Cross-sectional study of urinary biomarkers of environmental tobacco and e-cigarette exposure and asthma morbidity

Abstract

Exposure to environmental tobacco smoke or e-cigarette exposure (ETS) is common and may have a significant impact on asthma control.1 We leveraged the School Inner-City Asthma Study to establish whether urinary cotinine and total 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) levels (hereafter referred to as tobacco biomarkers), are independently associated with asthma morbidity. Furthermore, we studied the interaction between tobacco biomarkers and asthma morbidity by allergen sensitization, as an effect modifier.