{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T23:22:29Z","timestamp":1784330549172,"version":"3.55.0"},"reference-count":48,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2021,7,2]],"date-time":"2021-07-02T00:00:00Z","timestamp":1625184000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,8,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Serum cotinine is a sensitive and specific biomarker for tobacco exposure including second-hand smoke exposure (SHS). We sought to examine whether SHS is associated with heart failure (HF) among non-hospitalized adults.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This analysis included 11 219 non-smokers (age 48.4 \u00b1 20.5 years, 55.9% women, 70.5% whites) from the United States Third National Health and Nutrition Examination (NHANES) years 1988\u20131994. SHS was defined as serum cotinine \u22651 ng\/mL. To assess dose-response, cut-points of serum cotinine \u22653 ng\/mL and \u22656 ng\/mL were used. Multivariable logistic regression was used to examine the association between SHS and HF. The consistency of this association was tested among subgroups stratified by race, gender, and comorbidities. NHANES years 2003\u20132006 were examined for longitudinal comparison.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>18.9% (n = 2125) of participants had SHS exposure while 3.7% (n = 416) had HF. After adjusting for covariates, SHS was associated with a 35% increased odds of HF with a dose-response relationship between levels of serum cotinine and HF. This association was stronger in males than females (interaction p-value = 0.03) and those with a history of CVD versus those without (interaction p-value &amp;lt; 0.001). This association persisted in the NHANES 2003\u20132006 analysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>There is a dose-response relationship between SHS and HF with possible effect modification by gender and prior CVD. This is a novel finding that underscores the harmful effects of passive smoking on the cardiovascular system and highlights the needs for further prohibition of smoking in public areas and a personalized risk assessment among high-risk groups, especially in regions with less-stringent public health policies.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Implications<\/jats:title>\n                  <jats:p>This study showed a novel association between secondhand smoke exposure and prevalent heart failure among non-smokers, adding to the list of harmful cardiovascular manifestations of secondhand smoke exposure. This was more apparent in men and those with a prior history of cardiovascular disease. Heart failure is a debilitating disease process, so this finding has important policy implications in low-income countries and poor communities with less-stringent health policies because they are known to have the highest levels of exposure. Smoke-free policies targeting these regions would thus yield substantial public health benefits.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ntr\/ntab047","type":"journal-article","created":{"date-parts":[[2021,3,16]],"date-time":"2021-03-16T12:52:32Z","timestamp":1615899152000},"page":"1512-1517","source":"Crossref","is-referenced-by-count":17,"title":["Secondhand Smoke Exposure is Associated with Prevalent Heart Failure: Longitudinal Examination of the National Health and Nutrition Examination Survey"],"prefix":"10.1093","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5577-0307","authenticated-orcid":false,"given":"T M","family":"Skipina","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Wake Forest School of Medicine, Winston Salem, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B","family":"Upadhya","sequence":"additional","affiliation":[{"name":"Cardiovascular Medicine Section, Department of Internal Medicine, Wake Forest School of Medicine, Winston Salem, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5632-8150","authenticated-orcid":false,"given":"E Z","family":"Soliman","sequence":"additional","affiliation":[{"name":"Institute of Global Health and Human Ecology, School of Sciences and Engineering, American University in Cairo, New Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,7,2]]},"reference":[{"issue":"9760","key":"2021081815453116900_CIT0001","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/S0140-6736(10)61388-8","article-title":"Worldwide burden of disease from exposure to second-hand smoke: a retrospective analysis of data from 192 countries","volume":"377","author":"Oberg","year":"2011","journal-title":"Lancet"},{"issue":"6","key":"2021081815453116900_CIT0002","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1016\/j.amepre.2007.02.026","article-title":"The 2006 report of the surgeon general: the health consequences of involuntary exposure to tobacco smoke","volume":"32","author":"Moritsugu","year":"2007","journal-title":"Am J Prev Med"},{"issue":"10","key":"2021081815453116900_CIT0003","doi-asserted-by":"crossref","first-page":"1899","DOI":"10.1097\/HJH.0000000000002478","article-title":"Association between secondhand smoke exposure and