Exposure to environmental tobacco smoke is associated with lower plasma β-carotene levels among nonsmoking women married to a smoker

We evaluated the association between exposure to environmental tobacco smoke (ETS) from husbands who smoke and plasma levels of antioxidant vitamins among nonsmoking women. A total of 1249 women from four areas in Italy answered a self-administered questionnaire, reported their diets on a food frequency questionnaire, had a medical examination, and gave their blood for alpha and beta -carotene, retinol, L-ascorbic acid, alpha -tocopherol, and lycopene determinations. Urinary cotinine was used to evaluate the level of recent exposure to ETS. After adjusting for study center, age and education, we found no association between ETS exposure and daily nutrient intake of beta -carotene, retinol, L-ascorbic acid, and alpha -tocopherol. However, we found an inverse dose-response relationship between intensity of current husband's smoke and concentrations of plasma beta -carotene and L-ascorbic acid. The associations remained even after controlling for daily beta -carotene and vitamin C intake and for other potential confounders (vitamin supplementation, alcohol consumption, and body mass index). Moreover, when urinary cotinine was considered as the exposure variable, a significant inverse association with plasma beta -carotene was found. The findings may be of interest to explain the biological mechanism that link ETS exposure with lung cancer and ischemic heart diseases.