Abstract
Objectives
To assess the impact of different home-smoking rules and smoking habits of cohabitant on environmental tobacco smoke (ETS) exposure of children.
Methods
Information about 396 Italian children (5–11 years old) and cohabitants’ smoking habits was collected by a questionnaire. Exposure assessment was performed by determination of urinary cotinine (u-cotinine).
Results
Median u-cotinine concentrations in children significantly increased in a similar fashion as theoretical ETS exposure increase: cohabitants do not smoke (1.79 μg/g creatinine), cohabitant(s) smoker(s) never smoke at home (2.84), smoke at home only when children are out (3.90), and smoke at home even if children are in (6.02). Median u-cotinine levels of exposed children were associated to the strength of cohabitant’s smoking behaviours when smoker(s) consume daily a high number of cigarettes (≥ 20) respect to light consumption (1–9) (4.52 and 3.24 μg/g creatinine).
Conclusions
The magnitude of ETS exposure in children is correlated with smoking habits and home-smoking precautions adopted by their cohabitants. Educational interventions on parents are essential to increase their awareness about ETS exposure and to teach correct behaviours to protect health of kids, especially in household environment.
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References
Adgent MA (2006) Environmental tobacco smoke and sudden infant death syndrome: a review. Birth Defects Res B Dev Reprod Toxicol 77:69–85
Akhtar PC, Haw SJ, Currie DB, Zachary R, Currie CE (2009) Smoking restrictions in the home and second-hand smoke exposure among primary schoolchildren before and after introduction of the Scottish smoke-free legislation. Tob Control 18:409–415
Asomaning K, Miller DP, Liu G, Wain JC, Lynch TJ, Su L, Christiani DC (2008) Second hand smoke, age of exposure and lung cancer risk. Lung Cancer 61:13–20
Benowitz NL (1996) Cotinine as a biomarker of environmental tobacco smoke exposure. Epidem Rev 18:188–204
Benowitz NL, Perez-Stable EJ, Fong I, Modin G, Herrera B, Jacob P 3rd (1999) Ethnic differences in N-glucuronidation of nicotine and cotinine. J Pharmacol Exp Ther 291:1196–1203
Blackburn C, Spencer N, Bonas S, Coe C, Dolan A, Moy R (2003) Effect of strategies to reduce exposure of infants to environmental tobacco smoke in the home: cross sectional survey. BMJ 2(327):257
Borland R, Yong HH, Cummings KM, Hyland A, Anderson S, Fong GT (2006) Determinants and consequences of smoke-free homes: findings from the International Tobacco Control (ITC) Four Country Survey. Tob Control 15:iii42–iii50
Burton A (2011) Does the smoke ever really clear? Third-hand smoke exposure raises new concerns. Environ Health Perspec 119:A70–A74
Cheraghi M, Salvi S (2009) Environmental tobacco smoke (ETS) and respiratory health in children. Eur J Pediatr 168:897–905
Davis RA, Stiles MF, deBethizy JD, Reynolds JH (1991) Dietary nicotine: a source of urinary cotinine. Food Chem Toxicol 29:821–827
Destaillats H, Singer BC, Lee SK, Gundel LA (2006) Effect of ozone on nicotine desorption from model surfaces: evidence for heterogeneous chemistry. Environ Sci Technol 40:1799–1805
Domino EF, Hornbach E, Demana T (1993) The nicotine content of common vegetables. N Engl J Med 329:437
Haufroid V, Lison D (1998) Urinary cotinine as a tobacco-smoke exposure index: a minireview. Int Arch Occup Environ Health 71:162–168
Henry RJ (1974) Clinical chemistry principle and techniques, 2nd edn. Harper and Row, New York
Hyland A, Higbee C, Hassan L, Fong GT, Borland R, Cummings KM et al (2008) Does smoke-free Ireland have more smoking inside the home and less in pubs than the United Kingdom? Findings from the international tobacco control policy evaluation project. Eur J Public Health 18:63–65
