Factors Associated with Secondhand Smoke Exposure Prevalence and Secondhand Smoke Level of Children Living with Parental Smokers: A Cross Sectional Study

Ulbricht, Sabina; Unger, Friederike; Groß, Stefan; Nauck, Matthias; Meyer, Christian; John, Ulrich

doi:10.1007/s10900-014-9963-2

Cited by 8 publications

(6 citation statements)

References 28 publications

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“…27 Seasonal variation, daycare attendance, and the age of a child can also affect the degree of SHSe. 28 In our study, there were 5 children who had a positive cotinine screening result despite that their caregivers denied SHSe. We also found that children were more likely to have a positive urinary cotinine if their parents reported indoor smoking without any modifications.…”

Section: Discussionmentioning

confidence: 62%

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Secondhand Smoke Exposure Measured in Urinary Cotinine Levels and Severity of Pediatric Sleep Apnea

Rubinstein,

Vazifedan,

Baldassari

2024

JAMA Otolaryngol Head Neck Surg

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ImportanceExposure to secondhand smoke has been associated with numerous health problems in children, including obstructive sleep apnea. Secondhand smoke exposure may be a risk factor for increased pediatric sleep apnea severity.ObjectivesTo assess the association of secondhand smoke exposure (SHSe), quantified by urinary cotinine levels, with severity of obstructive sleep apnea (OSA) in children.Design, Setting, and ParticipantsThis was a prospective cohort trial including pediatric patients from 3 to 16 years of age with sleep-disordered breathing who underwent a polysomnogram at a tertiary-level children’s hospital in the US in either March 2014 to October 2016 or March 2020 to March 2021. Urine specimens were analyzed for cotinine, an important metabolite of nicotine. Each child’s caregiver completed a validated SHSe questionnaire. Data were analyzed from February to June 2023.ExposureOSA and secondhand smoke.Main Outcome and MeasuresSHSe and severity of pediatric OSA, quantified by urinary cotinine levels and obstructive apnea hypopnea index (AHI) scores. Secondary outcomes were association of urinary cotinine levels with nadir oxygen saturation, sleep-related quality of life measured by the OSA-18 questionnaire, and caregiver-reported smoking habits (collected through a questionnaire).ResultsThe study included 116 patients with a median (IQR) age of 6 (5-9) years, among whom 51 (45%) had obesity. The median (IQR) AHI was 3.0 (1.2-8.0), with 28 children (30.0%) having severe disease (AHI &gt;10). Thirty-four children (29.0%) were found to have a positive result for urine cotinine screening, with a mean (SD) level of 11.7 (9.4) ng/mL. The percentage of children with SHSe was less than anticipated. There was no association identified between urinary cotinine levels and either AHI (ρ = −0.04; 95% CI, −0.22 to 0.15) or nadir oxygen saturation (ρ = −0.07; 95% CI, −0.26 to 0.11). Furthermore, SHSe was not associated with the presence of severe OSA (odds ratio, 0.70; 95% CI, 0.26 to 1.90). Children whose caregivers reported indoor SHSe were more likely to have a detectable urinary cotinine level (odds ratio, 20.3; 95% CI, 6.67 to 61.8).Conclusions and RelevanceThis cohort study did not identify any clinically meaningful association between SHSe, quantified by urinary cotinine level, and pediatric OSA severity. Future research with a larger number of children with SHSe is needed to confirm these findings and determine whether SHSe affects OSA treatment outcomes in children.

