Browse > Article
http://dx.doi.org/10.4332/KJHPA.2020.30.4.505

Differences in Environmental Tobacco Smoke Exposure between Self-reporting and Cotinine Test: The Application of Biomarkers  

Park, Myung-Bae (Department of Gerontology Health and Welfare, Pai Chai University)
Sim, Boram (Review and Assessment Research Division, Health Insurance Review & Assessment Service)
Publication Information
Health Policy and Management / v.30, no.4, 2020 , pp. 505-512 More about this Journal
Abstract
Background: In monitoring exposure to environmental smoke (ETS), biomarkers can overcome the subjectivity and inaccuracy of self-reporting measurements, and have the advantage of reflecting ETS exposure in all places. This study aims to evaluate the effectiveness of ETS exposure measurement using biomarkers such as urine cotinine. Methods: This study used the Korea National Health and Nutrition Survey data from 2009 to 2018. A total of 28,574 non-smokers with urine cotinine data were selected for the study. The cotinine concentration and ETS exposure rate using urine cotinine was estimated and then compared with the self-reporting measurements. The degree of agreement among measurements of ETS exposure was confirmed. Results: As a result of measuring ETS exposure with urine cotinine, 23,594 (83.8%) out of 28,574 subjects were classified as to exposure groups. This estimate differs significantly from measurements made by self-reporting. In addition, the average concentration of cotinine in non-smokers has decreased to a 10th level over the past 10 years. Based on the biomarker, the sensitivity of the self-reporting was 8.5%-29.0%, the specificity was 16.4%-19.5%, and the kappa value was 2.0%-5.8%. Conclusion: The findings of our study show that self-reporting measurement does not well reflect the extent to which non-smoker's exposure to smoking materials. Whereas cotinine concentration has decreased significantly over the past 10 years, the ETS exposure rate has not reduced. It strongly suggests the need for intervention in the group of non-smokers exposed to low concentrations of smoke. Therefore, an assessment using biomarkers such as cotinine-based measurement should be made in the Health Plan 2030.
Keywords
Environmental smoke; Self-reporting; Cotinine; Biomarker; Health Plan;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Rosen LJ, Lev E, Guttman N, Tillinger E, Rosenblat S, Zucker DM, et al. Parental perceptions and misconceptions of child tobacco smoke exposure. Nicotine Tob Res 2018;20(11):1369-1377. DOI: https://doi.org/10.1093/ntr/ntx169.   DOI
2 Max W, Sung HY, Shi Y. Deaths from secondhand smoke exposure in the United States: economic implications. Am J Public Health 2012;102(11):2173-2180. DOI: https://doi.org/10.2105/AJPH.2012.300805.   DOI
3 Kwak J, Jeong H, Chun S, Bahk JH, Park M, Byun Y, et al. Effectiveness of government anti-smoking policy on non-smoking youth in Korea: a 4-year trend analysis of national survey data. BMJ Open 2017;7(7):e013984. DOI: https://doi.org/10.1136/bmjopen-2016-013984.   DOI
4 Ministry of Health and Welfare; Korea Health Promotion Institute. The 4th Health Plan (2016-2020). Sejong: Ministry of Health and Welfare of Korea; 2015.
5 Ministry of Health and Welfare; Korea Centers for Disease Control and Prevention. 2018 Korea health statistics. Sejong: Ministry of Health and Welfare; 2019.
6 Homa DM, Neff LJ, King BA, Caraballo RS, Bunnell RE, Babb SD, et al. Vital signs: disparities in nonsmokers' exposure to secondhand smoke: United States, 1999-2012. MMWR Morb Mortal Wkly Rep 2015;64(4):103-108.
7 Korea Centers for Disease Control and Prevention. Raw data guideline for the 7th Korea National Health and Nutrition Health Examination Survey. Cheongju: Korea Centers for Disease Control and Prevention; 2019.
