Exposure to Secondhand Smoke: Inconsistency between Self-Response and Urine Cotinine Biomarker Based on Korean National Data during 2009–2018

Sim, Boram; Park, Myung-Bae

doi:10.3390/ijerph18179284

Cited by 12 publications

(24 citation statements)

References 34 publications

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“…A low HPS assessed by the self-report does not necessarily mean less exposure to smoking in the home. Previous studies have revealed that SR does not reflect exposure at home fully 17 , 32 . Thirdhand smoke could happen in home without secondhand smoke, and homes are more vulnerable to long-term exposure to smoking materials, including thirdhand smoke, because people stay more at home than anywhere else 33 .…”

Section: Discussionmentioning

confidence: 91%

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Concordance assessment through comparison with urine cotinine: Does self-report adequately reflect passive smoking?

Park¹

2023

Tob. Induc. Dis.

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INTRODUCTION There is a paucity of studies evaluating passive smoking (PS) by comparing self-report (SR) and biomarkers. Our study aimed to confirm whether SR could accurately reflect PS compared to biomarkers, a golden standard for assessing the exposure of non-smokers. METHODS We used the 2014-2020 Korea National Health and Nutrition Examination Survey data and selected 29622 non-smokers aged >19 years as the study participants. The PS rate by SR was assessed during the last 7 days, and participants were interviewed to investigate their exposure at home, work, indoors, and in public places. In addition, participants having a limit of detection ≥0.5 ng/mL in urine cotinine (UC) was defined as the exposure group. All analyses reflected the weights of complex sampling. We first compared the rates of PS using biomarkers and SR, and then the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated based on biomarkers. RESULTS PS exposure by UC was the highest (44.4%), and the exposure by SR was significantly lower (5.1–29.5%). Kappa and sensitivity in PS in the indoor home (HPS) were lower than those in indoor workplaces (WPS) and indoor public places (PPS). Moreover, overall sensitivity and PPV were lower, and specificity and NPV were relatively higher in accuracy. Lastly, the sensitivity was poor, and the specificity was relatively good, which means that measurement by SR would identify people who were actually exposed to PS as non-exposed. CONCLUSIONS Despite exposure to PS, the use of the SR method is more likely to classify participants in the non-exposed group. Hence, to overcome measurement error in SR and reflect exposure in any place and setting, biomonitoring and SR should be performed.

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Section: Discussionmentioning

confidence: 91%

“…However, exposure may occur in other areas, such as bars and sports facilities. Furthermore, NHANES in the US, including Korea, and population-based surveys mostly conduct interviews on indoor exposure 17 , 29 . Therefore, it is difficult for self-report to properly reflect exposure to smoking outdoors.…”

Section: Discussionmentioning

confidence: 99%

Concordance assessment through comparison with urine cotinine: Does self-report adequately reflect passive smoking?

Park¹

2023

Tob. Induc. Dis.

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“…Regulations and social consensus for banning smoking in indoor public places and workplaces are becoming ubiquitous in recent years [6][7][8][9]. The consecutive Korean National Health and Nutrition Examination Survey (KNHANES) between 2008 and 2018 showed a trend toward significant decreases in self-reported tobacco smoke exposure and measured urinary cotinine concentrations [10][11][12]. Cotinine is a major metabolite of nicotine, and it is used as a biomarker for tobacco smoke exposure [12].…”

Section: Introductionmentioning

confidence: 99%

Effect of Second-Hand Smoke Exposure on Establishing Urinary Cotinine-Based Optimal Cut-Off Values for Smoking Status Classification in Korean Adults

