Association between Secondhand Smoke Exposure and Hypertension in 106,268 Korean Self-Reported Never-Smokers Verified by Cotinine.

Kim Kim,Kang Kang,Seo Seo,Sung Sung

doi:10.3390/jcm8081238

Abstract

No study has reported the relationship between secondhand smoke (SHS) exposure and hypertension in self-reported never-smokers verified by nicotine metabolite. The aim of this study is to determine the relationship between SHS exposure and hypertension in self-reported and cotinine-verified never-smokers. A total of 106,268 self-reported never-smokers, verified as nonsmokers by urinary cotinine, who participated in Kangbuk Samsung Cohort study (KSCS) between 2012 and 2016 were included. Cotinine-verified nonsmokers were defined as individuals having urinary cotinine <50 ng/mL. SHS exposure was defined as current exposure to passive smoke indoors at home or the workplace. The multivariate regression model revealed that SHS exposure was associated with hypertension (odds ratio (OR) (95% confidence interval (CI)), 1.16 (1.08, 1.24)). Current SHS exposure that has been exposed to home SHS (1.22 (1.11, 1.33)) as well as current SHS exposure only at the workplace (1.15 (1.02, 1.29)) significantly increased the ORs for hypertension compared to no SHS exposure. There was no significant gender interaction for the relationships between SHS exposure and hypertension. This study showed that SHS exposure was significantly associated with hypertension in self-reported never-smokers verified as nonsmokers by urinary cotinine, suggesting necessity of health program and stricter smoking regulation to reduce the risk of hypertension.

Highlights

Minimizing secondhand smoke (SHS) exposure has been a public health target globally
Because information on cigarette smoking is based on self-reported smoking questionnaires, actual smoking status could not be exactly assessed; respondents overreport never smoking because smoking is considered a socially undesirable behavior
This study showed that SHS exposure in self-reported never-smokers verified by urinary cotinine was significantly associated with prevalence of hypertension

Summary

Introduction

Minimizing secondhand smoke (SHS) exposure has been a public health target globally. The prevalence of SHS exposure in Korea is decreasing with extension of the range of smoke-free public facilities since 2012, the prevalence is not yet low. The Korean National Health and Nutrition Examination Survey (KNHANES) VII-1 reported that the prevalence of SHS exposure indoors at home or at the workplace was 27.5% for male never-smokers and 20.0% for female never-smokers [1]. Because information on cigarette smoking is based on self-reported smoking questionnaires, actual smoking status could not be exactly assessed; respondents overreport never smoking because smoking is considered a socially undesirable behavior. Cotinine has been used as a biomarker for the validation of self-reported smoking status. A previous study demonstrated that self-reported SHS significantly underestimated the actual SHS as determined by cotinine verification [2]

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