hypertension: nearly as large as smoking","volume":"38","author":"Skipina","year":"2020","journal-title":"J Hypertens"},{"issue":"9859","key":"2021081815453116900_CIT0004","doi-asserted-by":"crossref","first-page":"2224","DOI":"10.1016\/S0140-6736(12)61766-8","article-title":"A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990\u20132010: a systematic analysis for the Global Burden of Disease Study 2010","volume":"380","author":"Lim","year":"2012","journal-title":"Lancet"},{"issue":"7","key":"2021081815453116900_CIT0005","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1016\/j.jacc.2012.04.026","article-title":"Trends in prevalence, awareness, management, and control of hypertension among United States adults, 1999 to 2010","volume":"60","author":"Guo","year":"2012","journal-title":"J Am Coll Cardiol"},{"issue":"10","key":"2021081815453116900_CIT0006","doi-asserted-by":"crossref","first-page":"e56","DOI":"10.1161\/CIR.0000000000000659","article-title":"Heart disease and stroke statistics-2019 update: a report from the American Heart Association","volume":"139","author":"Benjamin","year":"2019","journal-title":"Circulation"},{"issue":"1","key":"2021081815453116900_CIT0007","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.mcna.2016.08.012","article-title":"Heart failure and hypertension: importance of prevention","volume":"101","author":"Pfeffer","year":"2017","journal-title":"Med Clin North Am"},{"issue":"4","key":"2021081815453116900_CIT0008","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1016\/j.hfc.2019.06.007","article-title":"Hypertension and Heart Failure","volume":"15","author":"Slivnick","year":"2019","journal-title":"Heart Fail Clin"},{"issue":"32","key":"2021081815453116900_CIT0009","first-page":"1","article-title":"Series 1: programs and collection procedures","author":"Plan and operation of the Third National Health and Nutrition Examination Survey, 1988\u201394.","year":"1994","journal-title":"Vital Health Stat 1."},{"issue":"35","key":"2021081815453116900_CIT0010","first-page":"1141","article-title":"Vital signs: nonsmokers\u2019 exposure to secondhand smoke \u2014 United States, 1999\u20132008","volume":"59","author":"Centers for Disease C, Prevention","year":"2010","journal-title":"MMWR Morb Mortal Wkly Rep."},{"issue":"6","key":"2021081815453116900_CIT0011","first-page":"e13","article-title":"2017 ACC\/AHA\/AAPA\/ABC\/ACPM\/AGS\/APhA\/ASH\/ASPC\/NMA\/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology\/American Heart Association Task Force on clinical practice guidelines","volume":"71","author":"Whelton","year":"2018","journal-title":"Hypertension."},{"issue":"12","key":"2021081815453116900_CIT0012","doi-asserted-by":"crossref","first-page":"2281","DOI":"10.1093\/clinchem\/43.12.2281","article-title":"Development and validation of sensitive method for determination of serum cotinine in smokers and nonsmokers by liquid chromatography\/atmospheric pressure ionization tandem mass spectrometry","volume":"43","author":"Bernert","year":"1997","journal-title":"Clin Chem"},{"key":"2021081815453116900_CIT0013","author":"Prevention CfDCa"},{"issue":"4","key":"2021081815453116900_CIT0014","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1038\/clpt.1984.67","article-title":"Daily intake of nicotine during cigarette smoking","volume":"35","author":"Benowitz","year":"1984","journal-title":"Clin Pharmacol Ther"},{"issue":"12","key":"2021081815453116900_CIT0015","doi-asserted-by":"crossref","first-page":"1414","DOI":"10.1097\/JOM.0b013e318188b90a","article-title":"Accuracy of self-reported smoking and secondhand smoke exposure in the US workforce: the National Health and Nutrition Examination Surveys","volume":"50","author":"Arheart","year":"2008","journal-title":"J Occup Environ Med"},{"key":"2021081815453116900_CIT0016","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1016\/j.ypmed.2014.07.003","article-title":"Tolerance for and potential indicators of second-hand smoke exposure among nonsmokers: a comparison of self-reported and cotinine verified second-hand smoke exposure based on nationally representative data","volume":"67","author":"Jeong","year":"2014","journal-title":"Prev Med."},{"issue":"1","key":"2021081815453116900_CIT0017","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1097\/FTD.0b013e3181957a3b","article-title":"Methods for quantification of exposure to cigarette smoking and environmental tobacco smoke: focus on developmental toxicology","volume":"31","author":"Florescu","year":"2009","journal-title":"Ther Drug Monit"},{"issue":"2","key":"2021081815453116900_CIT0018","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1093\/oxfordjournals.epirev.a017925","article-title":"Cotinine as a biomarker of environmental tobacco smoke exposure","volume":"18","author":"Benowitz","year":"1996","journal-title":"Epidemiol Rev"},{"issue":"1","key":"2021081815453116900_CIT0019","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1124\/pr.57.1.3","article-title":"Metabolism and disposition kinetics of nicotine","volume":"57","author":"Hukkanen","year":"2005","journal-title":"Pharmacol Rev"},{"issue":"1","key":"2021081815453116900_CIT0020","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1038\/nrcardio.2010.165","article-title":"Epidemiology and risk profile of heart failure","volume":"8","author":"Bui","year":"2011","journal-title":"Nat Rev Cardiol"},{"issue":"6","key":"2021081815453116900_CIT0021","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1038\/nrcardio.2016.25","article-title":"Epidemiology and aetiology of heart failure","volume":"13","author":"Ziaeian","year":"2016","journal-title":"Nat Rev Cardiol."