Skip to main content
Top
Published in: Clinical Oral Investigations 3/2012

01-06-2012 | Original Article

Assessment of smoking behaviour in the dental setting. A study comparing self-reported questionnaire data and exhaled carbon monoxide levels

Authors: Marc Frei, Odette Engel Brügger, Pedram Sendi, Peter A. Reichart, Christoph A. Ramseier, Michael M. Bornstein

Published in: Clinical Oral Investigations | Issue 3/2012

Login to get access

Abstract

The present study validated the accuracy of data from a self-reported questionnaire on smoking behaviour with the use of exhaled carbon monoxide (CO) level measurements in two groups of patients. Group 1 included patients referred to an oral medicine unit, whereas group 2 was recruited from the daily outpatient service. All patients filled in a standardized questionnaire regarding their current and former smoking habits. Additionally, exhaled CO levels were measured using a monitor. A total of 121 patients were included in group 1, and 116 patients were included in group 2. The mean value of exhaled CO was 7.6 ppm in the first group and 9.2 ppm in the second group. The mean CO values did not statistically significantly differ between the two groups. The two exhaled CO level measurements taken for each patient exhibited very good correlation (Spearman's coefficient of 0.9857). Smokers had a mean difference of exhaled CO values of 13.95 ppm (p < 0.001) compared to non-smokers adjusted for the first or second group. The consumption of one additional pack year resulted in an increase in CO values of 0.16 ppm (p = 0.003). The consumption of one additional cigarette per day elevated the CO measurements by 0.88 ppm (p < 0.001). Based on these results, the correlations between the self-reported smoking habits and exhaled CO values are robust and highly reproducible. CO monitors may offer a non-invasive method to objectively assess current smoking behaviour and to monitor tobacco use cessation attempts in the dental setting.
Literature
1.
go back to reference Doll R, Peto R, Boreham J, Sutherland I (2004) Mortality in relation to smoking: 50 years' observation on male British doctors. BMJ 328:1097–1102CrossRef Doll R, Peto R, Boreham J, Sutherland I (2004) Mortality in relation to smoking: 50 years' observation on male British doctors. BMJ 328:1097–1102CrossRef
2.
go back to reference Patel RR, Ryu JH, Vassallo R (2008) Cigarette smoking and diffuse lung disease. Drugs 68:1511–1527PubMedCrossRef Patel RR, Ryu JH, Vassallo R (2008) Cigarette smoking and diffuse lung disease. Drugs 68:1511–1527PubMedCrossRef
3.
go back to reference Gupta PC, Murti PR, Bhonsle RB (1996) Epidemiology of cancer by tobacco products and the significance of TSNA. Crit Rev Toxicol 26:183–198PubMedCrossRef Gupta PC, Murti PR, Bhonsle RB (1996) Epidemiology of cancer by tobacco products and the significance of TSNA. Crit Rev Toxicol 26:183–198PubMedCrossRef
4.
go back to reference Gandini S, Botteri E, Iodice S, Boniol M, Lowenfels AB, Maisonneuve P, Boyle P (2008) Tobacco smoking and cancer: a meta-analysis. Int J Cancer 122:155–164PubMedCrossRef Gandini S, Botteri E, Iodice S, Boniol M, Lowenfels AB, Maisonneuve P, Boyle P (2008) Tobacco smoking and cancer: a meta-analysis. Int J Cancer 122:155–164PubMedCrossRef
5.
