Background: Cigarette smoking, including secondhand exposure, is a leading cause of several atherosclerotic diseases (AS). Non-high-density lipoprotein cholesterol (non-HDL-C) is considered as a valuable predictor for dyslipidemia and AS. There is a need to identify the association of tobacco smoke exposure (TSE) and the marker of sub-clinical AS.Objective: To examine the association of TSE, including exposed status, cigarette smoking intensity and burden with serum non-HDL-C level.Methods: A cross-sectional study was carried out on 18-79 years old residents in 2017 in Beijing. All participants were interviewed on their tobacco exposed status (unexposed, passively exposed, actively exposed), smoking intensity (number of cigarettes smoked per week) and smoking burden (pack-years of smoking) among current smokers. Non-HDL-C was calculated by subtracting high density lipoprotein cholesterol (HDL-C) from total cholesterol (TC). Covariates were age, education status, alcohol drinking status within 30 days, hypertension, type 2 diabetes, physical inactivity and BMI. We plot graphs to show the tendency between the number of cigarettes smoked per week, passively exposed days per week and non-HDL-C levels, respectively. Multiple regression models were used to assess the association between non-HDL-C level and TSE after the adjustment for covariates. Results: Of the 12,798 participants, mean age was 44.9±15.4 years, 46.8% were male. The prevalence of actively exposed, passively exposed and unexposed to tobacco smoke was 25.7%, 35.7% and 38.6%, respectively. Of the tobacco passively exposed subjects, 21.7% had to exposed to second-hand smoke every day. Among current smokers, 41.2% were smoking more than 120 cigarettes per week, and 56.6% were smoking more over 20 pack-years. With the increasing of the number of cigarettes smoked per week, the serum level of non-HDL-C in male increased gradually (Male: F=2.83, P=0.04; Female: F=1.23, P=0.32; Total: F=3.29, P=0.02). After multivariable adjustment, smokers had a higher non-HDL-C level (OR=1.34, 95%CI: 1.20,1.59, P=0.001) compared with tobacco unexposed subjects. However, passively smokers were not associated with non-HDL-C levels regardless of gender (OR=0.98, 95%CI: 0.78,1.23, P=0.87). Compared with lighter smokers, male smokers who smoked more than 140 cigarettes per week had significantly higher non-HDL-C levels (OR=1.30, 95%CI: 1.00,1.70, P=0.04). Male higher burden smokers (>20 pack-years) had more risk of having higher non-HDL-C level (OR=1.88, 95%CI: 1.46,2.43, P<0.001) compared with other smokers. However, there were no significant differences between non-HDL-C and smoking intensity or burden among female smokers.Conclusions: This study showed that strong associations between TSE and non-HDL-C levels, especially in male smokers. Findings of this work emphasize the importance of encouragement to focus on blood lipid levels among smokers.