Self-reported Secondhand Smoke Research Articles

Tobacco use among prison staff in Germany: a cross-sectional study.

Studies on tobacco in the prison environment report high prevalence of use among detainees, but little data regarding staff are available. An observational study addressing tobacco control in German prisons was conducted in 2011. It involved multiple strands (quantitative and qualitative components) both among detainees and staff. This article presents quantitative results regarding staff. Cross-sectional study among prison employees in 16 different institutions in nine regions (Länder) in Germany. Tobacco use and second-hand smoke (SHS) exposure (primary outcomes) were assessed by a questionnaire designed specifically. Logistic regression models were used to assess the risk factors associated with each outcome. Among 704 participants (60.6% male, mean age 43.9 years ± 9.33), 27.7% are smokers and 68% declared to be exposed to SHS. Independent factors associated with smoking were female gender [odds ratio (OR) 1.49,P= 0.026], an age below 45 years (OR 1.35,P= 0.08) and working in areas other than administration (ORP= 0.08). An age below 45 was associated with a higher degree of self-reported SHS exposure. The association between SHS and gender was different depending on occupational area with significantly more men exposed to SHS in administrative area and more women in health/social area (interaction between gender and occupational area,P= 0.02). Importance of SHS exposure among prison employees and confirm the need for a comprehensive tobacco control policy including support to smoking cessation and better enforcement of the smoke-free regulation, especially where staff contributes to SHS. Particular attention has to be given to female employees.

Risk of all-cause mortality and cardiovascular disease associated with secondhand smoke exposure: A systematic review and meta-analysis

BackgroundEmerging studies have assessed the association between secondhand smoke (SHS) exposure and cardiovascular disease (CVD) as well as all-cause mortality. However, findings were not consistent due to the heterogeneity of study characteristics. MethodsPubMed and Embase were searched through May 2014 for prospective cohort and case–control studies investigating the associations of SHS exposure in never smokers with all-cause mortality and the risk of CVD. The main analysis was performed in studies using self-reported SHS exposure and secondary analysis was performed in studies using objectively measured SHS exposure. Summary estimates were calculated using random-effects models. ResultsTwenty-three prospective and 17 case–control studies were included. The pooled relative risks (RR) for never smokers exposed to SHS in comparison with those unexposed were 1.18 [95% confidence interval (CI): 1.10–1.27] for all-cause mortality (12 studies), and 1.23 (1.16–1.31) for CVD (38 studies). The association of SHS exposure with CVD was markedly stronger among studies conducted in China (RR=1.65, 95% CI 1.27–2.13) than that in the US (RR=1.09, 95% CI 1.03–1.16). Studies using objectively measured SHS exposure demonstrated a slightly higher risk for CVD compared with those using self-reported SHS exposure. ConclusionsExposure to SHS significantly increased the risk for all-cause mortality and CVD. The risk associated with SHS exposure was large in China while the risk was only modest in the US. Studies using objectively measured SHS exposure may yield a higher risk of CVD than those using self-reported SHS exposure.

Dose–response relations between second-hand smoke exposure and depressive symptoms among middle-aged women

A growing body of evidence indicates a strong association between smoking and depression. However, little is known about the possible effects of second-hand smoke (SHS) exposure on depression. This study aimed to examine the potential dose–response relation between SHS exposure and depressive symptoms among non-smoking middle-aged women. A cross-sectional survey was conducted using a stratified three-stage sampling method. Depressive symptoms were measured by the Center for Epidemiologic Studies Depression Scale with a cut-off point of 16. Self-reported SHS exposure was defined as non-smokers׳ inhalation of the smoke exhaled from smokers on at least one day a week. The multivariable logistic regression analysis was completed with adjustment for potential confounders. Among 1280 middle-aged women, 19.4% were classified as having depressive symptoms. There was a 104% increased odds of depressive symptoms corresponding to SHS exposure in general (OR=2.04, 95% CI 1.48–2.79) using no exposure as reference. There were significant positive relations between SHS exposure in general and depressive symptoms in a dose–response manner. These significant trends were observed consistently whether SHS exposure occurred in homes or workplaces. Our findings suggest that long-term and regular SHS exposure is associated with a significant, dose-dependent increase in risk of depressive symptoms.

Clear Skies and Grey Areas: Flight Attendants' Secondhand Smoke Exposure and Attitudes toward Smoke-Free Policy 25 Years since Smoking was Banned on Airplanes.

