship between smoking and pulmonary function in women may have been significantly over-estimated by studies that employed a self-reporting questionnaire.
Objective:
To evaluate whether this relationship was still observed among Korean women when smoking levels were determined by urinary cotinine measurements.
Design:
A total of 4584 Korean women from the spirometry data set of the Korean National Health and Nutrition Examination Surveys IV and V (2008-2010) were included. Analysis of covariance was performed to estimate the dose-related effect of urinary cotinine levels on pulmonary function after adjusting for covariates in this country-wide cross-sectional study.
Results:
Compared to urinary cotinine levels (cut-off 50 ng/ml), the false-positive rate of self-reported smoking was 53.2%. After the smokers were divided into deciles, the regression coefficients for percentage forced expiratory volume in 1 second (FEV₁%) and percentage forced expiratory volume/forced volume capacity (FEV₁/FVC) ratio (FEV1/FVC%) were -0.2903 and -0.2680 (%/decile), respectively (both P < 0.001).
Conclusion:
It is necessary to use objective methods when determining the smoking status of Korean women. Even after reducing information bias, smoking affected pulmonary function in a dose-dependent manner.
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