Abstract
BACKGROUND: Children with parents who smoke are often exposed to high levels of environmental tobacco smoke, and children with asthma are particularly susceptible to the detrimental effects of passive smoking. Data were collected from parents who smoke and from their asthmatic children. The families are currently taking part in a randomised controlled trial to test an intervention designed to reduce passive smoking in children with asthma. This paper reports on the baseline data. Questionnaire data and cotinine levels were compared in an attempt to assess exposure and to identify factors which influence exposure of the children. The aim of the study was to identify the scope for a reduction in passive smoking by these children. METHODS: A sample of 501 families with an asthmatic child aged 2-12 years was obtained. Factors influencing passive smoking were assessed by interviewing parents. Cotinine levels were measured from saliva samples using gas liquid chromatography with nitrogen phosphorous detection. RESULTS: Cotinine levels in children were strongly associated with the age of the child, the number of parents who smoked, contact with other smokers, the frequency of smoking in the same room as the child, and crowding within the home. Parental cotinine levels, the amount smoked in the home, and whether the home had a garden also exerted an independent effect on cotinine levels in the children. CONCLUSIONS: Many children are exposed to high levels of environmental tobacco smoke and their cotinine levels are heavily dependent upon proximity to the parent who smokes. Parents who smoke have a unique opportunity to benefit their child's health by modifying their smoking habits within the home.
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Selected References
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- Bakoula C. G., Kafritsa Y. J., Kavadias G. D., Lazopoulou D. D., Theodoridou M. C., Maravelias K. P., Matsaniotis N. S. Objective passive-smoking indicators and respiratory morbidity in young children. Lancet. 1995 Jul 29;346(8970):280–281. doi: 10.1016/s0140-6736(95)92167-2. [DOI] [PubMed] [Google Scholar]
- Charlton A. Children and passive smoking: a review. J Fam Pract. 1994 Mar;38(3):267–277. [PubMed] [Google Scholar]
- Chilmonczyk B. A., Salmun L. M., Megathlin K. N., Neveux L. M., Palomaki G. E., Knight G. J., Pulkkinen A. J., Haddow J. E. Association between exposure to environmental tobacco smoke and exacerbations of asthma in children. N Engl J Med. 1993 Jun 10;328(23):1665–1669. doi: 10.1056/NEJM199306103282303. [DOI] [PubMed] [Google Scholar]
- Cook D. G., Whincup P. H., Papacosta O., Strachan D. P., Jarvis M. J., Bryant A. Relation of passive smoking as assessed by salivary cotinine concentration and questionnaire to spirometric indices in children. Thorax. 1993 Jan;48(1):14–20. doi: 10.1136/thx.48.1.14. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Couriel J. M. Passive smoking and the health of children. Thorax. 1994 Aug;49(8):731–734. doi: 10.1136/thx.49.8.731. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ehrlich R., Kattan M., Godbold J., Saltzberg D. S., Grimm K. T., Landrigan P. J., Lilienfeld D. E. Childhood asthma and passive smoking. Urinary cotinine as a biomarker of exposure. Am Rev Respir Dis. 1992 Mar;145(3):594–599. doi: 10.1164/ajrccm/145.3.594. [DOI] [PubMed] [Google Scholar]
- Feyerabend C., Russell M. A. A rapid gas-liquid chromatographic method for the determination of cotinine and nicotine in biological fluids. J Pharm Pharmacol. 1990 Jun;42(6):450–452. doi: 10.1111/j.2042-7158.1990.tb06592.x. [DOI] [PubMed] [Google Scholar]
- Jarvis M. J., Russell M. A., Feyerabend C., Eiser J. R., Morgan M., Gammage P., Gray E. M. Passive exposure to tobacco smoke: saliva cotinine concentrations in a representative population sample of non-smoking schoolchildren. Br Med J (Clin Res Ed) 1985 Oct 5;291(6500):927–929. doi: 10.1136/bmj.291.6500.927. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Jarvis M. J., Strachan D. P., Feyerabend C. Determinants of passive smoking in children in Edinburgh, Scotland. Am J Public Health. 1992 Sep;82(9):1225–1229. doi: 10.2105/ajph.82.9.1225. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kun H. Y., Oates R. K., Mellis C. M. Hospital admissions and attendances for asthma--a true increase? Med J Aust. 1993 Sep 6;159(5):312–313. doi: 10.5694/j.1326-5377.1993.tb137867.x. [DOI] [PubMed] [Google Scholar]
- McNeill A. D., Jarvis M. J., West R., Russell M. A., Bryant A. Saliva cotinine as an indicator of cigarette smoking in adolescents. Br J Addict. 1987 Dec;82(12):1355–1360. doi: 10.1111/j.1360-0443.1987.tb00439.x. [DOI] [PubMed] [Google Scholar]
- Reese A. C., James I. R., Landau L. I., Lesouëf P. N. Relationship between urinary cotinine level and diagnosis in children admitted to hospital. Am Rev Respir Dis. 1992 Jul;146(1):66–70. doi: 10.1164/ajrccm/146.1.66. [DOI] [PubMed] [Google Scholar]
- Stoddard J. J., Miller T. Impact of parental smoking on the prevalence of wheezing respiratory illness in children. Am J Epidemiol. 1995 Jan 15;141(2):96–102. doi: 10.1093/oxfordjournals.aje.a117418. [DOI] [PubMed] [Google Scholar]
- Strachan D. P., Jarvis M. J., Feyerabend C. The relationship of salivary cotinine to respiratory symptoms, spirometry, and exercise-induced bronchospasm in seven-year-old children. Am Rev Respir Dis. 1990 Jul;142(1):147–151. doi: 10.1164/ajrccm/142.1.147. [DOI] [PubMed] [Google Scholar]
- Sturk A., van Deventer S. J., Wortel C. H., Levels J. H., ten Cate J. W., Büller H. R., Sanders G. T. Detection and clinical relevance of human endotoxemia. Z Med Lab Diagn. 1990;31(3):147–158. [PubMed] [Google Scholar]
- Weitzman M., Gortmaker S., Walker D. K., Sobol A. Maternal smoking and childhood asthma. Pediatrics. 1990 Apr;85(4):505–511. [PubMed] [Google Scholar]
- Willers S., Svenonius E., Skarping G. Passive smoking and childhood asthma. Urinary cotinine levels in children with asthma and in referents. Allergy. 1991 Jul;46(5):330–334. doi: 10.1111/j.1398-9995.1991.tb00595.x. [DOI] [PubMed] [Google Scholar]