Our objective was to provide descriptive data on flight attendant secondhand smoke (SHS) exposure in the work environment, and to examine attitudes toward SHS exposure, personal health, and smoke-free policy in the workplace and public places. Flight attendants completed a web-based survey of self-reported SHS exposure and air quality in the work environment. We assessed the frequency and duration of SHS exposure in distinct areas of the workplace, attitudes toward SHS exposure and its health effects, and attitudes toward smoke-free policy in the workplace as well as general public places. A total of 723 flight attendants participated in the survey, and 591 responded to all survey questions. The mean level of exposure per flight attendant over the past month was 249 min. The majority of participants reported being exposed to SHS always/often in outdoor areas of an airport (57.7%). Participants who worked before the in-flight smoking ban (n = 240) were more likely to support further smoking policies in airports compared to participants who were employed after the ban (n = 346) (76.7% versus 60.4%, p-value < 0.01). Flight attendants are still being exposed to SHS in the workplace, sometimes at concerning levels during the non-flight portions of their travel. Flight attendants favor smoke-free policies and want to see further restrictions in airports and public places.

Food Insecure Children's Exposure to Secondhand Smoke Is More Likely to Be Misclassified

Although food insecurity is more prevalent in households with smokers, no studies have examined the misclassification of children's secondhand smoke (SHS) exposure by household food security status. Our population‐based sample included 8453 participants (3‐12y) in the National Health and Nutrition Examination Survey 1999‐2010. Food security status was assessed by the USDA 18‐item Food Security Survey Module. Self‐reported SHS exposure by household reference participants were compared to children's serum cotinine levels. Serum cotinine levels of 蠅0.05 ng/ml were indicative of SHS exposure. Logistic regression models were used to estimate the association between household food security status and misclassification of SHS exposure. Controlling for age, gender, and race/ethnicity, children who were food insecure (Odds Ratio 1.3; 95% CI, 1.1‐1.6) were more likely to have their SHS exposure misclassified, compared to their fully food secure counterparts. The association was attenuated when family income was included in the model. In conclusion, regardless of food security status, household reference participants' reports of SHS exposure among children, especially food insecure children, may be biased.

Comparison of secondhand smoke exposure measures during pregnancy in the development of a clinical prediction model for small-for-gestational-age among non-smoking Chinese pregnant women

ObjectiveTo compare predictive values of small-for-gestational-age (SGA) by different measures for secondhand smoke (SHS) exposure during pregnancy and to develop and validate a prediction model for SGA using SHS exposure...

O025 Exposure to secondhand smoke and risk of peripheral arterial disease in Southern Chinese non-smokers: The Guangzhou Biobank Cohort Study-Cardiovascular Disease Subcohort

Objectives: We studied the association between secondhand smoke (SHS) exposure and peripheral arterial disease (PAD) in Chinese non-smokers. Methods: We conducted a cross-sectional study using baseline data from the Guangzhou Biobank Cohort Study: Cardiovascular Disease Sub-cohort Study (GBCS-CVD). Guangzhou residents aged ≥ 50 years were recruited between 2003 and 2008. Baseline data included measurement of ankle brachial pressure index (ABPI) and self-reported smoking status and SHS exposure. Univariate and multivariate logistic regression analyses were used to analyze the association between SHS and PAD (defined as ABPI < 0.9). Results: Of the 1507 non-smokers, 24 (1.6%) had PAD. Of these, 12 were men and 12 were women. Exposure to SHS at home of ≥25 h per week was reported by 16.7% of PAD cases compared with 3.8% of those without PAD (χ2 test, p = 0.003). After adjustment for potential confounders, exposure to ≥25 h per week at home was still associated with PAD (adjusted OR 7.86, 95% CI 2.00–30.95, p = 0.003), with suggestion of a dose-response relationship. Conclusions: Our results extend the US Surgeon General’s 2006 report that SHS exposure is an independent risk factor for PAD. National smoke-free legislation is needed to protect all people from exposure.

