Consistency of self-reported smoking over a 6-year interval from adolescence to young adulthood

Aims To examine the reliability of self-report cigarette smoking questions by describing recanting (denial of previous smoking reports) in a nationally representative sample of US adolescents followed throughout young adulthood. Predictors of recanting across stages of smoking uptake/progression are examined. Design A total of 12 985 respondents to cigarette smoking questions during in-home interviews at waves I and III (6 years apart) of the National Longitudinal Study of Adolescent Health (Add Health). The sample survey procedures of Stata 9.0 were used to produce nationally representative estimates, with standard errors adjusted for both clustering at the school level and stratification by geographical region. Measurements Recanting probabilities determined by reports of stages of smoking uptake/progression at each time-point were predicted by race/ethnicity, parental education, household income, poverty level, depression and peer daily smoking. Findings Stage-specific results indicated that recanting is higher when the earlier smoking was less frequent/intense. Recanters were older, from lower-income households and had higher baseline depression levels. Non-Hispanic black youth were significantly more likely to recant previous smoking compared to non-Hispanic white youth, even in multivariate models controlling for socio-demographic variables. Predictors of recanting differed by level of tobacco involvement. The greater likelihood of non-Hispanic black respondents to deny previous smoking may be a reflection of less intense or more intermittent use of tobacco that leads to recall differences over time. Conclusions Racial/ethnic subgroups and/or respondents endorsing depressive symptoms may be more vulnerable to misclassification during interpretation of national survey data and subsequently not identified properly for prevention/intervention programs.