Abstract
Objective: To assess the impact of different smoking behaviors of caregivers on environmental tobacco smoke (ETS) exposure in children aged 5–6 years in Changsha, China. Methods: We conducted a cross-sectional, random digit-dial telephone survey of caregivers (n = 543) between August and October 2013. Caregivers’ smoking behaviors were collected by a questionnaire. Exposure assessment was based upon determination of urinary cotinine levels in children employing gas chromatography–triple quadrupole mass spectrometry (GC-MS/MS). Results: In children not living with a smoker, children living with one smoker, and children living with more than one smoker at home, median urinary cotinine concentrations (ng/mL) were 0.72, 2.97, and 4.46, respectively. For children living with one smoker, median urinary cotinine levels of children exposed to ETS were associated with caregiver smoking behaviors, i.e., if a caregiver consumed more cigarettes (>20 compared with ≤10; 7.73 versus 2.29 ng/mL, respectively). Conclusions: The magnitude of ETS exposure in children is correlated with the smoking behaviors of the caregiver. Counseling for smoking cessation and educational interventions are needed urgently for smoking caregivers to increase their awareness about ETS exposure and to encourage smoking cessation at home or to take precautions to protect children’s health.
Highlights
Environmental tobacco smoke (ETS) is one of the most common indoor air pollutants
Variables entered into the model were the: caregiver’s age; size of the home; number of caregiver smokers; smoking restriction; number of cigarettes smoked by the caregiver at home; smoker smokes at home every day and daily cigarette consumption
The variables were coded as follows: “Daily cigarette consumption” was given as a categorical variable and coded in the regression analysis: (0–20 cigarettes/day = 0; >20 cigarettes/day = 1); domestic smoking restrictions; caregiver smokes cigarettes at home each day; and the number of caregiver smokers were analyzed as dummy variables
Summary
Environmental tobacco smoke (ETS) is one of the most common indoor air pollutants. There are two components attributed to ETS, second-hand smoke and third-hand smoke [1]. The government of the People’s Republic of China instigated a ban on smoking in any indoor public facility on 14th February, 2011 [13] These bans did not extend to protecting individuals exposed to ETS in their home environment [14]; an even greater concern exists for children, whose exposure is strongly associated with parental smoking [15]. ETS studies for children rely on self-reported measures given by their parents or caregivers, who are likely to be either the source of ETS or responsible for it [19] This type of exposure assessment is indirect and imprecise. To the best of our knowledge, no studies have been performed that measured the impact of smoking behaviors by Chinese smokers at home on children exposure to ETS using urinary levels of cotinine as an objective parameter. We hypothesized that the urinary cotinine levels of children who were exposed to ETS would be significantly higher compared with those of children who were not exposed to ETS at home
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