Korean J Fam Pract. 2016; 6(6): 568-576  https://doi.org/10.21215/kjfp.2016.6.6.568
Trends in Secondhand Smoke Exposure among Nonsmokers in the Korean Population: The 2008-2011 Korean National Health and Nutrition Examination Survey
Do-Kyung Park1, Hyun-Woo Kim2,*, Seok-Hwan Lee1, Jong-Myeng Park1, Se-Hwan Lee1
1Department of Family Medicine, Daegu Medical Center, Daegu; 2Department of Family Medicine, Hana General Hospital, Cheongju, Korea
Hyun-Woo Kim
Tel: +82-43-230-6114, Fax: +82-43-235-5300
E-mail: jamesinfm@gmail.com
Received: May 9, 2016; Revised: July 11, 2016; Accepted: July 27, 2016; Published online: December 20, 2016.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Adverse health effects from secondhand smoke (SHS) exposure have gradually been reported. The objective of this study was to assess the trends in SHS exposure among nonsmokers. This study used data from the Korean National Health and Nutrition Examination Survey (KNHANES) on measurements of urine cotinine concentration as an index of SHS exposure.
Methods: We analyzed data from the 2008-2011 KNHANES to estimate the exposure of nonsmokers to SHS. The subjects were Korean nonsmokers aged ≥10 for whom laboratory data were available. We investigated the trends of the geometric means of the urine cotinine levels of all nonsmokers.
Results: The urine cotinine concentrations by year tended to increase over time. The overall urine cotinine levels in 2008, 2009, 2010, and 2011 were 1.40, 1.66, 2.95, and 2.30 ng/mL, respectively. The subgroup analysis according to sex and age group revealed similar trends in urine cotinine levels.
Conclusion: We found an increasing trend in the exposure to SHS among nonsmokers from 2008 to 2011. Further long-term surveillance of SHS exposure should be performed, and the implementation of national policies should be strengthened. In addition, voluntary compliance of smokers to measures to reduce SHS exposure should be encouraged.
Keywords: Secondhand Smoke; Urine Cotinine; Korean National Health and Nutrition Examination Surveys; Trends
References
  1. US Department of Health and Human Services. A report of the surgeon general. The health consequences of involuntary exposure to tobacco smoke. Rockvile: US Department of Health and Human Services; 2006.
  2. Glantz SA, Parmley WW. Passive smoking and heart disease-epidemiolgy, physilolgy, and bilchemistry. Circulation 1991; 83: 1-12.
    CrossRef
  3. Aronow WS. Effect of passive smoking on angina pectoris. N Engl J Med 1978; 299: 21-4.
    Pubmed CrossRef
  4. Berkey CS, Ware JH, Dockery DW, Ferris BG Jr, Speizer FE. Indoor air pollution and pulmonary function growth in prealdolescent child. Am J Epidemiol 1986; 123: 250-60.
    Pubmed
  5. Chen Y, Li WX, Yu SZ, Qian WH. Chang-Ning epidemiological study of children’s health: I: passive smoking and children’s respiratory diseases. Int J Epidemiol 1988; 17: 348-55.
    Pubmed CrossRef
  6. Kraemer MJ, Richardson MA, Weiss NS, Furukawa CT, Shapiro GG, Pierson WE, et al. Risk factors for persistent middle-ear effusions. Otitis media, catarrh, cigarette smoke exposure, and atopy. JAMA 1983; 249: 1022-5.
    Pubmed CrossRef
  7. Gortmaker SL, Walker DK, Jacobs FH, Ruch-Ross H. Parental smoking and the risk of childhood asthma. Am J Public Health 1982; 72: 574-9.
    Pubmed KoreaMed CrossRef
  8. Ministry of Health and Welfare. Law for the promotion of nation’s health enforcement ordinanace article 6 [Internet]. Sejong: Ministry of Health and Welfare; 2014 [cited 2016 Mar 20].
    Available from: http://www.law.go.kr/lsInfoP.do?lsiSeq=149119#AJAX
  9. Korea Centers for Disease Control and Prevention. Health statistics 2014:Korea National Health and Nutrition Examination Survey [Internet]. Cheongju: Korea Centers for Disease Control and Prevention; 2015 [cited 2015 Jun 4].
    Available from: http://www.cdc.go.kr
  10. Haufroid V, Lison D. Urinary cotinine as a tobacco-smoke exposure index: a minireview. Int Arch Occup Environ Health 1998; 71: 162-8.
    Pubmed CrossRef
  11. Benowitz NL, Schultz KE, Haller CA, Wu AH, Dains KM, Jacob P 3rd. Prevalence of smoking assessed biochemically in an urban public hospital: a rationale for routine cotinine screening. Am J Epidemiol 2009; 170: 885-91.
    Pubmed KoreaMed CrossRef
  12. Goniewicz ML, Eisner MD, Lazcano-Ponce E, Zielinska-Danch W, Koszowski B, Sobczak A, et al. Comparison of urine cotinine and the tobaccospecific nitrosamine metabolite 4-(methylnitrosamino)-1-(3-pyridyl)1-butanol (NNAL) and their ratio to discriminate active from passive smoking. Nicotine Tob Res 2011; 13: 202-8.
    Pubmed KoreaMed CrossRef
  13. Farrelly MC, Nonnemaker JM, Chou R, Hyland A, Peterson KK, Bauer UE. Changes in hospitality workers’ exposure to secondhand smoke following the implementation of New York’s smoke-free law. Tob Control 2005; 14:236-41.
    Pubmed KoreaMed CrossRef
  14. Giovino GA, Pederson L, Trosclair A. The prevalence of selected cigarette smoking behaviors by occupational class in the United States [Internet]. Washington (DC): Work, Smoking, and Health, A NIOSH Scientific Workshop;2000:22-31 [cited 2015 Jun 6].
    Available from: https://www.cdc.gov/niosh/docs/2002-148/pdfs/2002-148.pdf
  15. Pirkle JL, Bernert JT, Caudill SP, Sosnoff CS, Pechacek TF. Trends in the exposure of nonsmokers in the U.S. population to secondhand smoke: 19882002. Environ Health Perspect 2006; 114: 853-8.
    Pubmed KoreaMed CrossRef
  16. Chen CI, Burton T, Baker CL, Mastey V, Mannino D. Recent trends in exposure to secondhand smoke in the United States population. BMC Public Health 2010; 10: 359.
    Pubmed KoreaMed CrossRef
  17. Park JH, Lee CK, Kim KH, Son BC, Kim JH, Suh CH, et al. Decrease in the urine cotinine concentrations of Korean non-smokers between 2009 and 2011 following implementation of stricter smoking regulations. Int J Hyg Environ Health 2016; 219: 123-8.
    Pubmed CrossRef
  18. Jain RB. Trends in exposure to second hand smoke at home among children and nonsmoker adolescents. Sci Total Environ 2016; 542: 144-52.
    Pubmed CrossRef
  19. Connor Gorber S, Schofield-Hurwitz S, Hardt J, Levasseur G, Tremblay M. The accuracy of self-reported smoking: a systematic review of the relationship between self-reported and cotinine-assessed smoking status. Nicotine Tob Res 2009; 11: 12-24.
    Pubmed CrossRef
  20. Lee HR, Kim HK, Yoo JS, Kim KN, Lee SY, Yoo SM, et al. Urine cotinine and environmental tobacco exposure in Korean adolescents. Korean J Fam Med 2009; 30: 31-8.
    CrossRef

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