BACKGROUND: Existing research shows a close concurrence between self-reports and biomarker indicators of tobacco use. This study aims to compare self-reported tobacco use (including smoked, smokeless, and e-cigarettes) with cotinine test results among adults in Mauritania.
METHODS: A random sample of 2,505 adults was selected from 8,400 participants in the Global Adult Tobacco Survey Mauritania 2021, for a biomarker survey and cotinine test. The survey assessed tobacco use within the 48 hours prior to the interview. The COT Rapid Test Cassette, a saliva-based test detecting cotinine at 20 ng/ml, was used to identify recent tobacco use. Of the sample, 1,732 participants completed both the tobacco use questions and had valid cotinine test results. The study examined the agreement between self-reported tobacco use and biomarker results using sensitivity, specificity, and kappa coefficient measures.
RESULTS: Among the 1,732 participants, 236 reported using any tobacco product. Of those who reported any tobacco use, 190 tested positive for cotinine while 46 tested negative. The sensitivity for detecting any tobacco use was 80.5%, specificity was 93.6%, and the Kappa coefficient was 0.68. For adults who exclusively smoked tobacco, 136 out of 162 tested positive (sensitivity: 84.0%, specificity: 93.6%, Kappa: 0.65). Among those who exclusively used smokeless tobacco, 30 out of 38 tested positive (sensitivity: 78.9%, specificity: 93.6%, Kappa: 0.34). Only two out of four individuals who exclusively used e-cigarettes tested positive (sensitivity: 50%, specificity: 93.6%, Kappa: 0.03).
CONCLUSIONS: Conclusion
The study found moderate agreement between self-reported tobacco use and rapid cotinine test results, possibly marking the first report of cotinine biomarker testing effectively identifying adults who used tobacco in Mauritania. This may help improve the reliability of self-reported data in surveys in the country. Additional research is needed to understand the discrepancies between self-reported tobacco use and the cotinine rapids test.