Simple Questions Spot Kids at Secondhand Smoke Risk

Mom's smoking is most important, study finds

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TUESDAY, May 3, 2005 (HealthDay News) -- Pediatricians and other health-care providers need only ask parents a few simple questions to reliably identify children at risk for exposure to secondhand smoke, researchers say.

Researchers at Ohio State University collected hair samples from 291 children ranging between 2 weeks and 3 years of age. They then divided the children into three groups -- low, medium and high secondhand smoke exposure -- based on their hair levels of a chemical called cotinine.

When children absorb nicotine from secondhand smoke, the nicotine is metabolized to cotinine and deposited in growing hair. Cotinine levels are considered the gold standard for assessing secondhand smoke exposure in children.

The children's cotinine levels were compared with answers to questions posed to parents and other caregivers about smoking in the home.

Reporting in the May issue of the journal Archives of Pediatrics & Adolescent Medicine, the researchers found that maternal, but not paternal, smoking was associated with higher cotinine levels in children, regardless of how many cigarettes per day the mother reported smoking or whether she reported that she only smoked outside the home.

Higher cotinine levels were also associated with living in a home where others smoke, where others smoke inside, and living in a home without a smoking ban.

"Based on our data, our practical clinical recommendations are as follows: Health care professionals can obtain an environmental tobacco smoke risk assessment for a child younger than three years by asking the mother 'Do you smoke?' " the study authors wrote.

"If the mother reports that she is a nonsmoker, then two more questions can be asked at that point: 'Do others who live or frequently visit with you smoke?' and 'Do they smoke indoors?' " they added.

These questions should serve as "a simple screening tool to be used in the office setting to define children at highest risk" for secondhand smoke exposure, the Ohio State team concluded.

Exposure to tobacco smoke impairs children's respiratory health, putting them at increased risk of pneumonia, asthma and ear infections, among other health problems, the researchers noted.

More information

The American Lung Association has more about secondhand smoke.

SOURCE: JAMA/Archives journals, news release, May 2, 2005

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