Are there gender differences in self-reported smoking practices? Correlation with thiocyanate and cotinine levels in smokers and nonsmokers from the Pawtucket Heart Health Program

J Womens Health (Larchmt). 2002 Dec;11(10):899-906. doi: 10.1089/154099902762203731.


Objectives: This study compared serum cotinine and thiocyanate in assessment of self-reported smoking behavior among 1400 men and 1809 women from two New England communities.

Methods: Serum thiocyanate and serum cotinine levels were analyzed on 2411 and 798 survey respondents, respectively, in an attempt to provide an objective measurement for validation of self-reported smoking behaviors that were obtained through an in-home interviewer-administered questionnaire. Cross-sectional household surveys were conducted with randomly selected men and women, aged 18-65, between 1981 and 1993 as part of the evaluation of the Pawtucket Heart Health Program.

Results: Among smokers, the thiocyanate test had similar rates of agreement for women(88.0%) and for men (89.3%). However, among nonsmokers, thiocyanate had higher rates of agreement for women (91.5%) than for men (85.2%). For cotinine, the rates of agreement among smokers were higher for women (91.6%) than for men (89.7%). Similarly, the rates of agreement among nonsmokers were also higher for women (93.9%) than for men (91.9%). Overall,serum cotinine had a higher concordance rate than serum thiocyanate for both men and women.

Conclusions: Although our results suggested that there were some differences in self-reporting of smoking status by gender, results were quite similar between self-reports of smoking and both biochemical tests. The results obtained from this large population-based study from two New England communities lend credibility to the use of self-reports as a low-cost accurate approach to obtaining information on smoking behaviors among both men and women in large population-based health surveys.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cotinine / blood*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Indicators and Reagents / analysis
  • Male
  • Middle Aged
  • Reproducibility of Results
  • Sex Factors
  • Smoking / blood*
  • Smoking / psychology
  • Smoking Cessation / psychology
  • Smoking Cessation / statistics & numerical data*
  • Surveys and Questionnaires
  • Thiocyanates / blood*
  • Truth Disclosure*


  • Indicators and Reagents
  • Thiocyanates
  • Cotinine
  • thiocyanate