ArticleBMC public health2013
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.
Article in BMC public health, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed, 30 citations in OpenAlex.
- Joint association of weight-adjusted waist index and serum cotinine levels with systemic inflammatory index in adults.BMC public health · 2025Article
- Secondhand Tobacco Exposure Assessed Using Urinary Cotinine Among 10-Year-Old Children in Japan: An 11-Year Repeated Cross-sectional Study.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2025Article
- A Comparison of Measured Airborne and Self-Reported Secondhand Smoke Exposure in the MADRES Pregnancy Cohort Study.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2024Article
- Active smoking in urban households: An association between urinary cotinine metabolite level and serum eGFR concentration.Tobacco induced diseases · 2024Article
- Association between Fathers' Use of Heated Tobacco Products and Urinary Cotinine Concentrations in Their Spouses and Children.International journal of environmental research and public health · 2022Article
- The effect of exposure to particulate matter during pregnancy on lower respiratory tract infection hospitalizations during first year of life.Environmental health : a global access science source · 2020Article
- Human biologic monitoring based on blood donations to the National Blood Services.BMC public health · 2020Article
- Short-Term Exposure to Waterpipe/Hookah Smoke Triggers a Hyperactive Platelet Activation State and Increases the Risk of Thrombogenesis.Arteriosclerosis, thrombosis, and vascular biology · 2020Article
- The promise - and pitfalls - of smoke-free policy adoption.Israel journal of health policy research · 2019Article
- Urine Cotinine Should Be Involved in Initial Evaluation of Tinnitus in Adolescents.Clinical and experimental otorhinolaryngology · 2018Article
- Exposure to environmental tobacco smoke in non - smoking adults in Israel: results of the second Israel biomonitoring survey.Israel journal of health policy research · 2018Article
- ETS Exposure and PAH Body Burden in Nonsmoking Italian Adults.International journal of environmental research and public health · 2018Article
- Biomarkers of Secondhand Smoke Exposure in Waterpipe Tobacco Venue Employees in Istanbul, Moscow, and Cairo.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2018Article
- Effects of chronic inhalation of electronic cigarettes containing nicotine on glial glutamate transporters and α-7 nicotinic acetylcholine receptor in female CD-1 mice.Progress in neuro-psychopharmacology & biological psychiatry · 2017Article
- Inhalation of the reactive aldehyde acrolein promotes antigen sensitization to ovalbumin and enhances neutrophilic inflammation.Journal of immunotoxicology · 2016Article
- Tobacco policy in Israel: 1948-2014 and beyond.Israel journal of health policy research · 2015Article
- The burden of smoking in Israel-attributable mortality and costs (2014).Israel journal of health policy research · 2014Article
Corrections and comments
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Authors and funding
9 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCotinine 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.
methodsWe 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.
resultsCotinine 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.
conclusionsOur 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.
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