Evaluation of a Smoke-Free Law on Indoor Air Quality and on Workers’ Health in Portuguese Restaurants

Workplace bans on smoking are interventions to reduce exposure to secondhand smoke (SHS) to try to prevent harmful health effects. The Portuguese Government on January 1, 2008, introduced the first national law banning smoking in public workplaces, including restaurants. The main aim of this study was to examine the impact of this law on indoor air quality (IAQ) in restaurants and on the respiratory and sensory health of restaurant workers. Concentrations of respirable suspended particulate matter (RSP), total volatile organic compounds (TVOC), carbon monoxide (CO), and carbon dioxide (CO2) in 10 restaurants were measured and compared before and after the ban. Benzene (C6H6) concentrations were also measured in all restaurants. Fifty-two and twenty-eight restaurant workers, respectively, answered questionnaires on exposure to SHS, and respiratory and sensory symptoms in the pre- and post-ban phases. There was a statistically significant decrease in RSP, CO, TVOC, and C6H6 concentrations after the ban. Additionally, in both phases the monitored CO2 concentrations greatly exceeded 1800 mg.m−3, suggesting inefficient ventilation of the indoor spaces. Between pre- and post-ban phases a significant reduction in self-reported workplace SHS exposure was also observed after the enforcement of the law, as well as a significant marked reduction in dry, itching, irritated, or watery eyes, nasal problems, sore or dry throat, cough, wheeze, and headache. This study provides, in a single investigation, comparison of IAQ and respiratory health in Portugal before and after the introduction of the smoke-free law, the first data reported in the literature to our knowledge. Our findings suggest that a total workplace smoking ban results in a significant reduction in indoor air pollution and an improvement in the respiratory health of restaurant workers. These observations may have implications for policymakers and legislators currently considering the nature and extent of their smoke-free workplace legislation and could provide a useful contribution to the implementation of public health prevention programs.

Second-hand smoke exposure in different types of venues: before and after the implementation of smoke-free legislation in Guangzhou, China

ObjectivesSmoke-free legislation was implemented in Guangzhou on 1 September 2010. However, the smoke-free policy did not cover all indoor areas and smoking rooms can be set in some public places....

Influence of CYP2A6*4 Genotypes on Maternal Serum Cotinine Among Chinese Nonsmoking Pregnant Women

Serum cotinine is a common biomarker for smoking and secondhand smoke (SHS) exposure, but it can be affected by the activity of nicotine-metabolizing enzymes. This study investigated the influence of CYP2A6*4 genotypes on serum cotinine among nonsmoking pregnant women. We analyzed the data from 545 Chinese nonsmoking pregnant women in a case-control study on SHS exposure and birth outcomes in southern China. Participants self-reported their status and duration of SHS exposure during pregnancy right after delivery in hospital. Research staff used polymerase chain reaction to genotype CYP2A6*4 and enzyme-linked immunosorbent assay to measure cotinine levels in maternal serum samples collected before delivery. We stratified women by their self-reported SHS exposure status and CYP2A6*4 genotypes and then compared their median levels of serum cotinine. Among women who self-reported non-SHS exposure (n = 317), the median serum cotinine levels were 2.83ng/ml for those with CYP2A6*1/*1 genotype, 1.39ng/ml for CYP2A6*1/*4, and 0.77ng/ml for CYP2A6*4/*4, respectively. Among women who self-reported SHS exposure (n = 228), the median cotinine levels were 3.32ng/ml for those with CYP2A6*1/*1 genotype, 2.38ng/ml for CYP2A6*1/*4, and 1.56ng/ml for CYP2A6*4/*4, respectively. Strikingly, self-reported SHS-exposed women with CYP2A6*1/*4 or CYP2A6*4/*4 genotype had significantly lower (rather than higher) median cotinine levels than self-reported non-SHS-exposed women with CYP2A6*1/*1 genotype (p = .012). CYP2A6*4 genotype is associated with lower serum cotinine among Chinese nonsmoking pregnant women. Measuring CYP2A6*4 genotype may help to improve the validity of SHS exposure measurement by serum cotinine in pregnant women and possibly also in other nonpregnant populations.

Secondhand smoke exposure in preterm infants with bronchopulmonary dysplasia

Preterm infants and children with bronchopulmonary dysplasia (BPD) often experience significant respiratory morbidities during the first two years of life. Second hand smoke (SHS) has been demonstrated to lead to respiratory morbidities in the general population. The objectives of this study were to assess the prevalence/impact of SHS on preterm infants and children with BPD. Subjects (n = 352) were recruited from the Johns Hopkins BPD outpatient clinic between January 2008 and August 2012. Second hand smoke exposure and respiratory morbidities were assessed through questionnaires and chart review. Twenty-eight percent of preterm infants with BPD were exposed to SHS in the home setting, despite having significant lung disease. SHS was associated with multiple measures of socio-economic status, including lower household income (P < 0.001), lower caregiver education level (P = 0.013), and having public versus private insurance (P = 0.002). We found no difference in acute care use or chronic symptoms with SHS exposure. We observed trends that preterm infants who were exposed to SHS were more likely to be prescribed inhaled corticosteroids (P = 0.054) and were weaned off of supplemental oxygen over 2 months later (P = 0.13) than infants not exposed to SHS. SHS exposure in preterm infants with BPD is common, even in those receiving supplemental oxygen and respiratory medications. Although there were no associations between respiratory outcomes and self-reported SHS exposure, trends toward increased use of inhaled steroids and a longer duration of supplemental oxygen use were noted. Further work is needed to determine more accurate means of assessing SHS risk in this vulnerable population.

