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Original Article Associations of active and passive tobacco exposure with elevated blood pressure in Korean adolescents
Hyerin Park1orcid , Hyunsuk Jeong2orcid , Hyeon Woo Yim2orcid , Sanghyuk Bae2orcid
Epidemiol Health 2024;46e2024028-0
DOI: https://doi.org/10.4178/epih.e2024028
Published online: February 13, 2024
1Graduate School of Public Health and Healthcare Management, The Catholic University of Korea, Seoul, Korea
2Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
Corresponding author:  Hyunsuk Jeong,
Email: suejeong@catholic.ac.kr
Received: 1 August 2023   • Accepted: 24 January 2024
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OBJECTIVES
To test the hypothesis that tobacco exposure is associated with elevated blood pressure (EBP) in Korean adolescents, and that the association is dose dependent.
METHODS
This cross-sectional study used data from the 2011-2020 Korea National Health and Nutrition Survey (KNHANES). Subjects were eligible if they were 13-18 years at the time of participation in KNHANES. Tobacco exposure was defined by urine cotinine level. The main outcomes were EBP and hypertension. Statistical analyses were conducted using SAS version 9.4 with appropriate sampling weights to account for the complex survey design, stratification, and cluster variable.
RESULTS
A total of 2,518 adolescents was included in the analysis, representing 2.5 million Korean adolescents. The mean± standard deviation participant age was 15.3±1.7 years, and 55.3% were male. The number of participants with active tobacco smoke exposure was 283 (11.2%), passive tobacco smoke exposure was 145 (5.8%), and no smoke exposure was 2,090 (83.0%). Analysis of the 2,518 urine-cotinine-verified participants showed that tobacco smoke exposure had a significant effect on EBP: with an odds of elevated blood pressure of 3.00 (95% confidence interval [CI], 1.14 to 7.89). The odds of hypertension were 3.61 (95% CI, 1.13 to 11.49) in the active smoking group compared with the no tobacco exposure group after adjustment for potential confounders.
CONCLUSIONS
It is necessary to present a range of public health plans to reduce tobacco exposure that affects adolescents’ blood pressure, and further research with a larger number of participants using urine cotinine as a biomarker is needed.


Epidemiol Health : Epidemiology and Health