Exposure and Risk Assessment of Second- and Third-Hand Tobacco Smoke Using Urinary Cotinine Levels in South Korea

Abstract

Exposure to environmental tobacco smoke (ETS) is the reason for approximately 1% of global mortality. ETS exposure can happen either as inhalation of direct cigarette smoke (second-hand smoke) or its associated residue particles (third-hand smoke), especially when living with a smoker in the same family. This study investigated the association between the urinary cotinine levels, as biomarkers of exposure to tobacco smoke, of smokers and those exposed to second-hand and third-hand smoke while living in the same family, through a Korean nationwide survey. Direct assessment of ETS exposure and its lifetime effect on human health is practically difficult. Therefore, this study evaluated the internal estimated daily intake (I-EDI) of nicotine and equivalent smoked cigarette per day (CPD). The carcinogenic and non-carcinogenic inhalation risks of ETS exposure were assessed by considering the calculated equivalent CPD and composition of cigarette smoke of high-selling cigarette brands in South Korea. The results show that there is a statistically significant positive correlation between the cotinine levels of smokers and those of the non-smokers living in the same family. The risk assessment results yielded that hazard index (HI) and total excess lifetime cancer risk (ECR) for both second-hand and third-hand smoke exposure can exceed 1 and 1 × 10−6, respectively, especially in women and children. In the composition of the cigarette smoke, 1,3-butadiene and acrolein substances had the highest contribution to HI and ECR. Consequently, the provision of appropriate plans for smoking cessation as a strategy for the prevention of ETS exposure to women and children is deemed necessary.

Association between the Urine Cotinine Level and Blood Pressure in Korean Adults with Secondhand Smoke Exposure: Korea National Health and Nutritional Examination Survey 2016–2018

“…Several studies have shown that corrected urine cotinine levels are a better representation of serum cotinine levels. 10,18) Conversely, in another study, uncorrected values showed a stronger correlation with serum cotinine levels than corrected values. 19) In the present study, cor- In a Western study on secondhand smoke, SBP elevation was associated with increased serum cotinine among those in contact with secondhand smok, 20) and preschool children with smoking parents had significantly higher SBP and DBP.…”

“…From this group, current self-reported non-smokers, verified by measuring urine cotinine levels, who did not use any cigarettes, e-cigarettes, nicotine replacement products, or other types of cigarettes, were included (n=9,328). Urine cotinineverified non-smokers were defined as those with a urine cotinine-tocreatinine ratio ≤100 μg/g [ 10 ]. After excluding participants with missing values, 9,273 participants were included in the final analysis.…”

“…Urine cotinineverified non-smokers were defined as those with a urine cotinine-tocreatinine ratio ≤100 μg/g. 10) After excluding participants with missing values, 9,273 participants were included in the final analysis. After calculating the weighted number of Koreans, the total number of participants in the final analysis was 20,663,797 (Figure 1).…”

“…rected urine cotinine levels were used to distinguish non-smokers from smokers. A previous study examined the urine cotinine cutoff values of smokers and nonsmokers based on data from the 7th KNHANES, which comprised the same population as in the present study 10). Excitation of the sympathetic nerve underlies the effect of nicotine on BP.…”

Association between Fathers’ Use of Heated Tobacco Products and Urinary Cotinine Concentrations in Their Spouses and Children

“…SHS exposure among people living with a combustion cigarette smoker is currently a popular topic [17][18][19]. However, assessments of SHS exposure due to HTP use are scarce.…”