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Section: Discussionmentioning

confidence: 62%

“…Caregivers often fail to acknowledge smoking in the car or home . Seasonal variation, daycare attendance, and the age of a child can also affect the degree of SHSe . In our study, there were 5 children who had a positive cotinine screening result despite that their caregivers denied SHSe.…”

Section: Discussionmentioning

confidence: 65%

Secondhand Smoke Exposure Measured in Urinary Cotinine Levels and Severity of Pediatric Sleep Apnea

Rubinstein,

Vazifedan,

Baldassari

2024

JAMA Otolaryngol Head Neck Surg

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“…Quantile regression estimates are more robust against outliers in the response measurements relative to the ordinary least squares regression [25]. Confounders were selected based on previous studies [26][27][28].…”

Section: Discussionmentioning

confidence: 99%

Higher hair nicotine level in children compared to mother living with smoking father in Malaysia

Mohamed

Loy

Man

et al. 2016

Environ Health Prev Med

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Objectives The objectives of this study are to determine parental and children's hair nicotine levels, their relationships as well as to investigate the association of smoking status of the fathers with mothers' and children's hair nicotine. Methods A cross-sectional study design was conducted among 124 families who were participants of the Universiti Sains Malaysia Pregnancy Cohort Study. Both parents with their 2 years old children joined this study. A total of 92 hair samples of fathers, 124 hair samples of mothers and 111 hair samples of children were collected and analyzed by gas chromatography-mass spectrometry. Results Of total, 52.4 % of the fathers reported smoking. None of the mothers were smokers. Hair nicotine levels of fathers were found to be significantly correlated with mothers (r = 0.233, p = 0.026) and children (r = 0.508, p \ 0.001). Children living with smoking fathers had significantly higher median hair nicotine level compared to the children of non-smoking fathers (6.08 vs 0.22 ng/mg, p = 0.046). However, this association was not seen in the mothers. Quantile regression showed significant association between fathers' and children's hair nicotine. Conclusion There is a positive relationship between fathers' hair nicotine with mother's and children's hair nicotine. Living with smoking fathers can contribute to higher hair nicotine levels in children but not in mothers.

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“…The rate of sustained SHS exposure has decreased in some countries including the USA [3], Japan [4], Korea [5], and Scotland [6], due to increased smoking regulations. However, in other countries, this rate has remained high, for example at 57.1% in Germany [7] and nearly 50% in Bangladesh [8]. Among pregnant women, this prevalence appears to be increasing over time, as demonstrated in a meta-analysis in 2014 which illustrated an even higher prevalence of pregnant women exposed to tobacco smoke (from more than 50% to 85%, depending on country) [9].…”

Section: Introductionmentioning

confidence: 99%

Inadequate Knowledge, Attitude and Practices about Second-Hand Smoke among Non-Smoking Pregnant Women in Urban Vietnam: The Need for Health Literacy Reinforcement

Ngo

Phan

et al. 2020

IJERPH

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The rate of exposure to second-hand smoke (SHS) is relatively high in several countries, including Vietnam, and health issues related to SHS have worsened in recent years, especially for pregnant women and their infants. Enhancement of knowledge, attitude, and practice (KAP) scores of pregnant women in Vietnam could raise practical interventions to protect their health and reduce complications of SHS. A cross-sectional study of 432 pregnant women who came to the Obstetrics Department of Bach Mai Hospital, Hanoi, Vietnam for antenatal care was conducted in 2016 to collect information about their KAP related to SHS. Composite mean scores from survey questions assessing their KAP were calculated on a 10-point scale, finding mean scores of 4.19, 7.45, and 4.30, respectively. Higher scores indicated better knowledge, attitude, and practice. Generalized linear models identified that age, occupation, living place, and sources of information were associated with SHS-related KAP. Findings from this study indicate that suitable programs related to SHS should be implemented to improve and reinforce health literacy to both mothers and smokers to reduce the harmfulness of smoking on women and their infants’ health.

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Factors Associated with Secondhand Smoke Exposure Prevalence and Secondhand Smoke Level of Children Living with Parental Smokers: A Cross Sectional Study

Cited by 8 publications

References 28 publications

Secondhand Smoke Exposure Measured in Urinary Cotinine Levels and Severity of Pediatric Sleep Apnea

Secondhand Smoke Exposure Measured in Urinary Cotinine Levels and Severity of Pediatric Sleep Apnea

Higher hair nicotine level in children compared to mother living with smoking father in Malaysia

Inadequate Knowledge, Attitude and Practices about Second-Hand Smoke among Non-Smoking Pregnant Women in Urban Vietnam: The Need for Health Literacy Reinforcement

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