go back to reference Johnson NW, Bain CA (2000) Tobacco and oral disease. EU-Working Group on Tobacco and Oral Health. Br Dent J 189:200–206PubMed Johnson NW, Bain CA (2000) Tobacco and oral disease. EU-Working Group on Tobacco and Oral Health. Br Dent J 189:200–206PubMed
6.
go back to reference Reichart PA (2001) Identification of risk groups for oral precancer and cancer and preventive measures. Clin Oral Investig 5:207–213PubMedCrossRef Reichart PA (2001) Identification of risk groups for oral precancer and cancer and preventive measures. Clin Oral Investig 5:207–213PubMedCrossRef
7.
go back to reference Warnakulasuriya S, Dietrich T, Bornstein MM, Peidró EC, Preshaw PM, Walter C, Wennström JL, Bergström J (2010) Oral health risks of tobacco use and effects of cessation. Int Dent J 60:7–30PubMed Warnakulasuriya S, Dietrich T, Bornstein MM, Peidró EC, Preshaw PM, Walter C, Wennström JL, Bergström J (2010) Oral health risks of tobacco use and effects of cessation. Int Dent J 60:7–30PubMed
8.
go back to reference Victoroff KZ, Lewis R, Ellis E, Ntragatakis M (2006) Patient receptivity to tobacco cessation counseling in an academic dental clinic: a patient survey. J Public Health Dent 66:209–211PubMedCrossRef Victoroff KZ, Lewis R, Ellis E, Ntragatakis M (2006) Patient receptivity to tobacco cessation counseling in an academic dental clinic: a patient survey. J Public Health Dent 66:209–211PubMedCrossRef
9.
go back to reference Needleman IG, Binnie VI, Ainamo A, Carr AB, Fundak A, Koerber A, Ohrn K, Rosseel J (2010) Improving the effectiveness of tobacco use cessation (TUC). Int Dent J 60:50–59PubMed Needleman IG, Binnie VI, Ainamo A, Carr AB, Fundak A, Koerber A, Ohrn K, Rosseel J (2010) Improving the effectiveness of tobacco use cessation (TUC). Int Dent J 60:50–59PubMed
10.
go back to reference Daly RJ, Blann AD (1996) Self-reported smoking in vascular disease: the need for biochemical confirmation. Br J Biomed Sci 53:204–208PubMed Daly RJ, Blann AD (1996) Self-reported smoking in vascular disease: the need for biochemical confirmation. Br J Biomed Sci 53:204–208PubMed
11.
go back to reference Coultas DB, Howard CA, Peake GT, Skipper BJ, Sarnet JM (1988) Discrepancies between self-reported and validated cigarette smoking in a community survey of New Mexico Hispanics. Am Rev Respir Dis 137:810–814PubMed Coultas DB, Howard CA, Peake GT, Skipper BJ, Sarnet JM (1988) Discrepancies between self-reported and validated cigarette smoking in a community survey of New Mexico Hispanics. Am Rev Respir Dis 137:810–814PubMed
12.
go back to reference Gorber SC, Schofield-Hurwitz S, Hardt J, Levasseur G, Tremblay M (2009) The accuracy of self-reported smoking: a systematic review of the relationship between self-reported and cotinine-assessed smoking status. Nicotine Tob Res 11:12–24PubMedCrossRef Gorber SC, Schofield-Hurwitz S, Hardt J, Levasseur G, Tremblay M (2009) The accuracy of self-reported smoking: a systematic review of the relationship between self-reported and cotinine-assessed smoking status. Nicotine Tob Res 11:12–24PubMedCrossRef
13.
go back to reference Scherer G, Richter E (1997) Biomonitoring exposure to environmental tobacco smoke (ETS): a critical reappraisal. Hum Exp Toxicol 16:449–459PubMedCrossRef Scherer G, Richter E (1997) Biomonitoring exposure to environmental tobacco smoke (ETS): a critical reappraisal. Hum Exp Toxicol 16:449–459PubMedCrossRef
14.
