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Our finding of higher levels of SHS exposure among participants with higher tobacco outlet density is consistent with previous reports of higher rates of smoking prevalence in low-income neighbourhoods with high tobacco outlet density.18 19 33 However, air nicotine levels and serum cotinine levels were elevated even in non-smoking homes, and a plausible explanation would be that the presence of tobacco outlets is leading to more smoking of tobacco products within the vicinity of tobacco outlets, which is polluting the nearby indoor environment