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Cigarette smoking is an established risk factor for cardiovascular disease, though its relationship with measured blood pressure has long been characterised as paradoxical [4,5,6]

1988-1991: almost 88 percent of non smokers had measurable levels of cotinine 2007-2008: 40 percent of non smokers had measurable levels of cotinine 2011-2012: 25 percent of non smokers had measurable levels of cotinine The main drivers for such decrease are: Laws implemented by a number of states and communities that forbid smoking in public areas, including restaurants, bars and casinos A growing number of households with voluntary smoke free home rule Dramatic decrease in smoking rates Smoking around non smokers has become less socially acceptable It is also worth mentioning that approximately 58 million non smokers in the United States were exposed to secondhand smoke during 2011-2012

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