Serum Cotinine Levels and Prehypertension in Never Smokers

Background. Few studies have shown that self-reported secondhand smoke exposure in never smokers is associated with high blood pressure. However, there are no studies investigating the relationship between secondhand smoke exposure, measured objectively by serum cotinine levels, and high blood pressure in never smokers. Methods. We examined never smokers (n = 2027) from the National Health and Nutrition Examination Survey 2005–2008. Our exposure of interest was the secondhand smoke exposure estimated by serum cotinine level and our outcome was prehypertension (n = 734), defined as a systolic blood pressure of 120–139 mmHg or diastolic blood pressure of 80–89 mmHg. Results. We found that, in never smokers, serum cotinine levels were positively associated with prehypertension. Compared to those with cotinine levels in the lowest quartile (≤0.024 ng/mL), the multivariable odds ratio (95% confidence interval) of prehypertension among those with cotinine levels in the highest quartile (≥0.224 ng/mL) was 1.45(1.00, 2.11); P trend = 0.0451. In subsequent subgroup analyses, the positive association was found to be stronger among men, non-Whites, and non-obese subjects. Conclusion. Higher secondhand smoke exposure measured objectively by serum cotinine levels was found to be associated with prehypertension in certain subgroups of a representative sample of the US population.

National and State Estimates of Secondhand Smoke Infiltration Among U.S. Multiunit Housing Residents

Multiunit housing (MUH) residents are susceptible to secondhand smoke (SHS), which can infiltrate smoke-free living units from nearby units and shared areas where smoking is permitted. This study assessed the prevalence and characteristics of MUH residency in the United States, and the extent of SHS infiltration in this environment at both the national and state levels. National and state estimates of MUH residency were obtained from the 2009 American Community Survey. Assessed MUH residency characteristics included sex, age, race/ethnicity, and poverty status. Estimates of smoke-free home rule prevalence were obtained from the 2006-2007 Tobacco Use Supplement to the Current Population Survey. The number of MUH residents who have experienced SHS infiltration was determined by multiplying the estimated number of MUH residents with smoke-free homes by the range of self-reported SHS infiltration (44%-46.2%) from peer-reviewed studies of MUH residents. One-quarter of U.S. residents (25.8%, 79.2 million) live in MUH (state range: 10.1% in West Virginia to 51.7% in New York). Nationally, 47.6% of MUH residents are male, 53.3% are aged 25-64 years, 48.0% are non-Hispanic White, and 24.4% live below the poverty level. Among MUH residents with smoke-free home rules (62.7 million), an estimated 27.6-28.9 million have experienced SHS infiltration (state range: 26,000-27,000 in Wyoming to 4.6-4.9 million in California). A considerable number of Americans reside in MUH and many of these individuals experience SHS infiltration in their homes. Prohibiting smoking in MUH would help protect MUH residents from involuntary SHS exposure.

Prenatal Secondhand Smoke Exposure and Infant Birth Weight in China

Epidemiologic evidence provides some support for a causal association between maternal secondhand smoke (SHS) exposure during pregnancy and reduction in infant birth weight. The purpose of this cross-sectional study is to examine the magnitude of this association in China, where both prevalence and dose of SHS exposure are thought to be higher than in U.S. populations. Women who gave birth in Beijing and Changchun September 2000–November 2001 were interviewed to quantify self-reported prenatal SHS exposure. Their medical records were reviewed for data on pregnancy complications and birth outcomes. Non-smoking women who delivered term babies (≥37 weeks gestation) were included in the study (N = 2,770). Nearly a quarter of the women (24%) reported daily SHS exposure, 47% reported no prenatal exposure, and 75% denied any SHS exposure from the husband smoking at home. Overall, no deficit in mean birth weight was observed with exposure from all sources of SHS combined (+11 grams, 95% CI: +2, +21). Infants had higher mean birth weights among the exposed than the unexposed for all measures of SHS exposure. Future studies on SHS exposure and infant birth weight in China should emphasize more objective measures of exposure to quantify and account for any exposure misclassification.

