Exposure to tobacco smoke based on urinary cotinine levels among Israeli smoking and nonsmoking adults: a cross-sectional analysis of the first Israeli human biomonitoring study

BMC Public Health

Itamar Grotto³  Tamy Shohat¹  Yona Amitai⁵  Lena Novack³  Judith Spungen⁶  Thomas Göen⁴  Rebecca Goldsmith⁶  Tamar Berman⁶  Hagai Levine² 

[1] Department of Epidemiology and Preventive Medicine, Tel Aviv University, Tel Aviv, Israel;The Hebrew University Center of Excellence in Agriculture and Environmental Health, Jerusalem, Israel;Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel;Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, University Erlangen-Nuremberg, Erlangen, Germany;Department of Management, Bar Ilan University, Ramat Gan, Israel;Public Health Services, Ministry of Health, Jerusalem, Israel

关键词: Urinary cotinine;    Human Biomonitoring;    Environmental tobacco smoke;    Exposure;    Secondhand smoke;    Public health;    Epidemiology;   

Others  :  1161383
DOI  :  10.1186/1471-2458-13-1241

 received in 2013-09-12, accepted in 2013-12-20,  发布年份 2013

【 摘 要 】

Background

Cotinine levels provide a valid measure of exposure to environmental tobacco smoke (ETS). The goal of this study was to examine exposure to tobacco smoke among smoking and nonsmoking Israeli adults and to identify differences in ETS exposure among nonsmokers by socio-demographic factors.

Methods

We analyzed urinary cotinine data from the first Israeli human biomonitoring study conducted in 2011. In-person questionnaires included data on socio-demographic and active smoking status. Cotinine levels were measured using a gas chromatography–mass spectrometry procedure. We calculated creatinine-adjusted urinary cotinine geometric means (GM) among smokers and nonsmokers, and by socio-demographic, smoking habits and dietary factors. We analyzed associations, in a univariable and multivariable analysis, between socio-demographic variables and proportions of urinary cotinine ≥1 μg/l (Limit of Quantification = LOQ) or ≥4 μg/l.

Results

Cotinine levels were significantly higher among 91 smokers (GM = 89.7 μg/g creatinine; 95% confidence interval [CI]: 47.4-169.6) than among 148 nonsmokers (GM = 1.3; 1.1-1.7). Among exclusive waterpipe smokers, cotinine levels were relatively high (GM = 53.4; 95% CI 12.3-232.7). ETS exposure was widespread as 62.2% of nonsmokers had levels ≥ LOQ, and was higher in males (75.8%) than in females (52.3%). In a multivariable model, urinary cotinine ≥ LOQ was higher in males (Prevalence ratio [PR] = 1.30; 95% CI: 1.02-1.64, p = 0.032) and in those with lower educational status (PR = 1.58; 1.04-2.38, p = 0.031) and decreased with age (PR = 0.99; 0.98-1.00, p = 0.020, per one additional year). There were no significant differences by ethnicity, residence type or country of birth.

Conclusions

Our findings indicate widespread ETS exposure in the nonsmoking Israeli adult population, especially among males, and younger and less educated participants. These findings demonstrate the importance of human biomonitoring, were instrumental in expanding smoke-free legislation implemented in Israel on July 2012 and will serve as a baseline to measure the impact of the new legislation.

【 授权许可】

   
2013 Levine et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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