8 Hackshaw A, Morris JK, Boniface S, Tang JL, Milenkovic D. Low cigarette consumption and risk of coronary heart disease and stroke: meta-analysis of 141 cohort studies in 55 study reports. BMJ 2018;360:j5855. DOI: https://doi.org/10.1136/bmj.j5855.   DOI
9 Prochaska JJ, Grossman W, Young-Wolff KC, Benowitz NL. Validity of self-reported adult secondhand smoke exposure. Tob Control 2015;24(1):48-53. DOI: https://doi.org/10.1136/tobaccocontrol-2013-051174.   DOI
10 Kim BJ, Kang JG, Kim JH, Seo DC, Sung KC, Kim BS, et al. Association between secondhand smoke exposure and hypertension in 106,268 Korean self-reported never-smokers verified by cotinine. J Clin Med 2019;8(8):1238. DOI: https://doi.org/10.3390/jcm8081238.   DOI
11 US Department of Health and Human Services. The health consequences of involuntary exposure to tobacco smoke: a report of the Surgeon General. Atlanta (GA): US Department of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2006.
12 Oberg M, Jaakkola MS, Woodward A, Peruga A, Pruss-Ustun A. Worldwide burden of disease from exposure to second-hand smoke: a retrospective analysis of data from 192 countries. Lancet 2011;377(9760):139-146. DOI: https://doi.org/10.1016/S0140-6736(10)61388-8.   DOI
13 Makate M, Whetton S, Tait RJ, Dey T, Scollo M, Banks E, et al. Tobacco cost of illness studies: a systematic review. Nicotine Tob Res 2020;22(4):458-465. DOI: https://doi.org/10.1093/ntr/ntz038.   DOI
14 Avila-Tang E, Al-Delaimy WK, Ashley DL, Benowitz N, Bernert JT, Kim S, et al. Assessing secondhand smoke using biological markers. Tob Control 2013;22(3):164-171. DOI: https://doi.org/10.1136/tobaccocontrol-2011-050298.   DOI
15 Osborne B, Cooper V. Health Survey for England 2017: adult health related behaviours. Leeds: NHS Digital; 2018.
16 Tsai J, Homa DM, Gentzke AS, Mahoney M, Sharapova SR, Sosnoff CS, et al. Exposure to secondhand smoke among nonsmokers: United States, 1988-2014. MMWR Morb Mortal Wkly Rep 2018;67(48):1342-1346. DOI: https://doi.org/10.15585/mmwr.mm6748a3.   DOI
17 Apelberg BJ, Hepp LM, Avila-Tang E, Gundel L, Hammond SK, Hovell MF, et al. Environmental monitoring of secondhand smoke exposure. Tob Control 2013;22(3):147-155. DOI: https://doi.org/10.1136/tobaccocontrol-2011-050301.   DOI
18 SRNT Subcommittee on Biochemical Verification. Biochemical verification of tobacco use and cessation. Nicotine Tob Res 2002;4(2):149-159. DOI: https://doi.org/10.1080/14622200210123581.   DOI
19 Hsieh SJ, Ware LB, Eisner MD, Yu L, Jacob P 3rd, Havel C, et al. Biomarkers increase detection of active smoking and secondhand smoke exposure in critically ill patients. Crit Care Med 2011;39(1):40-45. DOI: https://doi.org/10.1097/CCM.0b013e3181fa4196.   DOI
20 Kim S. Overview of cotinine cutoff values for smoking status classification. Int J Environ Res Public Health 2016;13(12):1236. DOI: https://doi.org/10.3390/ijerph13121236.   DOI
21 Park E, Cho SI, Seo HG, Kim Y, Jung HS, Driezen P, et al. Attitudes of Korean smokers towards smoke-free public places: findings from the longitudinal ITC Korea Survey, 2005-2010. BMJ Open 2019;9(8):e025298. DOI: https://doi.org/10.1136/bmjopen-2018-025298.   DOI
22 Sun LY, Cheong HK, Lee EW, Kang KJ, Park JH. Affecting factors of secondhand smoke exposure in Korea: focused on different exposure locations. J Korean Med Sci 2016;31(9):1362-1372. DOI: https://doi.org/10.3346/jkms.2016.31.9.1362.   DOI
23 Lee BE, Ha EH. Exposure to environmental tobacco smoke among South Korean adults: a cross-sectional study of the 2005 Korea National Health and Nutrition Examination Survey. Environ Health 2011;10:29. DOI: https://doi.org/10.1186/1476-069X-10-29.   DOI
24 Max W, Sung HY, Shi Y. Who is exposed to secondhand smoke?: self-reported and serum cotinine measured exposure in the U.S., 1999-2006. Int J Environ Res Public Health 2009;6(5):1633-1648. DOI: https://doi.org/10.3390/ijerph6051633.   DOI
25 Kang YH, Lee YJ, Kim HK, Yun YH, Jeong SY, Lee JS, et al. Usefulness of urinary cotinine test to distinguish smokers from nonsmokers. Ann Lab Med 2003;23(2):92-97.
