Accuracy of self-reported smoking and secondhand smoke exposure in the US workforce: the National Health and Nutrition Examination Surveys

J Occup Environ Med. 2008 Dec;50(12):1414-20. doi: 10.1097/JOM.0b013e318188b90a.


Objectives: Occupational health studies often rely on self-reported secondhand smoke (SHS) exposure. This study examines the accuracy of self-reported tobacco use and SHS exposure.

Methods: Data on serum cotinine, self-reported tobacco use, and SHS exposure for US workers were extracted from three National Health and Nutrition Examination Surveys (n = 17,011). Serum cotinine levels were used to classify workers into SHS exposure categories. The percent agreement between self-reported tobacco use and SHS exposure with the cotinine categories was calculated.

Results: Workers reporting tobacco use were 88% accurate whereas workers reporting work, home, or home+work exposures were 87% to 92% accurate. Workers reporting no SHS exposure were only 28% accurate.

Conclusions: Workers accurately reported their smoking status and workplace-home SHS exposures, but substantial numbers reporting "no exposures" had detectable levels of cotinine in their blood, indicating exposure to SHS.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.
  • Validation Study

MeSH terms

  • Adolescent
  • Adult
  • Cotinine / blood
  • Female
  • Hispanic or Latino / psychology
  • Hispanic or Latino / statistics & numerical data
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Nutrition Surveys
  • Occupational Exposure / analysis
  • Occupational Exposure / statistics & numerical data*
  • Reproducibility of Results
  • Self-Assessment*
  • Smoking / blood
  • Smoking / epidemiology*
  • Smoking / psychology*
  • Tobacco Smoke Pollution* / analysis
  • United States / epidemiology
  • Young Adult


  • Tobacco Smoke Pollution
  • Cotinine