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Passive smoking assessed by salivary cotinine and self-report in relation to cause-specific mortality: 17-year follow-up of study participants in the UK Health and Lifestyle Survey

Passive smoking assessed by salivary cotinine and self-report in relation to cause-specific mortality: 17-year follow-up of study participants in the UK Health and Lifestyle Survey
Passive smoking assessed by salivary cotinine and self-report in relation to cause-specific mortality: 17-year follow-up of study participants in the UK Health and Lifestyle Survey
Background Evidence that passive smoking is a risk factor for cardiovascular disease and selected cancers is largely derived from studies in which this exposure is self-reported. Objective assessment using biochemical techniques may yield a more accurate estimate of risk, although each approach has its strengths and weaknesses. We examined the association of salivary cotinine, a widely utilised biomarker for passive smoking, and self-reported passive smoking in the home, with mortality from all causes, cardiovascular disease and all cancers combined.

Methods In 1992, investigators on the UK Health and Lifestyle Survey collected data on salivary cotinine, self-reported smoking (direct and passive) and a range of covariates in 3731 men and women aged 25?years and over. Mortality was ascertained using linkage to national death records.

Results Analyses were based on 2523 individuals (1433 [57%] women) who classified themselves as non-smokers (never and former). Seventeen years of follow-up gave rise to 588 deaths (253 from cardiovascular disease and 146 from cancer). In men, adjusted hazard ratios (HR) for the association between cotinine levels (1.3–15.0 [high] vs ?0.3 [low] ng/mL) and the various mortality outcomes were weak for total mortality (HR; 95% CI: 1.22; 0.91 to 1.64) and cardiovascular disease (1.25; 0.78 to 1.99) and absent for all cancers combined (1.10; 0.61 to 2.00). Corresponding associations were generally stronger when self-reported passive smoking (some vs none) was the exposure of interest: 1.53 (1.12 to 2.08), 1.88 (1.20 to 2.96) and 1.58 (0.85 to 2.93). The pattern of association for women in both sets of analyses was less consistent.

Conclusions In men in the present study, compared with our biochemical marker of passive smoking, cotinine, mortality was generally more consistently associated with self-reported passive smoking.
0143-005X
1200-1203
Batty, G.D.
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Gale, C.R.
5bb2abb3-7b53-42d6-8aa7-817e193140c8
Jefferies, B.
87fdba3c-e014-4b6d-aaae-10fcfe1c9e2d
Kvaavik, E.
ac85db7d-9072-45b6-8143-7411d1cdbc02
Batty, G.D.
bf322937-2cfb-4174-b5cb-dc016f0d0b8a
Gale, C.R.
5bb2abb3-7b53-42d6-8aa7-817e193140c8
Jefferies, B.
87fdba3c-e014-4b6d-aaae-10fcfe1c9e2d
Kvaavik, E.
ac85db7d-9072-45b6-8143-7411d1cdbc02

Batty, G.D., Gale, C.R., Jefferies, B. and Kvaavik, E. (2014) Passive smoking assessed by salivary cotinine and self-report in relation to cause-specific mortality: 17-year follow-up of study participants in the UK Health and Lifestyle Survey. Journal of Epidemiology & Community Health, 68 (12), 1200-1203. (doi:10.1136/jech-2014-203870). (PMID:25138392)

Record type: Article

Abstract

Background Evidence that passive smoking is a risk factor for cardiovascular disease and selected cancers is largely derived from studies in which this exposure is self-reported. Objective assessment using biochemical techniques may yield a more accurate estimate of risk, although each approach has its strengths and weaknesses. We examined the association of salivary cotinine, a widely utilised biomarker for passive smoking, and self-reported passive smoking in the home, with mortality from all causes, cardiovascular disease and all cancers combined.

Methods In 1992, investigators on the UK Health and Lifestyle Survey collected data on salivary cotinine, self-reported smoking (direct and passive) and a range of covariates in 3731 men and women aged 25?years and over. Mortality was ascertained using linkage to national death records.

Results Analyses were based on 2523 individuals (1433 [57%] women) who classified themselves as non-smokers (never and former). Seventeen years of follow-up gave rise to 588 deaths (253 from cardiovascular disease and 146 from cancer). In men, adjusted hazard ratios (HR) for the association between cotinine levels (1.3–15.0 [high] vs ?0.3 [low] ng/mL) and the various mortality outcomes were weak for total mortality (HR; 95% CI: 1.22; 0.91 to 1.64) and cardiovascular disease (1.25; 0.78 to 1.99) and absent for all cancers combined (1.10; 0.61 to 2.00). Corresponding associations were generally stronger when self-reported passive smoking (some vs none) was the exposure of interest: 1.53 (1.12 to 2.08), 1.88 (1.20 to 2.96) and 1.58 (0.85 to 2.93). The pattern of association for women in both sets of analyses was less consistent.

Conclusions In men in the present study, compared with our biochemical marker of passive smoking, cotinine, mortality was generally more consistently associated with self-reported passive smoking.

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Accepted/In Press date: 24 July 2014
e-pub ahead of print date: 19 August 2014
Published date: December 2014
Organisations: Human Development & Health

Identifiers

Local EPrints ID: 374635
URI: http://eprints.soton.ac.uk/id/eprint/374635
ISSN: 0143-005X
PURE UUID: 891d72da-d641-44ff-9246-51062b50740e
ORCID for C.R. Gale: ORCID iD orcid.org/0000-0002-3361-8638

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Date deposited: 25 Feb 2015 16:26
Last modified: 15 Mar 2024 02:49

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Contributors

Author: G.D. Batty
Author: C.R. Gale ORCID iD
Author: B. Jefferies
Author: E. Kvaavik

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