},{"issue":"1S","key":"2021081815453116900_CIT0022","doi-asserted-by":"crossref","first-page":"S37","DOI":"10.1016\/j.amjcard.2017.05.014","article-title":"Diabetes mellitus and heart failure","volume":"120","author":"Lehrke","year":"2017","journal-title":"Am J Cardiol."},{"issue":"1","key":"2021081815453116900_CIT0023","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.annepidem.2005.04.008","article-title":"Cardiovascular disease in patients with chronic obstructive pulmonary disease, Saskatchewan Canada cardiovascular disease in COPD patients","volume":"16","author":"Curkendall","year":"2006","journal-title":"Ann Epidemiol"},{"issue":"10","key":"2021081815453116900_CIT0024","doi-asserted-by":"crossref","first-page":"1382","DOI":"10.1002\/ejhf.1252","article-title":"Cancer and heart failure-more than meets the eye: common risk factors and co-morbidities","volume":"20","author":"Anker","year":"2018","journal-title":"Eur J Heart Fail"},{"issue":"5","key":"2021081815453116900_CIT0025","doi-asserted-by":"crossref","first-page":"844","DOI":"10.1093\/cvr\/cvz035","article-title":"Common risk factors for heart failure and cancer","volume":"115","author":"Meijers","year":"2019","journal-title":"Cardiovasc Res"},{"issue":"2","key":"2021081815453116900_CIT0026","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1016\/j.hfc.2013.10.002","article-title":"The role of coronary artery disease in heart failure","volume":"10","author":"Lala","year":"2014","journal-title":"Heart Fail Clin"},{"issue":"1","key":"2021081815453116900_CIT0027","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/j.hfc.2019.08.005","article-title":"Sex and gender-related issues in heart failure","volume":"16","author":"Romiti","year":"2020","journal-title":"Heart Fail Clin"},{"issue":"10","key":"2021081815453116900_CIT0028","doi-asserted-by":"crossref","first-page":"1307","DOI":"10.1093\/ntr\/ntu069","article-title":"Exposure to secondhand smoke and attitudes toward smoke-free workplaces among employed U.S. adults: findings from the National Adult Tobacco Survey","volume":"16","author":"King","year":"2014","journal-title":"Nicotine Tob Res"},{"issue":"4","key":"2021081815453116900_CIT0029","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1056\/NEJM199907223410402","article-title":"Sex, clinical presentation, and outcome in patients with acute coronary syndromes. Global use of strategies to open occluded coronary arteries in acute coronary syndromes IIb Investigators","volume":"341","author":"Hochman","year":"1999","journal-title":"N Engl J Med"},{"issue":"4","key":"2021081815453116900_CIT0030","first-page":"103","article-title":"Vital signs: disparities in nonsmokers\u2019 exposure to secondhand smoke\u2013United States, 1999\u20132012","volume":"64","author":"Homa","year":"2015","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"12","key":"2021081815453116900_CIT0031","first-page":"e154","article-title":"ACC\/AHA 2005 Guideline update for the diagnosis and management of chronic heart failure in the adult: a report of the American College of Cardiology\/American Heart Association task force on practice guidelines (writing committee to update the 2001 guidelines for the evaluation and management of heart failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society","volume":"112","author":"Hunt","year":"2005","journal-title":"Circulation"},{"issue":"1","key":"2021081815453116900_CIT0032","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1186\/s12872-019-1269-y","article-title":"Association of household secondhand smoke exposure and mortality risk in patients with heart failure","volume":"19","author":"He","year":"2019","journal-title":"BMC Cardiovasc Disord"},{"issue":"9","key":"2021081815453116900_CIT0033","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1016\/j.cardfail.2019.12.008","article-title":"The association between secondhand smoke exposure and survival for patients with heart failure","volume":"26","author":"Psotka","year":"2020","journal-title":"J Card Fail"},{"issue":"21","key":"2021081815453116900_CIT0034","doi-asserted-by":"crossref","first-page":"1887","DOI":"10.1001\/archinternmed.2011.518","article-title":"Secondhand smoke exposure and quality of life in patients with heart failure","volume":"171","author":"Weeks","year":"2001","journal-title":"Arch Intern Med."