Characterization of urinary cotinine concentrations among non-smoking adults in smoking and smoke-free homes in the Korean national environmental health survey (KoNEHS) cycle 3 (2015\u20132017)

Jeonghoon Kim,Jungmin Ryu,Hyen-Mi Chung,Soo Ran Won,In-Keun Shim,Jongchun Lee

doi:10.1186/s12889-021-11265-y

Abstract

BackgroundAlthough many indoor public places have implemented smoke-free regulations, private homes have remained sources of tobacco smoke pollutants. This study examined differences in urinary cotinine concentrations in the Korean non-smoking adult population between living in smoking and smoke-free homes, and the relationship of urinary cotinine concentrations with socio-demographic factors in smoke-free homes.MethodsSamples from 2575 non-smoking adults (≥19 years old) in the Korean National Environmental Health Survey cycle 3 (2015–2017), a representative Korean study, were used. Smoking and smoke-free homes were defined based on whether there were smokers at homes. Weighted linear regression models were used to determine urinary cotinine concentrations and identify factors associated with urinary cotinine.ResultsThe geometric mean of urinary cotinine concentrations for non-smoking adults living in smoking homes was 2.1 μg/L (95% confidence interval [CI] = 1.8–2.4), which was significantly higher than the mean of 1.3 μg/L (95% CI = 1.2–1.4) for those living in smoke-free homes. Urinary cotinine concentrations were different significantly by home smoking status in most socio-demographic subgroups. Data from smoke-free home showed urinary cotinine concentration in adults was significantly higher in those who lived in homes with ventilation duration < 30 min/day, those who spent more time indoors at home, those who spent less time outdoors, and those who worked in non-manual or manual occupations.ConclusionsThe urinary cotinine concentration in Korean non-smoking adults living in smoking homes was higher than that in adults living in smoke-free homes. Even in smoke-free homes, home-related factors, such as ventilation duration and time spent indoors, were associated with urinary cotinine concentration. Further study is warranted to examine potential sources of tobacco smoke pollution in smoke-free homes.

Highlights

Many indoor public places have implemented smoke-free regulations, private homes have remained sources of tobacco smoke pollutants
The type of housing, ventilation duration at home, time spent at residential indoors, and time spent outdoors were not associated with living in a smoking or smoke-free home
The overall Geometric mean (GM) of the urinary cotinine concentrations of 2575 non-smoking adults was 1.5 μg/L

Summary

Introduction

Many indoor public places have implemented smoke-free regulations, private homes have remained sources of tobacco smoke pollutants. Secondhand smoke (SHS) exposure is causally associated with coronary heart disease, stroke, nasal irritation, and lung cancer in adults, and low birth weight [1]. SHS exposure can cause sudden infant death syndrome, middle-ear disease, respiratory infections, and lower respiratory illness in children [2]. In 2006, there were 42,000 SHS-attributable deaths in America, comprising more than 41,000 adult and 900 infant deaths [3]. 1% of deaths and 0.7% of disease burden in disability-adjusted life year was attributable to SHS exposure in 2004 [4]. To reduce SHS exposure, many countries have implemented smoke-free regulations in indoor public places or workplaces. Since January 1, 2015 [5] hospitality venues of all sizes implemented smoke-free regulations

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