TOBACCO CONTROL LAWS AND SERUM COTININE LEVELS IN NONSMOKING ADULTS, 1999-2000

Abstract

ISEE-6 Introduction: State and local bans or restrictions on indoor smoking are implemented to reduce exposure to environmental tobacco smoke (ETS), a known human carcinogen. Cotinine, a major metabolite of nicotine, is a biomarker of exposure to ETS in nonsmokers. Data from the National Health and Nutrition Examination Survey (NHANES) show that median cotinine levels in nonsmokers have declined by 70% since the late 1980’s. The objective of this study is to determine the relationship between State or local ordinances on indoor smoking and cotinine levels in the nonsmoking adult population, taking into account racial and ethnic differences. Methods: NHANES is a cross-sectional survey designed to monitor the health and nutritional status of the US population. Household interviews, physical examinations, and cotinine level assessments were performed on 4039 adults (83% response rate), of whom 3003 were non smokers. For each of 26 study locations, laws regulating indoor smoking (in enclosed public spaces, workplaces, restaurants, and bars) were categorized into one of three groups indicating minimal, moderate, or extensive regulations. The proportion of non-smoking adults with detectable levels of serum cotinine were compared across these three groups. Results: Approximately 49% of nonsmoking adults had detectable levels of cotinine. Non-Hispanic blacks had a higher proportion of detectable levels (69%) than did non-Hispanic whites (47%) and Mexican-Americans (44%). For Mexican Americans and non-Hispanic whites, persons living in areas with extensive smoking regulations had a significantly smaller proportion with detectable cotinine levels (29%) than persons living in areas with moderate (52%) and minimal (50%) smoking regulations. The difference between the moderate and minimal groups was not statistically significant. For non-Hispanic blacks, there was no difference in the proportion with detectable levels across the three smoking regulation categories. Discussion: These preliminary results suggest that at least for non-Hispanic white and Mexican American adults, those living in areas with extensive tobacco control laws have less ETS exposure compared to those living in areas with minimal or moderate smoking regulations. Multivariate analyses including covariates (age, gender, workplace smoke exposure, and cigarette smoke exposure in the home) will be conducted to further examine the relationship between tobacco control laws and ETS exposure and the lack of variability in cotinine levels by tobacco control laws among non-Hispanic blacks.