Secondhand Smoke Exposure Is Widely Underreported

Secondhand Smoke Exposure In Children Greater Than Reported [Study]

Because parents widely underreport their children’s exposure to secondhand smoke (SHS), routine biochemical screening may be necessary to identify and reduce secondhand smoke exposure, says a new study published online in the May 2012 issue of the Archives of Pediatrics & Adolescent Medicine.

Exposure to secondhand smoke is a significant health risk, especially in children. According to the American Cancer Society, secondhand smoke is a known carcinogen, or a cancer-causing agent. Children who are exposed to secondhand smoke are at an increased risk for sudden infant death syndrome (SIDS), acute respiratory infections, ear infections, and more severe and frequent asthma attacks as well as wheezing, coughing, bronchitis, and pneumonia, and slow lung growth. Secondhand smoke causes tens of thousands of deaths each year in the United States among individuals who do not smoke.

Conducted by researchers from the Division of Clinical Pharmacology and Experimental Therapeutics of the Departments of Medicine, Bioengineering, and Therapeutic Sciences and from the Center for Tobacco Control Research and Education, the present study aimed to determined the prevalence of secondhand smoke exposure among young children by assessing the levels of cotinine, a metabolite of nicotine, in the children’s bodies.

The study involved 496 infants and children whose average age was 2.4 years old. All of the participants became involved in the study through their receiving health care from urban county pediatric primary care clinics in San Francisco, California.

When asked about their children’s exposure to secondhand smoke, only 13 percent of parents admitted that their children were exposed. However, after testing cotinine levels in the children’s plasma, the researchers discovered that 55 percent of the children had detectable levels of cotinine in their bodies. Such high levels were surprising in light of the low smoking rate (12 percent) and public smoking bans in the area.

Although the female children were significantly more likely to have detectable cotinine levels, sex was not a significant predictor of secondhand smoke exposure. There was also no significant difference in the number of children who had detectable cotinine levels by age, insurance coverage, or blood lead levels. The African American children participating in the study had much higher cotinine levels on average than the Latino children participating in the study.

The results of this study indicate that other means besides parental reports should be used to determine secondhand smoke exposure in children. Routine biochemical screening may be necessary to identify and reduce secondhand smoke exposure among children.

As the researchers commented:

“Although the discrepancy between parental reporting and biochemical assessment highlights the need for better screening questions in the primary care setting, we believe that a biochemical assessment is necessary to fully assess exposure. Our data indicate that biochemical assessment of SHS would result in considerably enhanced detection of exposure and ultimately could result in more effective interventions to prevent SHS-related diseases in children.”

Are you surprised by the underreporting of such high levels of secondhand smoke exposure among these children?