26 Park MB, Kim CB, Nam EW, Hong KS. Does South Korea have hidden female smokers: discrepancies in smoking rates between self-reports and urinary cotinine level. BMC Womens Health 2014;14:156. DOI: https://doi.org/10.1186/s12905-014-0156-z.   DOI
27 Feng C, Wang H, Lu N, Chen T, He H, Lu Y, et al. Log-transformation and its implications for data analysis. Shanghai Arch Psychiatry 2014;26(2):105-109. DOI: https://doi.org/10.3969/j.issn.1002-0829.2014.02.009.   DOI
28 Jeong BY, Lim MK, Yun EH, Oh JK, Park EY, Lee DH. Tolerance for and potential indicators of second-hand smoke exposure among nonsmokers: a comparison of self-reported and cotinine verified second-hand smoke exposure based on nationally representative data. Prev Med 2014;67:280-287. DOI: https://doi.org/10.1016/j.ypmed.2014.07.003.   DOI
29 Park MB, Choi JK. Differences between the effects of conventional cigarettes, e-cigarettes and dual product use on urine cotinine levels. Tob Induc Dis 2019;17:12. DOI: https://doi.org/10.18332/tid/100527.   DOI
30 Kang EK, Lee HY, Yoo SH, Lee JA, Cho HJ. Factors affecting secondhand smoke exposure at home and in workplace among non-smoking Korean adults. Korean J Fam Pract 2016;6(5):395-403. DOI: https://doi.org/10.21215/kjfp.2016.6.5.395.   DOI
31 Kim J, Lee K. Characterization of urinary cotinine in non-smoking residents in smoke-free homes in the Korean National Environmental Health Survey (KoNEHS). BMC Public Health 2016;16:538. DOI: https://doi.org/10.1186/s12889-016-3212-9.   DOI
32 Wong SL, Malaison E, Hammond D, Leatherdale ST. Secondhand smoke exposure among Canadians: cotinine and self-report measures from the Canadian Health Measures Survey 2007-2009. Nicotine Tob Res 2013;15(3):693-700. DOI: https://doi.org/10.1093/ntr/nts195.   DOI
33 Yang L, Tong EK, Mao Z, Hu TW. Exposure to secondhand smoke and associated factors among non-smoking pregnant women with smoking husbands in Sichuan province, China. Acta Obstet Gynecol Scand 2010;89(4):549-557. DOI: https://doi.org/10.3109/00016341003713851.   DOI
34 US Department of Health and Human Services. The health consequences of smoking: 50 years of progress: a report of the Surgeon General. Atlanta (GA): US Department of Health and Human Services, National Center for Chronic Disease, Prevention and Health Promotion, Office on Smoking and Health; 2014.
35 Oberg M, Woodward A, Jaakkola MS, Peruga A, Pruss-Ustun A. Global estimate of the burden of disease from second-hand smoke. Geneva: World Health Organisation; 2011.