보건소 금연클리닉의 금연치료 결과에 대한 자가보고와 요중 코티닌 검사 간의 일치도

Agreement between Self-Report on Smoking Cessation and Urinary Cotinine Test

자가보고는 국내 보건소의 금연클리닉에서 금연 성공 여부를 평가하기 위한 여러 연구에서 사용되고 있다. 본 연구 에서는 금연 프로그램 시행 후 금연 여부에 대한 자가보고와 요중 코티닌 농도 검사를 시행하여 두 검사 결과 간의 일치 도와 현재 흡연 여부의 판단에 있어 자가보고의 유용성을 평가하였다. 결과로는 흡연 여부에 대한 자가보고와 요중 코티 닌 검사 결과의 일치도와 자가보고의 민감도, 음성 예측도는 낮았다. 따라서 자가보고만으로는 금연 치료의 성공을 평가하는데 있어 충분하지 못하며 요중 코티닌 검사와 같은 객관적인 평가 방식이 추가적으로 사용되어야 할 것이다.

ObjectivezzSelf-report is being used in most of studies investigating the therapeutic effect of smoking cessation clinics of public health centers in Korea instead of cotinine or other chemical markers of nicotine exposure. This study was conducted to evaluate the agreement between self-report and urinary cotinine test after smoking cessation program. MethodszzThe study subjects were 333 adult male who visited public health center and participated in 12-week scheduled smoking cessation program. Questionnaires including demographic data and information about cigarette use, blood test, and urinary cotinine test were performed to all subjects during initial evaluation. At the end of the program, smoking status of subjects was assessed by an oral self-report and additional blood and urinary cotinine tests were done to the subjects who agreed. Resultszz52 participants who gave both self-report on smoking status and urine sample were included in the final analysis. The overall percentage agreement was 67.3%, and the overall Kappa index was 0.367. The sensitivity, ecificity, positive predictive value, and negative predictive value of self-report in detecting smoking state were 46.43%, 91.67%, 86.67%, and 59.46%, respectively. ConclusionzzThe agreement between self-report and urinary cotinine test in detecting smoking status after smoking cessation program was relatively low on account of participants who failed to quit smoking but reported their smoking status incorrectly. Therefore, the use of objective measures such as urine cotinine should be considered in evaluation of successful smoking cessation.