While the adverse health risks associated with smoking have been well-documented, few studies have examined the cardiovascular outcomes associated with secondhand smoking. The purpose of the study was to assess the distributions and association of cardiovascular diseases (CVDs) in nonsmokers exposed to secondhand smoke (SHS). Data were extracted from the National Health and Nutrition Examination Survey (NHANES) 2015-2016 cycle. Self-reported smoking status and cotinine levels were used to identify exposure groups (smokers, nonsmokers, and secondhand smokers), and medical history of several cardiovascular diseases such as coronary heart diseases and stroke were also collected via self-report survey. The association between exposure to SHS and seven cardiovascular outcomes were analyzed using chi-square analysis and odd ratios (OR) with 95% confidence intervals (CIs) were calculated using two logistic regression models. The data included 5,709 subjects including 18.5% smokers, 23.6% secondhand smokers, and 57.9% nonsmokers. There was statistically significant association between exposure to SHS and only two out of seven cardiovascular outcomes, hypertension (OR 1.554, 95% CI [1.066, 2.265]) and cholesterol levels (OR 1.213, 95% CI [1.017, 1.446]). This study is one of the first to determine an association between SHS and seven cardiovascular outcomes, thus highlighting the importance of reducing SHS exposure and can be used for further research on SHS and cardiovascular health.

Thesis Completion




Thesis Chair/Advisor

Lopez Castillo, Humberto


Bachelor of Science (B.S.)


College of Health Professions and Sciences


Health Sciences

Degree Program

Health Sciences, Pre-Clinical Track



Access Status

Open Access

Release Date