Biomarkers of Secondhand Smoke and Vaping Exposure Among U.S. Adolescents
Document Type
Article
Publication Title
Addictive Behaviors
Abstract
Background
Despite reductions in smoking use among adults and adolescents, e-cigarette use has increased, raising a new public health concern.
Methods
We analyzed Wave 4 (2016–2018) data from the Population Assessment of Tobacco and Health (PATH) Study to assess biomarkers of exposure to secondhand smoke and vaping aerosols among U.S. adolescents (age range 12–17). Participants with no current tobacco use in the past 30 days were divided into four mutually exclusive groups: no exposure, exposure to secondhand smoke (SHS) only, exposure to secondhand aerosol (SHA) only, and dual exposure to both (SHD).
Results
Among 2,379 adolescents (mean[SD] of age = 14.4[0.02]), 1.5 % reported SHA, 18.3 % reported SHS, and 2.8 % reported SHD. Mean concentrations of cotinine were significantly higher among those exposed to SHA only (0.5 ng/mg creatinine, p = 0.04), SHS (3.0,p < 0.0001), or SHD (2.5,p < 0.0001) than among those with no exposure (0.2). As compared to the no-exposure group, both SHS and SHD groups also had higher mean concentrations of carcinogen, NNAL (4.1 and 2.8 pg/mg creatinine, respectively, vs. 0.9, p < 0.0001) and exposure to SHS had a higher level of CYMA (1.8 vs. 1.1 ng/mg creatinine, p < 0.0001). In comparison with the SHA group, the SHS and SHD groups had 6.8 and 3.6 times higher levels of cotinine and 4.6 and 2.2 times higher levels of NNAL, respectively; the SHS group also had higher levels of AAMA and CYMA.
Conclusions
Secondhand vaping aerosol poses a lower exposure risk to youth non-tobacco users than combustible cigarette smoke. The distinct exposure patterns emphasize the importance of implementing tobacco-free policies to reduce youth exposure to environments where combustible tobacco or e-cigarette use occurs.
DOI
10.1016/j.addbeh.2025.108381
Publication Date
10-2025
ISSN
1873-6327
Recommended Citation
Dai HD, Brown Keebler AK, Young B. Biomarkers of Secondhand Smoke and Vaping Exposure Among U.S. Adolescents. Addictive Behaviors. 2025; 169. doi: 10.1016/j.addbeh.2025.108381.
