Use of a 24-hour recall diary to assess exposure to environmental tobacco smoke

Passive smoking and adult asthma

Asthma is a common chronic health condition, affecting 5% of the United States adult population. In most developed countries, the prevalence of asthma and its severity continues to increase. Understanding the factors contributing to asthma morbidity and mortality has important clinical and public health implications. This article evaluates the evidence that secondhand smoke exposure is a risk factor for new-onset asthma among adults and exacerbates pre-existing adult asthma, resulting in greater symptom burden and morbidity.

Environmental tobacco smoke and adult asthma

The long-term health consequences of ETS exposure have been established over the past two decades. Consistent epidemiologic evidence links ETS exposure with serious chronic health effects, including lung cancer and cardiovascular disease [1, 48, 49]. In this article, the evidence suggests a causal relationship between ETS exposure and new-onset asthma and asthma exacerbation among adults. Despite the growing knowledge of ETS-related health effects, smoking is still permitted in many public locations and workplaces [50, 51]. Because asthma is a visible condition among the general public, the evidence that links ETS exposure with adverse asthma health outcomes should provide policymakers with additional impetus for regulating public smoking and creating smoke-free public environments.

Children's exposure to environmental tobacco smoke in the home: comparison of urine cotinine and parental reports

The authors examined the relationship between parent-reported estimates of children's exposure to environmental tobacco smoke (ETS) in the home and children's urinary cotinine levels. Data were collected from a largely ethnic minority, low-income, urban sample of households in which a child had asthma and at least 1 household member smoked. Information about level of household smoking restriction, parental smoking status, and number of cigarettes smoked per day accounted for approximately 45% of the variance in cotinine concentration. Detailed information about the duration of household smoking or children's ETS exposure added no additional significant information. Questionnaires eliciting detailed information about smoking habits and children's ETS exposure may be no better at predicting children's urinary cotinine levels than simpler surveys that inquire about smoking restrictions in the home, parental smoking status, and number of cigarettes smoked at home per day.

Exposure to environmental tobacco smoke in pregnant women: the association between self-report and serum cotinine

The risk of delivering a low-birth-weight infant as the result of exposing a nonsmoking pregnant woman to environmental tobacco smoke (ETS) is not well defined. The method of ascertaining ETS exposure during pregnancy may explain the lack of consistent study findings. In a large sample of pregnant women, we compared distributions between two methods of ETS exposure: self-report and cotinine, a nicotine metabolite, from serum. At livery, subjects were asked about duration and location of exposure to ETS during their second trimester. A single cotinine measurement was assayed from serum collected at 15-19 weeks gestation (limit of detection=0.05 ng/mL). Self-reported (hours per day) ETS exposure was correlated (r=0.38) with cotinine concentration. Regression analysis revealed that while self-reported ETS was significantly associated with (log) cotinine, it did not explain a large amount of total variation. While 72% of subjects reported no exposure to ETS, almost all had measurable levels of cotinine. Studies of pregnant women based upon an hours per day ETS question have likely misclassified a sizable portion of ETS-exposed women as "unexposed." Since there is recent evidence that low levels of ETS exposure result in unfavorable pregnancy outcomes, these studies have underestimated the effect of ETS.