PURPOSE:Exposure to secondhand smoke (SHS) is an important and preventable cause of morbidity and mortality in the US. Pirkle et al. have published two articles on the average secondhand smoke exposure level in nonsmokers using data from the National Health and Nutrition Surveys (NHANES). The most recent study estimated a significant downward trend in exposure between 1988 to 2002. The objective of this study was to assess whether the downward trend has continued in the latest NHANES data available through 2006. This time period is of interest given the magnitude of anti-smoking legislation (e.g., restaurants, other public places) that has been passed in recent years.
METHODS:We analyzed data from the 2001–2006 NHANES, replicating the methodology of Pirkle et al., to estimate exposure of nonsmokers to SHS. The geometric means and 95% confidence intervals of serum cotinine concentrations were calculated for all nonsmokers (age ≥ 4 yrs and serum cotinine ≤; 10 ng/mL) and each age, gender, and race/ethnicity subgroup. All analyses were performed using SUDAAN (Research Triangle Institute, Research Triangle Park, NC).
RESULTS:The results are depicted in the table. By comparison, the overall mean serum cotinine level reported by Pirkle et al. was 0.25 ng/mL for 1988–1991, 0.18 for 1992–1994, and 0.11 for 1999–2000.
CONCLUSION:The long-term trend of declining exposure to secondhand smoke among nonsmokers appears to have leveled off. However, the disparities noted in Pirkle’s 1996 article persist today, with the young, Non-Hispanic Blacks, and males experiencing higher levels of exposure. More work needs to done to eliminate disparities and resume the decline in exposure to secondhand smoke.
CLINICAL IMPLICATIONS:Exposure of nonsmokers to secondhand smoke, although reduced in recent years, remains important in the US, particularly among children and the black population.
DISCLOSURE:David Mannino, Grant monies (from industry related sources) TM Burton received research support from Pfizer Inc. to conduct this analysis. DM Mannino receives grant monies from Pfizer Inc., GlaxoSmithKline, and Novartis.; Employee CL Baker, C Chen, and V Mastey are all employees of Pfizer Inc.; Fiduciary position (of any organization, association, society, etc, other than ACCP DM Mannino: Board of Directors - COPD Foundation, USCOPD Coalition.; Consultant fee, speaker bureau, advisory committee, etc. DM Mannino: Pfizer, GlaxoSmithKline, Boehringer-Ingelheim, Astra-Zeneca, Novartis, Sepracor, Dey; No Product/Research Disclosure Information