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BACKGROUND Tobacco smoke exposure adversely affects respiratory health. However, the effects of exposure on adolescents without asthma are not well known. RESEARCH QUESTION To what degree are biochemically measured and self-reported tobacco smoke exposure associated with pulmonary function and healthcare utilization among U.S. nonsmoking adolescents? STUDY DESIGN and Methods We analyzed 2007-2012 National Health and Nutrition Examination Survey data (N=2,482). Tobacco smoke exposure was assessed with serum cotinine and self-reported home