Tobacco Use Behaviors and Perceptions of Parental Smokers in the Emergency Department Setting

Abstract

Background: More information is needed about modifiable child tobacco smoke exposure (TSE) patterns in racially diverse parental smokers to tailor interventions designed to help parents quit smoking and reduce their child’s TSE. Our objectives were to determine whether there were differences in smoking and TSE patterns based on parental race and child age and whether these patterns differed based on child age within black and white parental smokers. Secondary objectives were to assess the relationship between parental perceptions about the effects of smoking and the benefits of quitting on their child based on child age, race, and reported TSE patterns and to examine biochemically verified TSE levels by child age, race, and parent-reported TSE patterns. Methods: Participants (N = 415) were non-Hispanic black and non-Hispanic white parental smokers, mean age (standard deviation [SD]) = 31.2 (7.2) years, who visited the Pediatric Emergency Department (PED) or Urgent Care (UC) with their child, mean age (SD) = 4.7 (4.6) years. Parents reported sociodemographics, smoking, and child TSE patterns. We conducted chi-square tests, independent t-tests, and general linear regression models to answer our primary objectives and linear regression models to answer our secondary objectives. Results: Parents were 56.1% non-Hispanic black; 87.5% women; mean (SD) number of cigarettes smoked/day was 10.5(6.8). A higher proportion of parents with younger children <3 years old reported smoking bans compared with parents with older children ⩾3 to <18 years old (41.3% vs 19.7%, P < .0001). Subsequent analyses revealed this pattern for both black and white parents. A total of 212 (51%) of children had biochemical assessment of TSE; 89.6% had detectable TSE. Younger children had significantly higher cotinine levels than older children independent of their race ( P < .001). Conclusions: Children of parental smokers who visit the PED/UC were highly tobacco smoke exposed. Both black and white parental smokers with younger children were more likely to enforce smoking bans, but younger children had higher TSE levels than older children. Interventions that target this group of parental smokers with younger children may be more effective than interventions geared to all parental smokers.

Comparison of Liquid Chromatography Mass Spectrometry and Enzyme-Linked Immunosorbent Assay Methods to Measure Salivary Cotinine Levels in Ill Children

“…Our secondary objectives were to determine how differences in cotinine values based on child demographics, TSE patterns, and housing types compared between the two methods. Overall, our results were consistent with prior research in that we observed higher cotinine levels using both methods in children who were: younger [35][36][37]; had lower household incomes [36,38,39]; and had higher numbers of cigarettes smoked by their primary caregiver or around them [24,39]. We did, however, observe differences in cotinine associations with sex and race/ethnicity that were only significant in models using LC-MS/MS-derived cotinine levels.…”

“…We found that cotinine levels were lower in females and higher in non-Hispanic blacks than non-Hispanic whites. Other studies have not reported differences in cotinine by gender [24,35,37,40] and it is unclear why this is the case. However, similar to our findings, several other studies have observed differences by race/ethnicity with higher cotinine levels seen in non-Hispanic blacks.…”

Parental Health Risk Perceptions and Preventive Measures on Children’s Exposure to Secondhand Smoke (SHS) of Tobacco Cigarette in Malaysia: A Nationwide Study

“…While no amount of SHS is risk-free for children (1) having an understanding on the parental risk perception dimension of SHS exposure in children is one of the important constitutes in developing effective intervention to protect children from SHS (7,8).…”

“…Parents were 3.5 times more likely in using tobacco products in the vicinity of the house when there was a smoker in the family (11). Determining factors affecting the risk perception of SHS exposure among parents are important for strategy planning as study recommended that interventions targeting parents with speci c characteristics that affect the practice of SHS exposure to children are more effective than having interventions for all smoker parents (7,8).…”

“…In Malaysia, adolescent who were Malays and descendants of natives of Sabah and Sarawak were more likely to expose to SHS than those with the Chinese and Indian parents (10). Parental smokers with children younger than 3 years of age practicing stricter ban of smoking than parents with children of older age groups (8). Parents were 3.5 times more likely in using tobacco products in the vicinity of the house when there was a smoker in the family (11).…”