Secondhand smoke and aerosol exposure and awareness among non-smoking workers in a smoke-free workplace: A cross-sectional analysis using urinary cotinine concentrations.
- 1Department of Epidemiology and Prevention, Center for Clinical Sciences, Japan Institute for Health Security, Tokyo, Japan.
- 2Department of Environmental Health, National Institute of Public Health, Wako, Japan.
- 3Department of Health Administration, Furukawa Electric Co., Ltd., Tokyo, Japan.
Abstract
Although smoke-free workplaces have become increasingly common, residual nicotine exposure among non-smoking workers in such settings remains insufficiently characterized. This study aimed to assess secondhand smoke and aerosol (SSA) exposure and awareness of such exposure among non-smoking workers in a factory with a strict smoke-free workplace policy, using urinary cotinine as an objective biomarker of recent nicotine exposure. As part of an occupational cohort study in Japan, a cross-sectional survey was conducted among employees of a smoke-free factory in April 2024. Participants completed a self-administered questionnaire that included items on smoking habits and SSA exposure and provided first-morning urine samples. Urinary cotinine concentrations were measured and corrected for urinary creatinine. We calculated the prevalence of self-reported SSA exposure and detectable urinary cotinine (≥0.01 ng/mL). Logistic regression was used to examine the association of age, sex, education level, marital status, occupation, shift work, chronic conditions, former smoking, and alcohol use with high urinary exposure (≥0.207 ng/mg creatinine). Among 746 self-reported non-current smokers, 88.5% had detectable urinary cotinine concentrations, whereas only 21.1% reported SSA exposure from combustible cigarettes or heated tobacco products (HTPs) at least once per month. Higher odds of high urinary cotinine concentrations were observed for female sex (adjusted odds ratio, AOR=1.74; 95% CI: 1.01-2.99), manual work (AOR=1.66; 95% CI: 1.06-2.60), and former smoking (AOR=1.68; 95% CI: 1.18-2.41), whereas higher level of education was associated with lower odds (AOR=0.67; 95% CI: 0.46-0.98). Among 660 participants with detectable urinary cotinine, 78.0% were unaware of their SSA exposure. A substantial proportion of non-smoking employees working in a smoke-free factory had detectable urinary cotinine concentrations, whereas only a minority recognized SSA exposure. Further studies are warranted to clarify exposure sources and to better characterize SSA exposure in the context of the increasing use of HTPs.
Related
- Household secondhand smoke exposure and learning difficulties in children and adolescents: A cross-sectional study on the mediating roles of attention, memory, and adaptability
- The effect of childhood exposure to secondhand smoke on urinary cotinine and 8 hydroxy-2-deoxyguanosine levels: A cross-sectional study.
- Age and sex modify the association between secondhand smoke exposure and self-reported asthma in school-aged children (6-11 years): a cross-sectional study from NHANES 2005-2020.
- Awareness and Prescribing Practices for Doxycycline Post‐Exposure Prophylaxis (doxyPEP) Among Healthcare Providers Delivering Sexual Health Care in Australia: A Cross‐Sectional Survey
- Cancer Knowledge and Environmental Exposure Awareness Among Healthcare Workers and the General Public in Istanbul: A Cross-Sectional Study
BibTeX
@article{miyake2026secondhand,
title = {{Secondhand smoke and aerosol exposure and awareness among non-smoking workers in a smoke-free workplace: A cross-sectional analysis using urinary cotinine concentrations.}},
author = {Haruka Miyake and Yohei Inaba and Shota Yoshihara and Takeshi Kochi and Aoi Ito and Shohei Yamamoto and Maki Konishi and Akira Ushiyama and Tetsuya Mizoue},
journal = {Tobacco induced diseases},
year = {2026},
month = oct,
doi = {10.18332/tid/226747},
url = {https://europepmc.org/article/MED/42997470},
note = {CC BY},
}
RIS
TY - JOUR
TI - Secondhand smoke and aerosol exposure and awareness among non-smoking workers in a smoke-free workplace: A cross-sectional analysis using urinary cotinine concentrations.
AU - Haruka Miyake
AU - Yohei Inaba
AU - Shota Yoshihara
AU - Takeshi Kochi
AU - Aoi Ito
AU - Shohei Yamamoto
AU - Maki Konishi
AU - Akira Ushiyama
AU - Tetsuya Mizoue
PY - 2026
DA - 2026/10/31
JO - Tobacco induced diseases
DO - 10.18332/tid/226747
UR - https://europepmc.org/article/MED/42997470
AB - Although smoke-free workplaces have become increasingly common, residual nicotine exposure among non-smoking workers in such settings remains insufficiently characterized. This study aimed to assess secondhand smoke and aerosol (SSA) exposure and awareness of such exposure among non-smoking workers in a factory with a strict smoke-free workplace policy, using urinary cotinine as an objective biomarker of recent nicotine exposure. As part of an occupational cohort study in Japan, a cross-sectional survey was conducted among employees of a smoke-free factory in April 2024. Participants completed a self-administered questionnaire that included items on smoking habits and SSA exposure and provided first-morning urine samples. Urinary cotinine concentrations were measured and corrected for urinary creatinine. We calculated the prevalence of self-reported SSA exposure and detectable urinary cotinine (≥0.01 ng/mL). Logistic regression was used to examine the association of age, sex, education level, marital status, occupation, shift work, chronic conditions, former smoking, and alcohol use with high urinary exposure (≥0.207 ng/mg creatinine). Among 746 self-reported non-current smokers, 88.5% had detectable urinary cotinine concentrations, whereas only 21.1% reported SSA exposure from combustible cigarettes or heated tobacco products (HTPs) at least once per month. Higher odds of high urinary cotinine concentrations were observed for female sex (adjusted odds ratio, AOR=1.74; 95% CI: 1.01-2.99), manual work (AOR=1.66; 95% CI: 1.06-2.60), and former smoking (AOR=1.68; 95% CI: 1.18-2.41), whereas higher level of education was associated with lower odds (AOR=0.67; 95% CI: 0.46-0.98). Among 660 participants with detectable urinary cotinine, 78.0% were unaware of their SSA exposure. A substantial proportion of non-smoking employees working in a smoke-free factory had detectable urinary cotinine concentrations, whereas only a minority recognized SSA exposure. Further studies are warranted to clarify exposure sources and to better characterize SSA exposure in the context of the increasing use of HTPs.
SN - 2070-7266
SN - 1617-9625
ER -