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Seidman, D.S., Paz, I., Merlet-Aharoni, I., Vreman, H., Stevenson, D.K. and Gale, R. (1999) Noninvasive validation of tobacco smoke exposure in late pregnancy using end-tidal carbon monoxide measurements. Journal of Perinatology, 19, 358-361. doi:10.1038/sj.jp.7200193

has been cited by the following article:

• TITLE: Self-reported cigarette smoking status imprecisely quantifies exposure in pregnancy

  AUTHORS: Carolina C. Venditti, Graeme N. Smith

  KEYWORDS: Pregnancy; Cigarette Smoking; Carbon Monoxide; Cotinine; Self-Reported Levels

  JOURNAL NAME: Open Journal of Obstetrics and Gynecology, Vol.2 No.1, March 31, 2012

  ABSTRACT: Objective: We sought to determine the validity of self-reported smoking activity versus two quantitative measurements of tobacco exposure in pregnancy. We hypothesized that pregnant women would under-report their daily smoking amounts, due to the negative social stigmas associated with such a behavior. Methods: Cigarette-smoking and non-smoking pregnant women were recruited as part of a larger research study. Pregnant women with a singleton baby (>24 weeks) were recruited at a clinical appointment or prior to an elective caesarian section. Self-reported smoking status, including time since last cigarette, was recorded. End-tidal breath carbon monoxide (ETCO) levels and urine cotinine levels were measured and compared. Results: Both normotensive non-smoking (NTN) (n = 44) and normotensive smoking (NTS) (n = 24) pregnant women were recruited. A strong correlation was found between ETCO levels and urine cotinine measurements (r = 0.6566, p 0.05). Conclusion: Self-reported smoking status accurately identifies women who smoke in pregnancy, but not their level of tobacco exposure. Urine cotinine or ETCO are much better quantitative measurements of nicotine and carbon monoxide, respectively, and should be measured for a more precise indicator of smoking activity. These devices will allow for better counseling and monitoring of women who are trying to quit smoking and/or who enter into smoking cessation programs.