go back to reference Ramseier CA, Mattheos N, Needleman I, Watt R, Wickholm S (2006) Consensus report: First European Workshop on Tobacco Use Prevention and Cessation for Oral Health Professionals. Oral Health Prev Dent 4:7–18PubMed Ramseier CA, Mattheos N, Needleman I, Watt R, Wickholm S (2006) Consensus report: First European Workshop on Tobacco Use Prevention and Cessation for Oral Health Professionals. Oral Health Prev Dent 4:7–18PubMed
15.
go back to reference Ramseier CA, Bornstein MM, Saxer UP, Klingler K, Walter C (2007) Tobacco use prevention and cessation in the dental practice. Schweiz Monatsschr Zahnmed 117:253–278, in GermanPubMed Ramseier CA, Bornstein MM, Saxer UP, Klingler K, Walter C (2007) Tobacco use prevention and cessation in the dental practice. Schweiz Monatsschr Zahnmed 117:253–278, in GermanPubMed
16.
go back to reference Andersson MF, Moller AM (2010) Assessment of carbon monoxide values in smokers: a comparison of carbon monoxide in expired air and carboxyhaemoglobin in arterial blood. Eur J Anaesthesiol 27:812–818PubMedCrossRef Andersson MF, Moller AM (2010) Assessment of carbon monoxide values in smokers: a comparison of carbon monoxide in expired air and carboxyhaemoglobin in arterial blood. Eur J Anaesthesiol 27:812–818PubMedCrossRef
17.
go back to reference Middleton ET, Morice AH (2000) Breath carbon monoxide as an indication of smoking habit. Chest 117:758–763PubMedCrossRef Middleton ET, Morice AH (2000) Breath carbon monoxide as an indication of smoking habit. Chest 117:758–763PubMedCrossRef
18.
go back to reference Watt RG, Benzian H, Binnie V, Gafner C, Hovius M, Newton TJ, Mecklenburg RE (2006) Public health aspects of tobacco control: setting the agenda for action by oral health profession across Europe. Oral Health Prev Dent 4:19–26PubMed Watt RG, Benzian H, Binnie V, Gafner C, Hovius M, Newton TJ, Mecklenburg RE (2006) Public health aspects of tobacco control: setting the agenda for action by oral health profession across Europe. Oral Health Prev Dent 4:19–26PubMed
19.
go back to reference Gallagher JE, Alajbeg I, Büchler S, Carrassi A, Hovius M, Jacobs A, Jenner M, Kinnunen T, Ulbricht S, Zoitopoulos L (2010) Public health aspects of tobacco control revisited. Int Dent J 60:31–49PubMed Gallagher JE, Alajbeg I, Büchler S, Carrassi A, Hovius M, Jacobs A, Jenner M, Kinnunen T, Ulbricht S, Zoitopoulos L (2010) Public health aspects of tobacco control revisited. Int Dent J 60:31–49PubMed
20.
go back to reference Bornstein MM, Frei M, Sendi P, Ramseier CA, Reichart PA (2010) Patients' awareness of the potential benefit of smoking cessation. A study evaluating self-reported and clinical data from patients referred to an oral medicine unit. Clin Oral Invest. doi:10.1007/s00784-010-0488-5 Bornstein MM, Frei M, Sendi P, Ramseier CA, Reichart PA (2010) Patients' awareness of the potential benefit of smoking cessation. A study evaluating self-reported and clinical data from patients referred to an oral medicine unit. Clin Oral Invest. doi:10.​1007/​s00784-010-0488-5
21.
go back to reference Black JH 3rd (2010) Evidence base and strategies for successful smoking cessation. J Vasc Surg 51:1529–1537PubMedCrossRef Black JH 3rd (2010) Evidence base and strategies for successful smoking cessation. J Vasc Surg 51:1529–1537PubMedCrossRef
22.
