Table 5.

Urinary Levels of Cotinine, Total NNAL, and 3-HPMA in Children (≤5 Years) Living in Homes of Hookah-Only Smokers and Nonsmokers (N = 24)

	Nonsmoker homes (n = 5), GM (95% CI)a	Hookah-only smoker homes (n = 19), GM (95% CI)	p valueb	Hookah-only smoker homes by frequency of smoking			p valued	p valuee
				Daily hookah smoker Homes (n = 8), GM (95% CI)	p valuec	Weekly/monthly hookah smoker homes (n = 11), GM (95% CI)
Child exposure to hookah SHS
Hours exposed in 7 daysf	0 (0–0)	3.39 (2.01–5.39)	< .001	4.42 (1.92–9.06)	.003	2.76 (1.35–5.04)	.002	.247
Median		2.17		4.21		1.92
Range (hours)		0.02–19		0.33–19		0.02–15.17
Cotinine
Maximumg
ng/ml	0.34 (0.07–0.68)	0.92 (0.51–1.44)	.082	1.21 (0.38–2.52)	.079	0.73 (0.35–1.22)	.157	.620
ng/mg creatinine	0.90 (0.23–1.92)	3.26 (1.82–5.43)	.036	4.13 (1.52–9.48)	.040	2.71 (1.24–5.15)	.079	.563
Averageh
ng/ml	0.16 (0.06–0.26)	0.65 (0.30–1.08)	.063	0.88 (0.21–1.93)	.143	0.49 (0.17–0.91)	.062	.804
ng/mg creatinine	0.44 (0.16–0.79)	2.08 (1.07–3.58)	.021	2.85 (0.83–7.12)	.028	1.62 (0.71–3.00)	.047	.364
Range in ng/mg	0.05–2.86	0.05–28.44		0.05–28.44		0.05–15.85
%, Freq/n above LODi,j	60%, 9/15j	81%, 46/57		75%, 18/24		85%, 28/33
Total NNAL
Maximum
pg/mlk	0.20 (0.0–0.57)	3.40 (1.59–6.45)	.010	4.70 (1.10–14.46)	.013	2.64 (1.06–5.45)	.012	.455
pg/mg creatinine	0.56 (0.20–1.03)	8.53 (3.92–17.47)	.014	12.42 (2.98–44.24)	.013	6.43 (2.53–14.63)	.047	.364
Average
pg/ml	0.11 (0.0–0.24)	2.55 (1.15–4.87)	.009	3.70 (0.80–11.30)	.013	1.89 (0.71–3.90)	.012	.407
pg/mg creatinine	0.28 (0.14–0.43)	6.68 (2.93–13.99)	.012	10.43 (2.27–38.98)	.008	4.75 (1.80–10.81)	.047	.215
Range in pg/mg	0.08–1.43	0.08–242.20		0.15–242.20		0.08–66.32
%, Freq/n above LOD	7%, 1/15	68%, 39/57		71%, 17/24		67%, 22/33
3-HPMA
Maximum
pmol/mll	991 (479–2,050)	1,085 (749–1,573)	.546	950 (668–1,351)	.999	1,196 (658–2,173)	.336	.160
pmol/mg creatinine	2,306 (1,423–3,737)	3,665 (2,847–4,718)	.110	4,076 (2,965–5,603)	.057	3,392 (2,329–4,939)	.282	.409
Average
pmol/ml	616 (339–1,121)	714 (495–1,031)	.414	676 (439–1,040)	.770	744 (422–1,311)	.282	.322
pmol/mg creatinine	1,600 (1,112–2,303)	2,488 (1,890–3,277)	.095	2,966 (2,074–4,240)	.040	2,190 (1,476–3,250)	.282	.186
Range in pmol/mg	553–5,864	300–8,889		778–7,866		300–8,889
%, Freq/n above LOD	100%, 15/15	100%, 57/57		100%, 24/24		100%, 33/33

Note. 3-HPMA = 3-hydroxypropylmercapturic acid; LOD = limit of detection; NNAL = 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol; SHS = secondhand smoke.

^aGM (95% CI) = geometric mean and 95% confidence interval.

^b–e p values were derived from Mann–Whitney U tests on raw data; two-tailed with an alpha level p < .05; statistically significant p values are noted in bold. p ^b, p ^c, p ^d, p ^e, respectively, ^bhookah smokers vs. nonsmokers, ^cdaily smokers vs. nonsmokers, ^dweekly/monthly smokers vs. nonsmokers, ^gedaily smokers vs. weekly/monthly smokers.

^fNumber of hours child exposed to hookah SHS in 7 days was calculated from reported data from two diaries: 7-Day Home Tobacco Use Diary and 7-Day Child observation Diary.

^gMaximum = GM of the highest level of three spot urine samples collected during 1 week, uncorrected and corrected by creatinine.

^hAverage = GM of the average level of three spot urine samples collected during 1 week, uncorrected and corrected by creatinine.

ⁱPercentage (% rounded up) of urine samples above the LOD: cotinine LOD = 0.05ng/ml, NNAL LOD = 0.25 pg/ml, and 3-HPMA LOD = 2 pmol/ml.

^jFreq/n = frequency of samples with levels above the LOD/sample size of samples per group, for example, three urine sample per child × 5 homes = 15 urine samples.

^kMolecular weight for NNAL is 209: to convert from pg/ml to pmol/ml divide by 209, for example, 0.25 pg/ml = 0.0012 pmol/ml.

^lMolecular weight for 3-HPMA is 221: to convert from pmol/ml to pg/ml multiply by 221, for example, 2 pmol/ml × 221 = 442 pg/ml.