Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2021 Jan;11(1):17-24.
doi: 10.1542/hpeds.2020-0122. Epub 2020 Dec 3.

Smoking Behaviors Among Tobacco-Using Parents of Hospitalized Children and Association With Child Cotinine Level

Karen M Wilson  1   2 , Angela Moss  3 , Michelle Lowary  4 , Jessica Gambino  4 , Jonathan D Klein  2   5 , Gwendolyn S Kerby  3 , Melbourne Hovell  6 , Jonathan P Winickoff  2   7
Affiliations
Randomized Controlled Trial

Smoking Behaviors Among Tobacco-Using Parents of Hospitalized Children and Association With Child Cotinine Level

Karen M Wilson et al. Hosp Pediatr. 2021 Jan.

Abstract

Objectives: Understanding patterns of parental tobacco use and their association with child exposure can help us target interventions more appropriately. We aimed to examine the association between parental smoking practices and cotinine levels of hospitalized children.

Methods: This is a secondary analysis of data collected from parents of hospitalized children, recruited for a cessation intervention randomized controlled trial. Smoking parents were identified by using a medical record screening question. Parent-reported demographics and smoking habits were compared to child urine cotinine by using geometric means and log-transformed cotinine levels in multivariable linear regression analyses.

Results: A total of 213 patients had complete baseline parent-interview and urine cotinine data. The median age was 4 (interquartile range: 1-9); 57% were boys; 56% were white, 12% were Black, and 23% were multiracial; 36% identified as Hispanic. Most families (54%) had 1 smoker in the home; 36% had 2, and 9% had ≥3. Many (77%) reported having a ban on smoking in the home, and 86% reported smoking only outside. The geometric mean cotinine level of the cohort was 0.98 ng/mL. Higher cotinine levels were associated with more smokers in the home (ratio of 2.99) and smoking inside the house (ratio of 4.11).

Conclusions: Having more smokers in the home and parents who smoke inside are associated with increased smoke exposure; however, even children whose families who smoke only outside the home have significant levels of cotinine, a marker for toxin exposure.

PubMed Disclaimer

Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
Main randomized controlled trial Consolidated Standards of Reporting Trials diagram.
FIGURE 2
FIGURE 2
Multivariate predictors of increased cotinine level. CI, confidence interval; SHS, secondhand smoke.
See this image and copyright information in PMC

References

    1. Homa DM, Neff LJ, King BA, et al. ; Centers for Disease Control and Prevention. Vital signs: disparities in nonsmokers’ exposure to secondhand smoke–United States, 1999-2012. MMWR Morb Mortal Wkly Rep. 2015;64(4):103–108 - PMC - PubMed
    1. Tsai J, Homa DM, Gentzke AS, et al. Exposure to secondhand smoke among nonsmokers - United States, 1988-2014. MMWR Morb Mortal Wkly Rep. 2018;67(48):1342–1346 - PMC - PubMed
    1. Merianos AL, Dixon CA, Mahabee-Gittens EM. Secondhand smoke exposure, illness severity, and resource utilization in pediatric emergency department patients with respiratory illnesses. J Asthma. 2017;54(8):798–806 - PMC - PubMed
    1. Chatzimichael A, Tsalkidis A, Cassimos D, et al. The role of breastfeeding and passive smoking on the development of severe bronchiolitis in infants. Minerva Pediatr. 2007;59(3):199–206 - PubMed
    1. Akinbami LJ, Kit BK, Simon AE. Impact of environmental tobacco smoke on children with asthma, United States, 2003-2010. Acad Pediatr. 2013;13(6):508–516 - PMC - PubMed

Publication types