Merianos AL, et al. - Via analyzing 2007-2012 National Health and Nutrition Examination Survey data (n = 2,482), researchers desired to know the degree of biochemically measured and self-reported exposure of tobacco smoke correlated with pulmonary function and healthcare utilization among US nonsmoking adolescents. The exposure of tobacco smoke to serum cotinine and self-reported home exposure was evaluated. According to results, around 3% of adolescents had high cotinine (3.00-15.00ng/mL), 35.7% had low cotinine (0.05-2.99ng/ml), and 10.9% had home exposure. Adolescents with high cotinine had significantly lower FEV1% and FVC% compared with those with no/minimal cotinine. Adolescents with high cotinine were less likely to have a healthcare visit in the past year, but were more likely to have an overnight hospital stay, and at greater risk of having a higher number of overnight stays in hospitals. Adolescents with low cotinine were less likely to have a healthcare visit, but were more likely to have an overnight hospital stay compared with those with no/minimal cotinine. Adolescents with home exposure were more likely to have overnight hospital stays and more likely to have a higher number of overnight hospital stays. Detectable levels of serum cotinine and self-reported home exposure were distinctively correlated with reduced pulmonary function and increased use of healthcare.