go back to reference Christen AG (1970) The dentist's role in helping patients to stop smoking. J Am Dent Assoc 81:1146–1152PubMed Christen AG (1970) The dentist's role in helping patients to stop smoking. J Am Dent Assoc 81:1146–1152PubMed
23.
go back to reference Needleman I, Warnakulasuriya S, Sutherland G, Bornstein MM, Casals E, Dietrich T, Suvan J (2006) Evaluation of tobacco use cessation (TUC) counselling in the dental office. Oral Health Prev Dent 4:27–47PubMed Needleman I, Warnakulasuriya S, Sutherland G, Bornstein MM, Casals E, Dietrich T, Suvan J (2006) Evaluation of tobacco use cessation (TUC) counselling in the dental office. Oral Health Prev Dent 4:27–47PubMed
24.
go back to reference Davis JM, Ramseier CA, Mattheos N, Schoonheim-Klein M, Compton S, Al-Hazmi N, Polychronopoulou A, Suvan J, Antohé ME, Forna D, Radley N (2010) Education of tobacco use prevention and cessation for dental professionals—a paradigm shift. Int Dent J 60:60–72PubMed Davis JM, Ramseier CA, Mattheos N, Schoonheim-Klein M, Compton S, Al-Hazmi N, Polychronopoulou A, Suvan J, Antohé ME, Forna D, Radley N (2010) Education of tobacco use prevention and cessation for dental professionals—a paradigm shift. Int Dent J 60:60–72PubMed
25.
go back to reference Ramseier CA, Warnakulasuriya S, Needleman IG, Gallagher JE, Lahtinen A, Ainamo A, Alajbeg I, Albert D, Al-Hazmi N, Antohe E, Beck-Mannagetta J, Benzian H, Bergstrom J, Binnie V, Bornstein M, Buchler S, Carr A, Carrassi A, Peidro EC, Compton S, Crail J, Crews K, Davis JM, Dietrich T, Enmark B, Fine J, Gallagher J, Jenner T, Forna D, Fundak A, Gyenes M, Hovius M, Jacobs A, Kinnunen T, Knevel R, Koerer A, Labella R, Lulic M, Mattheos N, McEwen A, Needleman I, Ohrn K, Polychronopoulou A, Preshaw P, Radley N, Ramseier C, Rosseel J, Schoonheim-Klein M, Suvan J, Ulbricht S, Verstappen P, Walter C, Wennstrom J, Wickholm S, Zoitopoulos L (2010) Consensus report: 2nd European workshop on tobacco use prevention and cessation for oral health professionals. Int Dent J 60:3–6PubMed Ramseier CA, Warnakulasuriya S, Needleman IG, Gallagher JE, Lahtinen A, Ainamo A, Alajbeg I, Albert D, Al-Hazmi N, Antohe E, Beck-Mannagetta J, Benzian H, Bergstrom J, Binnie V, Bornstein M, Buchler S, Carr A, Carrassi A, Peidro EC, Compton S, Crail J, Crews K, Davis JM, Dietrich T, Enmark B, Fine J, Gallagher J, Jenner T, Forna D, Fundak A, Gyenes M, Hovius M, Jacobs A, Kinnunen T, Knevel R, Koerer A, Labella R, Lulic M, Mattheos N, McEwen A, Needleman I, Ohrn K, Polychronopoulou A, Preshaw P, Radley N, Ramseier C, Rosseel J, Schoonheim-Klein M, Suvan J, Ulbricht S, Verstappen P, Walter C, Wennstrom J, Wickholm S, Zoitopoulos L (2010) Consensus report: 2nd European workshop on tobacco use prevention and cessation for oral health professionals. Int Dent J 60:3–6PubMed
26.
go back to reference Scott DA, Palmer RM, Stapleton JA (2001) Validation of smoking status in clinical research into inflammatory periodontal disease. J Clin Periodontol 28:715–722PubMedCrossRef Scott DA, Palmer RM, Stapleton JA (2001) Validation of smoking status in clinical research into inflammatory periodontal disease. J Clin Periodontol 28:715–722PubMedCrossRef
27.
go back to reference Wells AJ, English PB, Posner SF, Wagenknecht LE, Perez-Stable EJ (1998) Misclassification rates for current smokers misclassified as nonsmokers. Am J Public Health 88:1503–1509PubMedCrossRef Wells AJ, English PB, Posner SF, Wagenknecht LE, Perez-Stable EJ (1998) Misclassification rates for current smokers misclassified as nonsmokers. Am J Public Health 88:1503–1509PubMedCrossRef
