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. 2019 Nov;28(6):692-695.
doi: 10.1136/tobaccocontrol-2018-054599. Epub 2018 Aug 29.

Assessing progress in protecting non-smokers from secondhand smoke

Sean Semple  1 , Will Mueller  2 , Alastair H Leyland  3 , Linsay Gray  3 , John W Cherrie  2   4
Affiliations

Assessing progress in protecting non-smokers from secondhand smoke

Sean Semple et al. Tob Control. 2019 Nov.

Abstract

Objective: To examine trends in population exposure to secondhand smoke (SHS) and consider two exposure metrics as appropriate targets for tobacco control policy-makers.

Design: Comparison of adult non-smokers' salivary cotinine data available from 11 Scottish Health Surveys between 1998 and 2016.

Methods: The proportions of non-smoking adults who had measurable levels of cotinine in their saliva were calculated for the 11 time points. The geometric mean (GM) concentrations of cotinine levels were calculated using Tobit regression. Changes in both parameters were assessed for the whole period and also for the years since implementation of smoke-free legislation in Scotland in 2006.

Results: Salivary cotinine expressed as a GM fell from 0.464 ng/mL (95% CI 0.444 to 0.486 ng/mL) in 1998 to 0.013 ng/mL (95% CI 0.009 to 0.020 ng/mL) in 2016: a reduction of 97.2%. The percentage of non-smoking adults who had no measurable cotinine in their saliva increased by nearly sixfold between 1998 (12.5%, 95% CI 11.5% to 13.6%) and 2016 (81.6%, 95% CI 78.6% to 84.6%). Reductions in population exposure to SHS have continued even after smoke-free legislation in 2006.

Conclusions: Scotland has witnessed a dramatic reduction in SHS exposure in the past two decades, but there are still nearly one in five non-smoking adults who have measurable exposure to SHS on any given day. Tobacco control strategies globally should consider the use of both the proportion of non-smoking adults with undetectable salivary cotinine and the GM as targets to encourage policies that achieve a smoke-free future.

Keywords: cotinine; public policy; secondhand smoke.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1. Scottish Health Survey salivary cotinine data from non-smoking adults 1998-2016.
The bars represent the percentage of non-smoking adults with non-detectable cotinine, the dashed line shows the GM value calculated by the previous methodology using one-half the LOD; the solid line shows the GM value calculated using Tobit regression.
See this image and copyright information in PMC

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