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Association between secondhand smoke exposure and incidence of metabolic syndrome: analyses of Korean Genome and Epidemiology Study (KoGES) data
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Seungmi Choi, Sanghyuk Bae
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Epidemiol Health. 2025;e2025041. Published online July 29, 2025
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DOI: https://doi.org/10.4178/epih.e2025041
[Accepted]
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 Abstract
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Abstract
OBJECTIVES
Secondhand smoke exposure remains a major public health concern and is linked to various chronic diseases, including metabolic syndrome (MetS). Although smoking rates have declined, exposure to secondhand smoke remains common and poses significant health risks to non-smokers. This study investigated the association between secondhand smoke exposure and the incidence of MetS using longitudinal data from a community-based cohort in South Korea.
METHODS We utilized data from the Korean Genome and Epidemiology Study, collected biennially between 2001 and 2020. Of 10,030 adults aged 40-69 years, a total of 3,042 never-smokers without pre-existing MetS were included. Secondhand smoke exposure was assessed through self-reported questionnaires. Cox proportional hazards models were employed to estimate hazard ratios (HRs) and 95% confidence intervals, adjusting for potential confounders.
RESULTS During follow-up, 638 participants in the secondhand smoke exposure group developed MetS. Those exposed to secondhand smoke had a significantly higher risk of developing MetS compared to the non-exposed group (HR, 1.15; 95% CI, 1.02-1.27). Among MetS components, secondhand smoke exposure was significantly associated with increased risks of hypertension (HR, 1.13; 95% CI, 1.00-1.28) and hyperglycemia (HR, 1.19; 95% CI, 1.03-1.37). Although home exposure was not significantly associated with MetS risk, workplace exposure to secondhand smoke demonstrated a dose-response relationship according to exposure frequency and duration.
CONCLUSIONS Our findings suggest that secondhand smoke exposure may increase the risk of developing MetS. These results underscore the importance of strengthening regulations on secondhand smoke in public places and raising social awareness of its detrimental effects on non-smokers.
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Summary
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