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Original Research

Open Access

Sex-specific association between secondhand smoke exposure and acute coronary syndrome using KoGES epidemiological cohort data

  • Eujene Jung1
  • Hyun Yi Kook2
  • Hyun Lee Kim3
  • Hyun Ho Ryu4,*,

1Department of emergency medicine, Chonnam National University Hospital, 61456 Gwangju, Republic of Korea

2College of Nursing, Chonnam National University, 61456 Gwangju, Republic of Korea

3Department of internal medicine, Chosun University Hospital, 61456 Gwangju, Republic of Korea

4Department of medicine, Chonnam National University, 61456 Gwangju, Republic of Korea

DOI: 10.22514/jomh.2024.074 Vol.20,Issue 5,May 2024 pp.89-94

Submitted: 27 October 2023 Accepted: 17 November 2023

Published: 30 May 2024

*Corresponding Author(s): Hyun Ho Ryu E-mail:


While numerous studies highlight sex differences in the adverse effects of direct smoking, research on sex-specific risks from secondhand smoking (SHS)-induced diseases is sparse. We hypothesized that acute coronary syndrome (ACS) could be influenced by SHS exposure, with effects varying by sex. We utilized the Korea Genome Epidemiology Study (KoGES) data which was collected starting from 2001 and follow-up for 19 years, to conduct our study. Our primary exposure was secondhand smoke (SHS), and the main outcome of interest was acute coronary syndrome (ACS). We conducted Cox proportional logistic regression analysis and performed an interaction analysis to investigate the interaction between SHS and sex in relation to ACS incidence. SHS exposure was not associated with an increased risk of ACS, exhibiting a hazard ratio (HR) of 1.44 (95% confidence interval (CI), 0.88–1.49) in comparison to the non-exposed group. In the interaction analysis between SHS exposure and sex on the incidence of ACS, in females, SHS was not a risk factor for ACS (HR: 0.97 (95%CI: 0.70–1.35)), whereas, in males, SHS was a significant risk factor for ACS (HR: 1.63 (1.02–2.60). We identified a significant association between SHS exposure and an increased risk of ACS in males. Our findings emphasize the importance of minimizing secondhand smoke exposure, particularly among the male demographic.


Secondhand smoke; Sex; Acute coronary syndrome

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Eujene Jung,Hyun Yi Kook,Hyun Lee Kim,Hyun Ho Ryu. Sex-specific association between secondhand smoke exposure and acute coronary syndrome using KoGES epidemiological cohort data. Journal of Men's Health. 2024. 20(5);89-94.


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