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Non-smokers who are exposed to secondhand smoke inhale and metabolize the harmful components of tobacco smoke. Secondhand smoke biomarkers can be measured to provide an estimate of the SHS components that have entered the body. The amount of time spent in smoky environments will impact the levels of chemicals found in the body. Biomarkers represent an integrated measure of exposure, across all environments where an individual spends time. They do not provide information on the specific locations where exposure occurred, and should therefore be used in conjunction with questionnaires or air monitoring to target the locations where exposure took place.

Currently, the most commonly used biomarkers for tobacco smoke are nicotine and its derivative cotinine1. Nicotine and cotinine are specific biomarkers because they are not usually present in the body in the absence of exposure to tobacco smoke or use of tobacco or nicotine products. Cotinine can be measured in several body fluids including urine, saliva and blood2. Nicotine can also be measured in the hair3. The amount of cotinine found in the body or nicotine in hair provides an objective measure of personal SHS exposure2.

  • Saliva Biomonitoring: Saliva collection is less invasive than other bodily fluids such as blood, but there are logistical requirements for collection and shipment to the laboratory. The saliva samples should be frozen soon after collection and kept frozen until they are shipped to a laboratory for cotinine analysis.
  • Hair Biomonitoring: Like cotinine, nicotine can be measured in the body as well. It is found in hair. Hair monitoring is less invasive, less expensive and samples are easier to store than other body fluids. Hair samples do not require special storage or shipping conditions and can be easily sent to a laboratory for analysis.

1 U.S. Department of Health and Human Services, 2006; International Agency for Research on Cancer, 2004; Jarvis et al. 1984;
2 Benowitz, 1996
3 Nafstad, 1997


This project is funded by the Bloomberg Initiative to Reduce Tobacco Use and the Flight Attendant Medical Research Institute (FAMRI), developed in consultation with Roswell Park Cancer Institute and the University of Southern California, Institute for Global Health.