Passive smoking is associated with a small increase in the risk of coronary heart disease. Given the high prevalence of cigarette smoking, the public health consequences of passive smoking with regard to coronary heart disease may be important.

Summary and conclusions Urinary concentrations of nicotine and its major metabolite cotinine were measured in volunteers whose smoking habits were known to test the reliability of the measurements as indicators of current smoking. In the non-smokers detectable concentrations were always below the confidence limits set for the method, while in smokers the concentrations were always above these limits. After subjects stopped smoking cotinine appeared in the urine for longer than nicotine and was still detectable at least 36 hours after the last cigarette had been smoked. When this method was used to verify the smoking histories given by patients attending an infarction clinic it was estimated that 46-53% of previous smokers had actually stopped smoking compared with the 63% who said that they had done so.

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Objective The aim of this study was to compare knowledge and lifestyles in relation to coronary heart disease (CHD) risk factors in a student population within the UK. Design Cross-sectional study. Setting and Participants A questionnaire was distributed to 279 students over four sites on the University of Leeds' main campus. This assessed the knowledge and lifestyles of the students using 55 close-ended multiple choice questions. Main Outcome Measures/Data Interpretation The data were quantitatively analysed using a weighted scoring system. The data were descriptively analysed. Univariate modelling was accomplished with unpaired t-tests. Results A significant difference in lifestyle score was evident between high and low knowledge groups (p<0.05) in the population studied. Furthermore, a significant, weak positive correlation was found between lifestyle and knowledge scores (R¼0.13). Science-based students had a significantly better knowledge of CHD risk factors than arts-based students (p<0.05), without a significant improvement in lifestyle score (p¼0.15). Females (p<0.01) and individuals with a family history of CHD (p<0.05) demonstrated significantly better lifestyles than males and individuals without a history of CHD, respectively, without a significant improvement in knowledge. Conclusion This study confirms that lifestyle is related to CHD risk factor knowledge. It also indicates that various factors constrain behaviour. Social factors including perceived susceptibility, financial concerns, university culture, family history, discrepancies in knowledge and the risk taking nature that is prevalent in young adults may all influence behaviour in this population. Given that the pathogenesis of CHD begins early in life and health behaviour patterns attained during childhood extend into adulthood, this indicates that current trends in the health related behaviour of students is an area for concern. As CHD preventative efforts are predominantly focused on older generations, readdressing health promotion campaigns to include younger generations could disrupt the seemingly inevitable global increase in CHD. Given the role of CHD risk factor knowledge as a prerequisite for the intention of health promoting behaviour, the ongoing education of such information to the public is fundamental. However, it is equally important to address the variety of constraints that inhibit beneficial behavioural changes.