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Open Access Research article

Recent trends in exposure to secondhand smoke in the United States population

Chieh-I Chen1*, Tanya Burton2, Christine L Baker1, Vera Mastey1 and David Mannino3

Author Affiliations

1 Pfizer Inc., 235 East 42nd Street, New York, NY 10017, USA

2 Abt-Biopharma Solutions Inc. 181 Spring Street Lexington, MA 02421, 781.372.6652, USA

3 University of Kentucky School of Medicine, 740 S. Limestone, K 528 Lexington, KY 40536, USA

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BMC Public Health 2010, 10:359  doi:10.1186/1471-2458-10-359

Published: 23 June 2010



Previous research using the National Health and Nutrition Examination Surveys (NHANES) data documented a significant downward trend in secondhand smoke (SHS) exposure between 1988 and 2002. The objective of this study was to assess whether the downward trend in exposure continued from 2001 through 2006.


We analyzed data from the 2001-2006 NHANES to estimate exposure of nonsmokers to SHS. Geometric means of serum cotinine levels for all nonsmokers were computed.


Overall serum cotinine levels (95% Confidence Intervals) in 2001-2002, 2003-2004, and 2005-2006 were 0.06 ng/mL (0.05-0.07), 0.07 ng/mL (0.06-0.09), and 0.05 ng/mL (0.05-0.06), respectively. Subgroup analysis by age, gender, and race/ethnicity groups showed similar trends in cotinine levels. Children, males, and non-Hispanic Blacks had higher cotinine levels than adults, females, and non-Hispanic Whites and Mexican Americans, respectively. Insignificant P values from the Wald test indicate that serum cotinine levels did not differ over time.


The long-term trend of declining exposure to SHS among nonsmokers appears to have leveled off. However, disparities noted in previous research persist today, with the young, non-Hispanic Blacks, and males experiencing higher levels of exposure.