Comparing two approaches to remote biochemical verification of self-reported cessation in very low-income smokers

Rachel Garg, Amy McQueen, Jennifer Wolff, Taylor Butler, Tess Thompson, Charlene Caburnay, Matthew W. Kreuter

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Little is known about the acceptability and use of remote biochemical verification of self-reported cessation among low-income and racially diverse smokers. We compared responses to an in-person carbon monoxide breath test and in-home urine cotinine test among 270 adults who reported 7-day continuous abstinence at 6-month follow-up in a community-based randomized cessation trial. Half of participants (50%) reported annual household income below $10,000, one in four (28%) had not completed high school, and 69% were Black or African American. Regardless of whether the two tests were offered separately, sequentially, or as a head-to-head choice, participants were more likely to accept an offer to take the urine test than the breath test (89% vs. 32%), and complete it (46% vs. 13%). The proportion of participants completing the urine test and returning a digital photo of the test result is comparable to several studies completed with less disadvantaged samples. Self-report was confirmed by urine test for 74% of participants with a conclusive test result, although a high percentage (39%) of test results were inconclusive. In-home urine testing appears both acceptable and feasible for many low-income smokers, but challenges with testing technology and response rates currently limit its value to increase confidence in self-reports.

Original languageEnglish
Article number100343
JournalAddictive Behaviors Reports
StatePublished - Jun 2021


  • Biochemical verification
  • Cotinine
  • Low-income
  • Minority health
  • Smoking cessation


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