Smoking, secondhand smoke, and cotinine levels in a subset of EPIC cohort

Valéria Troncoso Baltar, Wei W. Xun, Shu Chun Chuang, Caroline Relton, Per Magne Ueland, Stein Emil Vollset, Øivind Midttun, Mattias Johansson, Nadia Slimani, Mazda Jenab, Fraņcoise Clavel-Chapelon, Marie Christine Boutron-Ruault, Guy Fagherazzi, Rudolf Kaaks, Sabine Rohrmann, Heiner Boeing, Cornelia Weikert, H. Bas Bueno-de-Mesquita, Hendriek C. Boshuizen, Carla H. Van GilsPetra H.M. Peeters, Antonio Agudo, Aurelio Barricarte, Carmen Navarro, Laudina Rodríguez, José Maria Huerta Castaño, Nerea Larrañaga, Maria José Sánchez Pérez, Kay Tee Khaw, Nick Wareham, Naomi E. Allen, Francesca Crowe, Valentina Gallo, Teresa Norat, Giovanna Tagliabue, Giovanna Masala, Salvatore Panico, Carlota Sacerdote, Rosario Tumino, Antonia Trichopoulou, Pagona Lagiou, Christina Bamia, Torgny Rasmuson, Göran Hallmans, Nina Roswall, Anne Tjønneland, Elio Riboli, Paul Brennan, Paolo Vineis

Research output: Contribution to journalArticleResearchpeer-review

30 Citations (Scopus)


Background: Several countries are discussing new legislation regarding the ban on smoking in public places, based on the growing evidence of the hazards of secondhand smoke (SHS) exposure. The objective of the present study is to quantitatively assess the relationship between smoking, SHS, and serum cotinine levels in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Methods: From a study on lung cancer in the EPIC cohort, questionnaire information on smoking was collected at enrolment, and cotinine was measured in serum. Three statistical models were applied by using samples available in a cross-section design: (i) cotinine levels by categories combining smoking and SHS (n = 859); (ii) the effect of hours of passive smoking exposure in nonsmokers only (n = 107); (iii) the effect of the number of cigarettes consumed per day in current smokers only (n = 832). All models were adjusted for country, sex, age, and body mass index. Results: Among nonsmokers, passive smokers presented significant differences in cotinine compared with nonexposed, with a marked (but not significant) difference among former-smokers. A one hour per day increment of SHS gave rise to a significant 2.58 nmol/L (0.45 ng/mL) increase in mean serum cotinine (P < 0.001). In current smokers, a one cigarette per day increment gave rise to a significant 22.44 nmol/L (3.95 ng/ mL) increase in cotinine mean (P < 0.001). Conclusions: There is clear evidence that not only tobacco smoking but also involuntary exposure increases cotinine levels. Impact: This study strengthens the evidence for the benefits of a smoking ban in public places.

Original languageEnglish
Pages (from-to)869-875
Number of pages7
JournalCancer Epidemiology Biomarkers and Prevention
Issue number5
Publication statusPublished - May 2011
Externally publishedYes


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