International Agency for Research on Cancer (2004) Tobacco smoke and involuntary smoking. IARC Monographs on the evaluation of carcinogenic risks to humans. vol 83. IARC, Lyon. http://monographs.iarc.fr/ENG/Monographs/vol83/volume83.pdf. Accessed 10 Aug 2011
Jarvis MJ, Mindell J, Gilmore A, Feyerabend C, West R (2009) Smoke-free homes in England: prevalence, trends and validation by cotinine in children. Tob Control 18:491–495
Johansson A, Hermansson G, Ludvigsson J (2004) How should parents protect their children from environmental tobacco-smoke exposure in the home? Pediatrics 113:e291–e295
Keskinoglu P, Cimrin D, Aksakoglu G (2007) Which cut-off level of urine cotinine: creatinine ratio (CCR) should be used to determine passive smoking prevalence in children in community based studies? Tob Control 16:358–359
Manini P, De Palma G, Andreoli R, Poli D, Petyx M, Corradi M, Mutti A, Apostoli P (2008) Biological monitoring of low benzene exposure in Italian traffic policemen. Tox Let 181:25–30
Mannino DM, Caraballo R, Benowitz N, Repace J (2001) Predictors of cotinine levels in US children: data from the Third National Health and Nutrition Examination Survey. Chest 120:718–724
Matt GE, Quintana PJ, Hovell MF, Bernert JT, Song S, Novianti N, Juarez T, Floro J, Gehrman C, Garcia M, Larson S (2004) Households contaminated by environmental tobacco smoke: sources of infant exposures. Tob Control 13:29–37
Matt GE, Hovell MF, Quintana PJ, Zakarian J, Liles S, Meltzer SB, Benowitz NL (2007) The variability of urinary cotinine levels in young children: implications for measuring ETS exposure. Nicotine Tob Res 9:83–92
Matt GE, Quintana PJ, Zakarian JM, Fortmann AL, Chatfield DA, Hoh E, Uribe AM, Hovell MF (2011) When smokers move out and non-smokers move in: residential third-hand smoke pollution and exposure. Tob Control 20:e1
McNabola A, Gill LW (2009) The control of environmental tobacco smoke: a policy review. Int J Environ Res Public Health 6:741–758
Muller T (2007) Breaking the cycle of children’s exposure to tobacco smoke. British Medical Association, London http://www.bma.org.uk/images/Breakingcycle_tcm41-147270.pdf. Accessed 17 Aug 2011
O’Dowd A (2005) Smoking ban in public places also cuts smoking at home. BMJ 331:129
Pérez-Stable EJ, Herrera B, Jacob P 3rd, Benowitz NL (1998) Nicotine metabolism and intake in black and white smokers. JAMA 280:152–156
Petrick LM, Svidovsky A, Dubowski Y (2011) Third-hand smoke: heterogeneous oxidation of nicotine and secondary aerosol formation in the indoor environment. Environ Sci Technol 45:328–333
Protano C, Vitali M (2011) The new danger of thirdhand smoke: why passive smoking does not stop at secondhand smoke. Environ Health Perspect 119:A422
Protano C, Guidotti M, Manini P, Petyx M, La Torre G, Vitali M (2010) Benzene exposure in childhood: role of living environments and assessment of available tools. Environ Int 36:779–787
Sleiman M, Gundel LA, Pankow JF, Jacob P 3rd, Singer BC, Destaillats H (2010) Formation of carcinogens indoors by surface-mediated reactions of nicotine with nitrous acid, leading to potential third-hand smoke hazards. Proc Natl Acad Sci USA 107:6576–6581
Winickoff JP, Friebely J, Tanski SE, Sherrod C, Matt GE, Hovell MF, McMillen RC (2009) Beliefs about the health effects of “third-hand” smoke and home smoking bans. Pediatrics 123:e74–e79
World Health Organization (2007) Protection from exposure to second-hand tobacco smoke. Policy recommendations. World Health Organization. http://whqlibdoc.who.int/publications/2007/9789241563413_eng.pdf. Accessed 17 Apr 2011
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Protano, C., Andreoli, R., Manini, P. et al. How home-smoking habits affect children: a cross-sectional study using urinary cotinine measurement in Italy. Int J Public Health 57, 885–892 (2012). https://doi.org/10.1007/s00038-012-0354-0
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DOI: https://doi.org/10.1007/s00038-012-0354-0