Kim BJ, et al. - The link between coronary artery calcium (CAC) and urinary cotinine or self-reported smoking status was studied in 22,797 individuals (19,181 men; mean age±SD 39.2±7.1 years) who were enrolled in the Kangbuk Samsung Health Study and Kangbuk Samsung Cohort Study between 2011 and 2013. Cotinine-verified current smokers were defined as having a urinary cotinine level of above 50 ng/ml. In self-reported current smokers vs self-reported never/former smokers, a higher prevalence of CAC was noted, which was higher in cotinine-verified current smokers vs in cotinine-verified never smokers. Both self-reported and cotinine-verified smoking was found to be independently associated with the presence of CAC in Korean adults. This study is the first large cohort study to show this association.