Trends And Correlates Of Secondhand Smoke Exposure Among Non-Smoking Cancer Survivors In The United States: 1999-2012.

10105 Background: Secondhand smoke exposure (SHSe) adversely affects outcomes in certain cancers and also increases the risk of non-cancer related deaths among cancer survivors. We sought to estimate and trend the prevalence of SHSe as well as the proportion of SHSe due to indoor household tobacco exposure among non-smoking adult cancer survivors in the United States (US). Methods: Data were obtained from the National Health and Nutrition Examination Survey for 3,482 adults aged at least 20 years with a self-reported history of cancer who were examined in 2 year cross-sectional cycles from 1999-2012. SHSe was defined with serum cotinine levels 0.05-10ng/ml among non-smokers. We calculated and trended the prevalence of SHSe as well as the geometric means of serum cotinine among non-smoking adult cancer survivors with SHSe. Independent associations of the following with SHSe were examined with multivariable logistic regression: age, gender, race, education, income, smoking history, cancer site, time since cancer diagnosis, and survey cycle. Survey weights were applied in estimating the population-based prevalence and 95% confidence intervals (CI). Results: The prevalence of SHSe among non-smoking US adult cancer survivors declined from 31.9% (CI 22.6-44.1%) to 14.1% (CI 9.1-19.1%) in 1999/2000 and 2011/2012, respectively (P-value for trend < 0.01). The geometric means of serum cotinine also declined from 1.8ng/ml (CI 1.3-2.6ng/ml) to 1.3ng/ml (CI 1.2-1.4ng/ml) (P-value for trend < 0.01). Among those with SHSe, exposure from indoor household smoking declined from 23.4% (CI 13.7-33.4%) in 2001/2002 to 8.8% (CI 0.2-17.3%) in 2011/2012 (P-value for trend < 0.01). Increasing age and being female were protective against SHSe while blacks, former smokers, poor, and less educated survivors had higher odds of SHSe. Conclusions: SHSe among non-smoking cancer survivors in the US is on the decline. However, SHSe is increasingly being mediated by tobacco exposure in settings outside the home. These findings suggest the need for a paradigm shift by healthcare professionals who address SHSe among non-smoking cancer survivors to encouraging their vigilance and avoidance of SHSe in settings outside the home.