Korean J Fam Pract 2020; 10(5): 378-385  https://doi.org/10.21215/kjfp.2020.10.5.378
Trends in Secondhand Smoking and Urine Cotinine Concentration in Non-Smoking Adults in Korea: The 2008–2011, 2014–2018 Korea National Health and Nutrition Examination Survey
Nuri Kim, Jiwon Ha, Kyunam Kim*, Seonyeong Lee, Jongwoo Kim, Jeongki Paek
Department of Family Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
Kyunam Kim
Tel: +82-2-950-8856, Fax: +82-2-950-4093
E-mail: kimkn@paik.ac.kr
ORCID: https://orcid.org/0000-0002-4289-6816
Received: August 14, 2020; Accepted: September 10, 2020; Published online: October 20, 2020.
© 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.
Background: The risk of secondhand smoke (SHS) is gradually becoming apparent, and as smoking cessation zones are expanding, the exposure to SHS in workplaces, homes, and public places is decreasing. The objective of this study was to evaluate the actual exposure to SHS in nonsmokers.
Methods: This study used data from 2008 to 2011 and 2014 to 2018 from the Korean National Health and Nutrition Examination Survey (KNHANES). The urine cotinine concentration values were compared by the geometric mean according to sex, age group, and rurality for non-smokers aged 19 years or older who were tested for urine cotinine.
Results: The overall trend of urine cotinine concentration in Korean adult non-smokers have shown a decline since 2011. It gradually decreased from 2.82 ng/mL in 2010 to 0.50 ng/mL in 2016 but slightly increased to 0.79 ng/mL in 2018. Both male and female showed this trend. The decline tended to be lower in those aged 60 years and older, with higher urine cotinine concentrations in the recent 3 years in the rural than in urban residents.
Conclusion: The urinary cotinine concentration levels in Korean non-smokers increased from 2008 to 2010, then decreased till 2016, but gradually increased thereafter. This is possibly due to limiting the exposure to SHS through expanding the smoking area. Furthermore, a policy to lower the smoking rate with strict implementation and monitoring of the existing policy will be needed.
Keywords: Secondhand Smoking; Cotinine; Smoke-Free Policy; Trends
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