28.
go back to reference SNRT Subcommittee on Biochemical Verification (2002) Biochemical verification of tobacco use and cessation. Nicotine Tob Res 2002(4):149–159 SNRT Subcommittee on Biochemical Verification (2002) Biochemical verification of tobacco use and cessation. Nicotine Tob Res 2002(4):149–159
29.
go back to reference Raiff BR, Faix C, Turturici M, Dallery J (2010) Breath carbon monoxide output is affected by speed of emptying the lungs: implications for laboratory and smoking cessation research. Nicotine Tob Res 12:834–838PubMedCrossRef Raiff BR, Faix C, Turturici M, Dallery J (2010) Breath carbon monoxide output is affected by speed of emptying the lungs: implications for laboratory and smoking cessation research. Nicotine Tob Res 12:834–838PubMedCrossRef
30.
go back to reference Taniguchi S, Niitsuya M, Inoue Y, Katagiri H, Kadowaki T, Aizawa Y (1999) Evaluation of passive smoking by measuring urinary trans, trans-muconic acid and exhaled carbon monoxide levels. Ind Health 37:88–94PubMedCrossRef Taniguchi S, Niitsuya M, Inoue Y, Katagiri H, Kadowaki T, Aizawa Y (1999) Evaluation of passive smoking by measuring urinary trans, trans-muconic acid and exhaled carbon monoxide levels. Ind Health 37:88–94PubMedCrossRef
31.
go back to reference Zevin S, Gourlay SG, Benowitz NL (1998) Clinical pharmacology of nicotine. Clin Dermatol 16:557–564PubMedCrossRef Zevin S, Gourlay SG, Benowitz NL (1998) Clinical pharmacology of nicotine. Clin Dermatol 16:557–564PubMedCrossRef
32.
go back to reference Simmons MS, Connett JE, Nides MA, Lindgren PG, Kleerup EC, Murray RP, Bjornson WM, Tashkin DP (2005) Smoking reduction and the rate of decline in FEV(1): results from the Lung Health Study. Eur Respir J 25:1011–1017PubMedCrossRef Simmons MS, Connett JE, Nides MA, Lindgren PG, Kleerup EC, Murray RP, Bjornson WM, Tashkin DP (2005) Smoking reduction and the rate of decline in FEV(1): results from the Lung Health Study. Eur Respir J 25:1011–1017PubMedCrossRef
33.
go back to reference Hughes J, Lindgren P, Connett J, Nides M (2004) Smoking reduction in the Lung Health Study. Nicotine Tob Res 6:275–280PubMedCrossRef Hughes J, Lindgren P, Connett J, Nides M (2004) Smoking reduction in the Lung Health Study. Nicotine Tob Res 6:275–280PubMedCrossRef
34.
go back to reference Nasry HA, Preshaw PM, Stacey F, Heasman L, Swan M, Heasman PA (2006) Smoking cessation advice for patients with chronic periodontitis. Br Dent J 200:272–275PubMedCrossRef Nasry HA, Preshaw PM, Stacey F, Heasman L, Swan M, Heasman PA (2006) Smoking cessation advice for patients with chronic periodontitis. Br Dent J 200:272–275PubMedCrossRef
Metadata
Title
Assessment of smoking behaviour in the dental setting. A study comparing self-reported questionnaire data and exhaled carbon monoxide levels
Authors
Marc Frei
Odette Engel Brügger
Pedram Sendi
Peter A. Reichart
Christoph A. Ramseier
Michael M. Bornstein
Publication date
01-06-2012
Publisher
Springer-Verlag
Published in
Clinical Oral Investigations / Issue 3/2012
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI
https://doi.org/10.1007/s00784-011-0583-2

Other articles of this Issue 3/2012

Clinical Oral Investigations 3/2012 Go to the issue