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The prevalence of and factors associated with urinary cotinine-verified smoking in Korean adults: The 2008–2011 Korea National Health and Nutrition Examination Survey

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  • Jae Won Hong
  • Jung Hyun Noh
  • Dong-Jun Kim

Abstract

Background: Smoking rate based on self-reporting questionnaire might be underestimated. Cotinine is the principal metabolite of nicotine and is considered an accurate biomarker of exposure to cigarette smoke. Objectives: This study evaluated the prevalence of and factors associated with urinary cotinine-verified smoking in Korean adults. Methods: We analyzed data from 12,110 adults in the 2008–2011 Korea National Health and Nutrition Examination Survey (KNHANES), using three threshold levels of urinary cotinine ≥100ng/ml, ≥50ng/ml, and ≥30ng/ml. Results: The weighted prevalence of urinary cotinine levels of ≥100, ≥50, and ≥30 ng/mL in the whole study population was 34.7%, 37.1%, and 41.1%, respectively. Male sex, younger age, elementary school graduation, household income in the ≤24th percentile, service and sales workers and assembly workers, and high-risk alcohol drinking were associated with a higher prevalence of urinary cotinine level of ≥ 50 or 30 ng/mL, after we adjusted for age, sex, education level, number of family members, household income, occupation, and alcohol drinking. Conclusions: Based on a threshold urinary cotinine level of 50 ng/mL, the prevalence of cotinine-verified smoking in a representative sample of Korean adults was 37.1% (men 52.7%, women 15.4%). Younger age, male sex, low education level, service and sales workers, low household income, and high-risk alcohol drinking were associated with the risk of smoking.

Suggested Citation

  • Jae Won Hong & Jung Hyun Noh & Dong-Jun Kim, 2018. "The prevalence of and factors associated with urinary cotinine-verified smoking in Korean adults: The 2008–2011 Korea National Health and Nutrition Examination Survey," PLOS ONE, Public Library of Science, vol. 13(6), pages 1-14, June.
    • Handle: RePEc:plo:pone00:0198814
    DOI: 10.1371/journal.pone.0198814
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    References listed on IDEAS

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    1. Patrick, D.L. & Cheadle, A. & Thompson, D.C. & Diehr, P. & Koepsell, T. & Kinne, S., 1994. "The validity of self-reported smoking: A review and meta-analysis," American Journal of Public Health, American Public Health Association, vol. 84(7), pages 1086-1093.
    2. Wells, A.J. & English, P.B. & Posner, S.F. & Wagenknecht, L.E. & Perez-Stable, E.J., 1998. "Misclassification rates for current smokers misclassified as nonsmokers," American Journal of Public Health, American Public Health Association, vol. 88(10), pages 1503-1509.
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