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

Author

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  • Hyun-Seung Lee

    (Department of Laboratory Medicine, School of Medicine, Wonkwang University, Iksan 54538, Korea)

  • Ji-Hyun Cho

    (Department of Laboratory Medicine, School of Medicine, Wonkwang University, Iksan 54538, Korea)

  • Young-Jin Lee

    (Department of Laboratory Medicine, School of Medicine, Wonkwang University, Iksan 54538, Korea)

  • Do-Sim Park

    (Department of Laboratory Medicine, School of Medicine, Wonkwang University, Iksan 54538, Korea)

Abstract

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.

Suggested Citation

  • Hyun-Seung Lee & Ji-Hyun Cho & Young-Jin Lee & Do-Sim Park, 2022. "Effect of Second-Hand Smoke Exposure on Establishing Urinary Cotinine-Based Optimal Cut-Off Values for Smoking Status Classification in Korean Adults," IJERPH, MDPI, vol. 19(13), pages 1-14, June.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:13:p:7971-:d:851599
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    References listed on IDEAS

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    1. Jarvis, M.J. & Tunstall-Pedoe, H. & Feyerabend, C. & Vesey, C. & Saloojee, Y., 1987. "Comparison of tests used to distinguish smokers from nonsmokers," American Journal of Public Health, American Public Health Association, vol. 77(11), pages 1435-1438.
    2. Sungroul Kim, 2016. "Overview of Cotinine Cutoff Values for Smoking Status Classification," IJERPH, MDPI, vol. 13(12), pages 1-15, December.
    3. Boram Sim & Myung-Bae Park, 2021. "Exposure to Secondhand Smoke: Inconsistency between Self-Response and Urine Cotinine Biomarker Based on Korean National Data during 2009–2018," IJERPH, MDPI, vol. 18(17), pages 1-14, September.
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    1. Hyun-Seung Lee, 2022. "Diagnostic Performance Evaluation of the Novel Index Combining Urinary Cotinine and 4-(Methylnitrosamino)-1-(3-pyridyl)-1-butanol in Smoking Status Verification and Usefulness for Trend Monitoring of ," IJERPH, MDPI, vol. 19(19), pages 1-11, September.

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