How accurate is in-patient smoking status data collected by hospital admissions staff?

Objective: To determine the validity of self-reported in-patient smoking status data collected by admissions staff. Method: Smoking status of new inpatients was recorded on to the computer registration screen. Urine samples collected from the patients (n = 167) were analysed for the presence of cotinine. Results: Only 63% (95% CI 46%-81%) of the patients classified as smokers on the basis of urinary cotinine levels were recorded as smokers on the computerised record created by hospital admissions staff. Conclusion: Admissions staff do not obtain reliable data on smoking status. However, most patients entered as nonsmokers by admissions staff but registering high cotinine levels were subsequently recorded as smokers by their doctor in their medical record. Implications: This study suggests that inpatients are more likely to report their smoking status accurately to their doctor than an admissions clerk, but about two-thirds of smokers will be correctly identified at admission and so could be targeted in computer-driven smoking-cessation interventions.