Eliminating second-hand smoke from Mexican-American households: Outcomes from Project Clean Air–Safe Air (CASA)

Exposure to second-hand smoke (SHS) is a major public health problem and a risk factor for morbidity and mortality. The objective of this randomized trial was to estimate the impact of a culturally-sensitive intervention to reduce SHS exposure in Mexican-American households. MethodA total of 91 households (with a child under 18years of age and two adults, one of whom was a smoker) were recruited from a population-based cohort of Mexican-American households and randomized to receive the experimental intervention (EI; n=47) or standard care (SC; n=44). Of these, 74 households (83%) provided baseline, 6-month, and 12-month survey and nicotine monitor data (EI, n=39; SC, n=35). The EI materials, designed to increase the participants' likelihood of adopting a smoke-free indoor home air policy, included one culturally-appropriate bilingual comic book for children and two fotonovelas for adults. ResultsAmbient nicotine levels significantly decreased over the 12 study months (F=13.6, DF=147; p<0.001); with a significantly greater decrease in the EI households compared to the SC households (F=4.1, DF=72; p<0.05). At 12months, 73% of EI households had banned smoking vs. 56% of SC households. Ambient nicotine levels, measured using nicotine air sampling monitors, were significantly associated with self-reported SHS exposure at the 12-month follow-up. Knowledge of the health effects of SHS increased from baseline to 6 and 12months in the EI condition but not in the SC condition (F=6.0, DF=238; p<0.01), and smokers and quitters in the EI group reported an increased perception of health vulnerability compared to those in the SC group. ConclusionOur low-cost intervention impacted SHS-related knowledge and exposure among Mexican Americans. This culturally-appropriate intervention has the potential to decrease SHS-related health problems in the target population substantially.

Secondhand smoke exposure and osteoporosis in never-smoking postmenopausal women: the Fourth Korea National Health and Nutrition Examination Survey

The association between secondhand smoke (SHS) exposure and lumbar and femoral neck osteoporosis was assessed in postmenopausal never-smoking Korean women. The presence of family members who actively smoked was associated with femoral neck osteoporosis. The number of cigarettes consumed by cohabitant smokers was positively associated with lumbar and femoral neck osteoporosis. This study aimed to assess the association between SHS and postmenopausal osteoporosis. Of 2,067 postmenopausal women (age, ≥55 years) participating in the Fourth Korea National Health and Nutrition Examination Survey, 925 never-smokers identified through interviews and urinary cotinine level verification were enrolled. Cross-sectional relationships between self-reported SHS exposure and osteoporosis of the lumbar vertebrae and femoral neck (defined using the World Health Organization T-score criteria) were investigated by bone densitometry. Participants having actively smoking family members showed increased adjusted odds ratio (aOR) for femoral neck osteoporosis compared with participants not exposed to SHS (aOR, 3.68; 95 % confidence interval [CI], 1.23-10.92). Participants whose cohabitant smokers consumed any number of cigarettes per day showed increased occurrences for lumbar and femoral neck osteoporosis compared with the nonexposed group. Participants whose cohabitant smokers consumed ≥20 cigarettes/day showed increased aORs for lumbar (aOR, 5.40; 95 % CI, 1.04-28.04) and femoral neck (aOR, 4.35; 95 % CI, 1.07-17.68) osteoporosis compared with participants not exposed to SHS. In postmenopausal never-smoking Korean women, exposure to SHS was positively associated with osteoporosis. This finding further emphasizes a need to identify vulnerable groups exposed to SHS to increase bone health.

Exposure to Secondhand Smoke at Home and at Work in California

We estimated self-reported secondhand smoke (SHS) exposure in California at home and at work. We used data from the 2005 and 2007 California Health Interview Surveys (n=109,809) for home exposure analysis, and we used data from the 2002 and 2005 California Tobacco Surveys (n=12,883) for workplace exposure analysis. Differences in exposure by age, race/ethnicity, and socioeconomic characteristics were assessed using Chi-square tests and multivariate logistic regression analyses. In the home, children had the lowest rates of SHS exposure (3.4%), followed by adolescents (4.7%) and adults (6.0%). For all age groups, Hispanic people had the lowest exposure to SHS at home, and black people of all ages had higher exposure rates than white people. In the workplace, 12.9% of Californians were exposed to SHS. Men had higher rates of exposure than women, and rates declined with age. Hispanic people had the highest rates of SHS exposure at work (19.5%), followed by Asian/Pacific Islanders (10.5%), black people (10.4%), and white people (9.7%). Workplace exposure rates were highest for people who worked in stores or warehouses, followed by plants or factories, restaurants or bars, and vehicles. Despite many years of tough tobacco-control policies in California, people continue to be exposed to SHS at home and in the workplace. The policies that are already in place, such as smoke-free workplace laws, need to be fully enforced. Interventions for reducing SHS exposure should be targeted to the groups with the greatest exposure rates, including Hispanic people, black people, young adults, and those who work in high-exposure settings.

