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A 2007 meta-analysis of prospective studies showed that active smoking is associated with cognitive impairment (Am J Epidemiol 2007; 166:367). However, whether exposure to secondhand smoke has the same effect remains unclear. To answer this question, investigators conducted a population-based cross-sectional study of 4809 nonsmoking community-dwelling adults (age, ≥50) in England.
Salivary cotinine — a metabolite of nicotine and a marker of recent exposure to secondhand smoke — was measured in each participant. Cognitive impairment was defined as scoring among the lowest 10% on a composite of several neuropsychological tests. In analyses that were adjusted for age, sex, education, alcohol consumption, medical disease, and other potential con…