Geometric Mean Serum Cotinine Concentrations Confirm a Continued Decline in Secondhand Smoke Exposure among U.S. Nonsmokers—NHANES 2003 to 2018

Kevin T. Caron, Wanzhe Zhu, John T. Bernert, Lanqing Wang, Benjamin C. Blount, Kristin Dortch, Ronald E. Hunter, Tia Harmon, J. Ricky Akins, James Tsai, David M. Homa, James L. Pirkle and Connie S. Sosnoff
Additional contact information
Kevin T. Caron: Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
Wanzhe Zhu: Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
John T. Bernert: Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
Lanqing Wang: Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
Benjamin C. Blount: Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
Kristin Dortch: Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
Ronald E. Hunter: Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
Tia Harmon: Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
J. Ricky Akins: Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
James Tsai: Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
David M. Homa: Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
James L. Pirkle: Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
Connie S. Sosnoff: Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA

IJERPH, 2022, vol. 19, issue 10, 1-16

Abstract: The objective of this study was to examine long-term trends in serum cotinine (COT) concentrations, as a measure of secondhand smoke (SHS) exposure, in U.S. nonsmokers using data from the National Health and Nutrition Examination Surveys (NHANES) from 2003 to 2018. We analyzed NHANES serum COT results from 8 continuous NHANES 2 year cycles from 2003 to 2018 using a liquid chromatography–tandem mass spectrometry assay that has been maintained continuously at the Centers for Disease Control and Prevention (CDC) since 1992. Serum COT concentrations (based on the geometric means) among nonsmokers in the U.S. decreased by an average of 11.0% (95% confidence interval (CI) [8.8%, 13.1%]; p < 0.0001) every 2 year cycle. From 2003 to 2018, serum COT concentrations in U.S. nonsmokers declined by 55.0%, from 0.065 ng/mL in 2003–2004 to 0.029 ng/mL in 2017–2018 ( p < 0.0001). Significant decreases in serum COT concentrations were observed in all demographic groups. While disparities between these groups seems to be shrinking over time, several previously observed disparities in SHS exposure remain in 2017–2018. Serum COT concentrations of the non-Hispanic Black population remained higher than those of non-Hispanic Whites and Mexican Americans ( p < 0.0001). Additionally, serum COT concentrations were significantly higher for children aged 3–5 years than other age groups ( p ≤ 0.0002), and men continued to have significantly higher serum COT concentrations than women ( p = 0.0384). While there is no safe level of exposure to SHS, the decrease in serum COT concentrations in the U.S. population as well as across demographic groupings represents a positive public health outcome and supports the importance of comprehensive smoke-free laws and policies for workplaces, public places, homes, and vehicles to protect nonsmokers from SHS exposure.

Keywords: secondhand smoke; biomarker; serum cotinine; tobacco exposure; NHANES; nicotine (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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