TY  - JOUR
T1  - DEtermination of tobacco smoke exposure by plasma cotinine levels in infants and children attending urban public hospital clinics
AU  - Dempsey DA, Meyers MJ, Oh SS, et al
Y1  - 2012/09/01
N1  - 10.1001/archpediatrics.2012.170
JO  - Archives of Pediatrics & Adolescent Medicine
SP  - 851
EP  - 856
VL  - 166
IS  - 9
N2  - Objective 
                  To determine the prevalence of secondhand smoke (SHS) exposure among infants and young children who received preventive care at pediatric preventative care clinics associated with an urban public hospital. Cotinine, a metabolite of nicotine, has been used to study SHS exposure in population-based studies of children 3 years of age or older.Design 
                  Retrospective study using a convenience sample.Setting 
                  Urban county pediatric primary care clinics in San Francisco, California.Participants 
                  A total of 496 infants and children (mean [SD] age, 2.4 [1.9] years).Interventions 
                  Discarded plasma samples (which were routinely collected for lead screening) were tested, and medical records were reviewed, for SHS exposure.Main Outcome Measure 
                  Secondhand smoke exposure based on cotinine plasma level and history of exposure in the medical record.Results 
                  Thirteen percent of parents reported that their child was exposed to SHS, yet biochemical testing detected cotinine in 55% of samples, at a geometric mean (SD) of 0.23 (3.55) ng/mL. There were no significant sex or age differences. African American children had much higher mean cotinine levels than did Latino children (geometric mean difference, 6.07 ng/mL [95% CI, 4.37 to 8.43 ng/mL]).Conclusion 
                  In a city with a low smoking rate (12%) and public smoking bans, we documented 55% exposure among infants and young children, using a plasma biomarker, compared with 13% exposure reported by parents. Because SHS is associated with significant respiratory diseases and parents underreport exposure, routine biochemical screening should be considered as a tool to identify and reduce SHS exposure.
SN  - 1072-4710
M3  - doi: 10.1001/archpediatrics.2012.170
UR  - http://dx.doi.org/10.1001/archpediatrics.2012.170
ER  -