},{"issue":"1","key":"2021081815453116900_CIT0035","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1378\/chest.112.1.289","article-title":"Passive smoking and the 6-minute walk test in heart failure","volume":"112","author":"Jay","year":"1997","journal-title":"Chest"},{"issue":"9859","key":"2021081815453116900_CIT0036","doi-asserted-by":"crossref","first-page":"2163","DOI":"10.1016\/S0140-6736(12)61729-2","article-title":"Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990\u20132010: a systematic analysis for the Global Burden of Disease Study 2010","volume":"380","author":"Vos","year":"2012","journal-title":"Lancet"},{"issue":"4","key":"2021081815453116900_CIT0037","first-page":"e38","article-title":"Heart disease and stroke statistics-2016 update: a report From the American Heart Association","volume":"133","author":"Writing Group M","year":"2016","journal-title":"Circulation"},{"key":"2021081815453116900_CIT0038","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1186\/1471-2407-10-105","article-title":"Long-term survival of cancer patients compared to heart failure and stroke: a systematic review","volume":"10","author":"Askoxylakis","year":"2010","journal-title":"BMC Cancer"},{"issue":"6","key":"2021081815453116900_CIT0039","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1002\/ejhf.284","article-title":"National trends in rate of patients hospitalized for heart failure and heart failure mortality in France, 2000\u20132012","volume":"17","author":"Gabet","year":"2015","journal-title":"Eur J Heart Fail"},{"issue":"3","key":"2021081815453116900_CIT0040","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1016\/j.ijcard.2013.12.028","article-title":"The annual global economic burden of heart failure","volume":"171","author":"Cook","year":"2014","journal-title":"Int J Cardiol"},{"issue":"2","key":"2021081815453116900_CIT0041","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1016\/j.ahj.2014.11.007","article-title":"Factors associated with variations in hospital expenditures for acute heart failure in the United States","volume":"169","author":"Ziaeian","year":"2015","journal-title":"Am Heart J"},{"issue":"24","key":"2021081815453116900_CIT0042","doi-asserted-by":"crossref","first-page":"2572","DOI":"10.1001\/jama.2013.7103","article-title":"Contribution of preventable acute care spending to total spending for high-cost medicare patients","volume":"309","author":"Joynt","year":"2013","journal-title":"JAMA"},{"issue":"3","key":"2021081815453116900_CIT0043","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1007\/s40572-014-0020-1","article-title":"Cardiovascular events following smoke-free legislations: an updated systematic review and meta-analysis","volume":"1","author":"Jones","year":"2014","journal-title":"Curr Environ Health Rep"},{"issue":"2","key":"2021081815453116900_CIT0044","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1016\/j.gheart.2012.05.002","article-title":"Second hand smoke and cardiovascular disease in low and middle income countries: a case for action","volume":"7","author":"Olasky","year":"2012","journal-title":"Glob Heart"},{"issue":"9","key":"2021081815453116900_CIT0045","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1177\/153537020222700916","article-title":"Side-stream cigarette smoke induces dose-response in systemic inflammatory cytokine production and oxidative stress","volume":"227","author":"Zhang","year":"2002","journal-title":"Exp Biol Med (Maywood)"},{"issue":"3","key":"2021081815453116900_CIT0046","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1097\/FJC.0b013e318185fa26","article-title":"Acute effect of sidestream cigarette smoke extract on vascular endothelial function","volume":"52","author":"Argacha","year":"2008","journal-title":"J Cardiovasc Pharmacol"},{"issue":"20","key":"2021081815453116900_CIT0047","doi-asserted-by":"crossref","first-page":"2684","DOI":"10.1161\/CIRCULATIONAHA.104.492215","article-title":"Cardiovascular effects of secondhand smoke: nearly as large as smoking","volume":"111","author":"Barnoya","journal-title":"Circulation"},{"issue":"12","key":"2021081815453116900_CIT0048","doi-asserted-by":"crossref","first-page":"1236","DOI":"10.3390\/ijerph13121236","article-title":"Overview of cotinine cutoff values for smoking status classification","volume":"13","author":"Kim","year":"2016","journal-title":"Int J Environ Res Public Health"}],"container-title":["Nicotine &amp; Tobacco Research"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ntr\/advance-article-pdf\/doi\/10.1093\/ntr\/ntab047\/38852664\/ntab047.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ntr\/article-pdf\/23\/9\/1512\/39778589\/ntab047.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ntr\/article-pdf\/23\/9\/1512\/39778589\/ntab047.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,18]],"date-time":"2021-08-18T16:56:29Z","timestamp":1629305789000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ntr\/article\/23\/9\/1512\/6313108"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,2]]},"references-count":48,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2021,7,2]]},"published-print":{"date-parts":[[2021,8,18]]}},"URL":"https:\/\/doi.org\/10.1093\/ntr\/ntab047","relation":{},"ISSN":["1469-994X"],"issn-type":[{"value":"1469-994X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,9,1]]},"published":{"date-parts":[[2021,7,2]]}}}