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ABSTRACT
Background: Clinical reliability of self-reported data for alcohol, caffeine, and nicotine consumptions is lacking, particularly in adolescents. Objectives: To compare a self-report questionnaire and hair analysis to assess the reliability and effectiveness of the self-report. Methods: A cross-sectional study on 14–15-year-old Italian students (n = 874, 38% males, 62% females) was performed comparing self-reported data to hair analysis. The latter quantified hair concentrations of caffeine, nicotine, cotinine, ethyl glucuronide (EtG), and fatty acid ethyl esters (FAEEs) using mass spectrometry. Results: Concordance between self-report and hair testing ranged from good to poor across substances and levels of use: poor for heavy alcohol intake (EtG: k = 0.36, 20 positive cases by hair analysis, false negative by self-report, 2.3% of total sample; FAEE k = 0.31, 25 positive cases, 2.9% of total sample); fair to poor for active smokers (k = 0.40, 125 positive cases, 14.3% of total sample); and moderate for caffeine (k = 0.57, 56 positive cases, 6.4% of total sample). Conclusions: Epidemiological studies on alcohol, caffeine, and nicotine consumption in adolescents may benefit from the inclusion of toxicological analysis on hair samples to overcome the under-reporting phenomenon of questionnaires and detect more cases of problematic substance use.
Declarations of interest
Funding for this study was provided by the Italian Department of Anti-Drug Policies, under the Presidency of the Council of Ministers (Regular Grant DPA 0004629 P-4-35-14). These Agencies had no role in the study design, analysis or interpretation of the data, or the writing of the manuscript. The authors report no declarations of interest.