Lee

Cho

Lee

et al. 2022

IJERPH

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Regulations for banning smoking in indoor public places and workplaces have increased worldwide in recent years. A consecutive Korean National Health and Nutrition Examination Survey (KNHANES) between 2008 and 2018 showed a trend toward significant decreases in self-reported tobacco smoke exposure and measured urinary cotinine concentrations. We established and compared each optimal cut-off value for assessing the effect of second-hand smoke (SHS) exposure on establishing urinary cotinine-based cut-off values for smoking status classification in a population setting controlled for racial and cultural diversity, using four KNHANES datasets consisting of the 2008, 2011, 2014, and 2018 surveys. A total of 18,229 Korean participants aged >19 years with measured urinary cotinine concentrations were enrolled. Self-reports of current smoking status showed that the prevalence of current smokers decreased from 22.9% to 18.2% between 2008 and 2018. During this period, the median value of urinary cotinine in nonsmokers decreased from 5.86 µg/L to 0.48 µg/L, whereas the median value showed no remarkable decrease in current smokers. The AUC-based optimal cut-off values of urinary cotinine concentration for distinguishing current smokers from nonsmokers decreased from 86.5 µg/L to 11.5 µg/L. Our study showed that decreased SHS exposure would result in decreased optimal cut-off values for distinguishing current smokers from nonsmokers. In addition, the study suggests that the range of urinary cotinine concentration to define SHS exposure for the trend monitoring of populationof SHS exposure is appropriate between 0.30 µg/L and 100 µg/L. In addition, our study showed the importance of determination of cotinine concentration, which would have allowed us to avoid mistakes in qualification to the study group in an increased use of e-cigarette setting.

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“…Despite the globally declining trend of SHS, evidence on THS is limited. In a study in which Korean national data were used, Sim [18] reported that the SHS exposure rate among nonsmokers dropped by more than 80% since 2010 but that their cotinine concentrations did not considerably decrease. One possible reason for this phenomenon is THS.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Thirdhand Smoke Exposure after Short Visits to Public Facilities (Noraebang and Internet Cafés): A Prospective Cohort Study

Park

Sim

2022

Toxics

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We aimed to evaluate the degree of thirdhand smoke (THS) caused by short-term exposure to smoking-related substances. To this end, we evaluated the change in concentration of a smoking-related urine biomarker in volunteers before and after visiting public spaces where there is likely THS exposure. We hypothesized that a visit to such public spaces would result in an increase in such biomarkers. Participants visited one of the predetermined facilities (noraebang, PC café) and revisited the same facility after 24 h, spending around 2 h per visit. We selected creatinine-corrected urine cotinine (CUC) as a biomarker to evaluate THS. In addition, we collected nicotine-derived nitrosamine ketone (NNK) from surface dust at each site with cotton swabs (diameter of 2.5 cm). We examined whether CUC concentration significantly changed across three time points (baseline, first visit, and second visit) via repeated-measures analysis of variance (RM-ANOVA). Moreover, we analyzed the interaction to determine whether cigarette smell affects the CUC concentration. Finally, CUC and dust NNK were analyzed with Pearson’s correlation. The CUC concentration did not increase from baseline to the first visit, but increased from the baseline to the second visit (Diff = Ln [0.565] ng/mg, P < 0.01). Further, the CUC concentration increased from the first to the second visit (Diff = Ln [0.393] ng/mg, p < 0.01). In the case of the interaction effect, there were statistically significant differences in CUC concentration depending on the smell of smoke in the facility (Diff = Ln [0.325], F value = 4.438, p value = 0.041). The change in CUC concentration from baseline to the second visit (r = 0.562, p < 0.001) and from the first to the second visit (r = 0.544, p < 0.001) were correlated with NNK concentration. We evaluated whether a short stay in a facility with smoke-related substances that adhere to the surrounding environment would expose individuals to THS even if they do not smell or are directly exposed to cigarette smoke. We confirmed that even two relatively short stays (approximately 2 h each) in a facility in which people had previously smoked can lead to THS exposure.

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Exposure to Secondhand Smoke: Inconsistency between Self-Response and Urine Cotinine Biomarker Based on Korean National Data during 2009–2018

Cited by 12 publications

References 34 publications

Concordance assessment through comparison with urine cotinine: Does self-report adequately reflect passive smoking?

Concordance assessment through comparison with urine cotinine: Does self-report adequately reflect passive smoking?

Effect of Second-Hand Smoke Exposure on Establishing Urinary Cotinine-Based Optimal Cut-Off Values for Smoking Status Classification in Korean Adults

Evaluation of Thirdhand Smoke Exposure after Short Visits to Public Facilities (Noraebang and Internet Cafés): A Prospective Cohort Study

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