Comparison between self-reported smoking habits and daily ad-libitum smoking topography in a group of Korean smokers

Tobacco smoking is associated with a high global mortality rate since it is known to cause cancers and lung and heart diseases. To control and reduce annual mortality attributed to smoking, it is essential to design applicable smoke cessation programs based on realistic tobacco exposure risk assessment. In this regard, understanding the smoking habits of the smoker is crucial. Using self-report smoking habit surveys is a common approach in measuring basic variables of smoking habits. However, smoking topography measurement devices have recently become available for investigating smoking habit variables accurately. In this study, we conducted a self-report survey to investigate a group of Korean smokers' smoking habit variables such as the number of smoked cigarettes per day, puff counts, and total smoking time. The survey also included items from the Fagerström Test for Nicotine Dependence (FTND). The results were compared with the corresponding variables from machine-determined data to investigate their correlation and reliability. Results indicate that Korean smokers have a reliable understanding of the average number of cigarettes they smoke daily (ρ = 0.517, Cronbach's α = 0.754) and the time to first cigarette (TTFC) after waking up (ρ = -0.587, Cronbach's α = 0.623), as fundamental items of the FTND score. Nevertheless, these smokers significantly under-reported the puff number and total smoking time, which can cause significant underestimation in the tobacco exposure risk assessment. Consequently, we suggest the application of self-report surveys that are based on the amount of daily smoked cigarettes (e.g. FTND) for clinical or risk assessment purposes. Using smoking topography measurement devices is recommended overusing self-report surveys in measuring smoking habit variables such as puff count and smoking time more accurately.