Pirkle J L, Flegal K M, Bernert J T, Brody D J, Etzel R A, Maurer K R
National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341-3725, USA.
JAMA. 1996 Apr 24;275(16):1233-40.
To estimate the extent of exposure of the US population to environmental tobacco smoke and the contribution of the home and workplace environment to environmental tobacco smoke exposure.
Nationally representative cross-sectional survey including questionnaire information from persons aged 2 months and older (n=16818) and measurements of serum cotinine (a metabolite of nicotine) from persons aged 4 years and older (n=10642).
SETTING/PARTICIPANTS: Participants in the Third National Health and Nutrition Examination Survey, October 25, 1988, to October 21, 1991.
Of US children aged 2 months to 11 years, 43% lived in a home with at least 1 smoker, and 37% of adult non-tobacco users lived in a home with at least 1 smoker or reported environmental tobacco smoke exposure at work. Serum cotinine levels indicated more widespread exposure to nictoine. Of non-tobacco users, 87.9% had detectable levels of serum cotinine. Both the number of smokers in the household and the hours exposed at work were significantly and independently associated (P<.001, multiple regression t test) with increased serum cotinine levels. Serum cotinine levels of children, non-Hispanic blacks, and males indicated that these groups had higher exposure to environmental tobacco smoke. Dietary variables showed no consistent association with serum cotinine levels, and dietary contribution to serum cotinine level, if any, appeared to be extremely small.
The high proportion of the population with detectable serum cotinine levels indicates widespread exposure to environmental tobacco smoke in the US population. Both the home and workplace environments significantly contribute to environmental tobacco smoke exposure in the United States.
评估美国人群接触环境烟草烟雾的程度，以及家庭和工作场所环境对环境烟草烟雾接触的贡献。
具有全国代表性的横断面调查，包括来自2个月及以上人群（n = 16818）的问卷信息，以及来自4岁及以上人群（n = 10642）的血清可替宁（尼古丁的一种代谢物）测量值。
地点/参与者：1988年10月25日至1991年10月21日期间参加第三次全国健康和营养检查调查的参与者。
在2个月至11岁的美国儿童中，43%生活在至少有1名吸烟者的家庭中，37%的成年非烟草使用者生活在至少有1名吸烟者的家庭中，或报告在工作场所接触到环境烟草烟雾。血清可替宁水平表明尼古丁的接触更为普遍。在非烟草使用者中，87.9%的人血清可替宁水平可检测到。家庭中吸烟者的数量和工作场所接触时间均与血清可替宁水平升高显著且独立相关（P <.001，多元回归t检验）。儿童、非西班牙裔黑人及男性的血清可替宁水平表明这些群体接触环境烟草烟雾的程度更高。饮食变量与血清可替宁水平无一致关联，饮食对血清可替宁水平的贡献（如果有的话）似乎极小。
血清可替宁水平可检测到的人群比例很高，这表明美国人群广泛接触环境烟草烟雾。家庭和工作场所环境均对美国环境烟草烟雾接触有显著贡献。
