Home Smoking Bans and Urinary NNAL Levels to Measure Tobacco Smoke Exposure in Chinese American Household Pairs

Emiley Chang, Melanie Dove, Anne Saw, Janice Y. Tsoh, Lei-Chun Fung and Elisa K. Tong
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Emiley Chang: Department of Medicine, Harbor-UCLA Medical Center, 1000 W. Carson St, Torrance, CA 90502, USA
Melanie Dove: Department of Public Health Sciences, University of California—Davis, One Shields Ave, Medical Sciences 1-C, Davis, CA 95616, USA
Anne Saw: Department of Psychology, DePaul College of Science and Health, 2219 North Kenmore Ave, Chicago, IL 60614, USA
Janice Y. Tsoh: Department of Psychiatry, University of California—San Francisco, 401 Parnassus Ave, San Francisco, CA 94143, USA
Lei-Chun Fung: Chinatown Public Health Center, San Francisco Department of Public Health, 1490 Mason St, San Francisco, CA 94133, USA
Elisa K. Tong: Department of Medicine, UC Davis Medical Center, 2315 Stockton Blvd, Sacramento, CA 95817, USA

IJERPH, 2021, vol. 18, issue 14, 1-11

Abstract: Home smoking bans can reduce tobacco smoke exposure, but little is known about the impact for Chinese American household pairs. In this study of 202 household pairs with low acculturation, 53.9% reported a home smoking ban, 31.7% had inconsistent reports, and 14.4% reported no ban. With decreasing home smoking ban enforcement, more nonsmokers had tobacco smoke exposure (66.1%–86.2%) as measured by the tobacco-specific nitrosamine biomarker urine NNAL (4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol). Despite reported bans, about one-quarter of nonsmokers still reported tobacco smoke exposure at home (23.6%–30%) within the past 2 months and three-quarters reported outdoor exposure. In adjusted regression analyses of geometric mean NNAL ratios, nonsmokers in households with no ban had over two times higher levels than nonsmokers in households with a ban: adjusted log NNAL ratio = 2.70 (95% CI 1.21, 6.03). Higher smoker NNAL level and nonsmoker English fluency were also significantly associated with nonsmoker NNAL levels. Nonsmoker levels in households with an inconsistent ban were not significantly different compared to those with a ban. Although home smoking bans were generally associated with lower NNAL levels, tobacco smoke exposure in this immigrant population with low English proficiency was higher than that of the general population. From a health equity standpoint, there is a need for broader implementation and enforcement of comprehensive smoke-free policies.

Keywords: tobacco smoke exposure; tobacco-specific nitrosamine; NNAL; biomarker; household pairs; home smoking ban; Chinese American; immigrant health (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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