Second-hand smoke exposure and mitigation strategies among home visitation workers

ObjectivesProtection of workers from second-hand smoke (SHS) in occupational settings is an important policy priority, yet little attention has been given to SHS protection for home visitation health workers, who...

A survey of schoolchildren's exposure to secondhand smoke in Malaysia.

BackgroundThere is a lack of data describing the exposure of Malaysian schoolchildren to Secondhand Smoke (SHS). The aim of this study is to identify factors influencing schoolchildren's exposures to SHS in Malaysia.MethodThis cross-sectional study was carried out to measure salivary cotinine concentrations among 1064 schoolchildren (10-11 years) attending 24 schools in Malaysia following recent partial smoke-free restrictions. Parents completed questionnaires and schoolchildren provided saliva samples for cotinine assay.ResultsThe geometric mean (GM) salivary cotinine concentrations for 947 non-smoking schoolchildren stratified by household residents' smoking behaviour were: for children living with non-smoking parents 0.32 ng/ml (95% CI 0.28-0.37) (n = 446); for children living with a smoker father 0.65 ng/ml (95% CI 0.57-0.72) (n = 432); for children living with two smoking parents 1.12 ng/ml (95% CI 0.29-4.40) (n = 3); for children who live with an extended family member who smokes 0.62 ng/ml (95% CI 0.42-0.89) (n = 33) and for children living with two smokers (father and extended family member) 0.71 ng/ml (95% CI 0.40-0.97) (n = 44). Parental-reported SHS exposures showed poor agreement with children's self-reported SHS exposures. Multiple linear regression demonstrated that cotinine levels were positively associated with living with one or more smokers, urban residence, occupation of father (Armed forces), parental-reported exposure to SHS and education of the father (Diploma/Technical certificate).ConclusionsThis is the first study to characterise exposures to SHS using salivary cotinine concentrations among schoolchildren in Malaysia and also the first study documenting SHS exposure using salivary cotinine as a biomarker in a South-East Asian population of schoolchildren. Compared to other populations of similarly aged schoolchildren, Malaysian children have higher salivary cotinine concentrations. The partial nature of smoke-free restrictions in Malaysia is likely to contribute to these findings. Enforcement of existing legislation to reduce exposure in public place settings and interventions to reduce exposure at home, especially to implement effective home smoking restriction practices are required.

Secondhand Smoke Exposure and Coronary Artery Calcification among Nonsmoking Participants of a Population-Based Cohort

Background: Secondhand smoke (SHS) consists of fine particulate matter, carcinogens, and various toxins that affect large parts of the population. SHS increases the risk for acute cardiovascular events and may contribute to the development of atherosclerosis.Objectives: We investigated the association of SHS with coronary artery calcification (CAC).Methods: In this cross-sectional analysis, we used baseline data (2000–2003) from 1,766 never-smokers without clinically manifested coronary heart disease, 45–75 years of age, from the Heinz Nixdorf Recall Study, an ongoing, prospective, population-based cohort study in Germany. Self-reported frequent SHS at home, at work, and in other places was assessed by questionnaire. CAC scores were derived based on electron-beam computed tomography. We conducted multiple linear regression analysis using exposure to SHS as the explanatory variable and ln(CAC+1) as the response variable. We conducted logistic regression to estimate the odds ratio (OR) for presence of any CAC.Results: Frequent exposure to SHS was reported by 21.5% of participants. After adjustment for age, sex, and socioeconomic status, CAC + 1 was 21.1% [95% confidence interval (CI): –5.5%, 55.2%] higher in exposed than in unexposed participants. After adjusting for other cardiovascular risk factors, the association was attenuated (15.4%; 95% CI: –9.6%, 47.2%). SHS exposure was also associated with a CAC score > 0 (fully adjusted OR = 1.38; 95% CI: 1.03, 1.84).Conclusions: Self-reported frequent exposure to SHS was associated with subclinical coronary atherosclerosis in our cross-sectional study population. Considering the widespread exposure and the clinical relevance of coronary atherosclerosis, this result, if confirmed, is of public health importance.