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 May;6(5):1633-48. doi: 10.3390/ijerph6051633. Epub 2009 May 14.


This study presents self-reported and serum cotinine measures of exposure to secondhand smoke (SHS) for nonsmoking children, adolescents, and adults. Estimates are disaggregated by time periods and sociodemographic characteristics based on analyses of the 1999-2006 National Health and Nutrition Examination Survey. Self-reported exposure rates are found to be highest for children, followed by adolescents and adults. Important differences in exposure are found by socioeconomic characteristics. Using serum cotinine to measure exposure yields much higher prevalence rates than self-reports. Rates of SHS exposure remain high, but cotinine levels are declining for most groups.

Keywords: environmental tobacco smoke; passive smoking; secondhand smoke (SHS); self-reported exposure; serum cotinine.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Cotinine / blood*
  • Humans
  • Nutrition Surveys
  • Prevalence
  • Socioeconomic Factors
  • Tobacco Smoke Pollution*
  • United States / epidemiology


  • Tobacco Smoke Pollution
  • Cotinine