Abstract
Objective: Preschool children exposed to environmental tobacco smoke (ETS) are at risk of developing adverse respiratory health effects. The present study aimed to investigate the relationship between the effects of cigarette-smoking caregivers on respiratory symptoms and urinary cotinine (UC) levels in children.Methods: A cross-sectional study consisting of 543 children (aged between 5 and 6 years) from 5 kindergartens in central China was conducted using a structured questionnaire. We also analyzed UC levels to investigate the relationship between respiratory symptoms and ETS exposure. We further performed logistic regression analyses to establish the relationship between respiratory symptoms (coughing, rhinorrhea, and sneezing) and UC levels.Results: A total of 71 (13.08%) children had a history of hospital admission with respiratory illnesses including bronchitis and pneumonia over the last 6 months. In addition, 102 (18.78%) children presented coughing symptoms, 114 (20.99%) experienced rhinorrhea and 79 (14.55%) presented sneezing symptoms over the last 6 months. After adjusting the confounders, odds ratio (OR) indicated that the number of cigarettes smoked by a caregiver was associated with coughing (OR = 11.02; 95% CI, 3.72–33.66), rhinorrhea (OR = 41.83; 95% CI, 5.58–313.05) and sneezing (OR = 4.71; 95% CI, 1.33–16.48). Furthermore, UC levels in children with coughing, rhinorrhea and sneezing were significantly higher than in children without respiratory symptoms (P = 0.002, P < 0.001, P < 0.001, respectively).Conclusions: This study reveals that children exposed to ETS have higher levels of UC. Compared with caregiver who non-smoked live with children, smoked cigarettes were highly risk of developing respiratory illnesses in children. Notably, the higher the UC levels the greater the respiratory risk. Our results also signify that UC can be used as an indicator of ETS exposure to inform caregivers of the associated risks, and inform efforts to reduce related effects.
Highlights
40% of children are regularly exposed to environmental tobacco smoke (ETS) resulting in 28% of deaths globally [1]
The UC level of ETS exposure in children who lived with caregivers who smoked 1-10 cigarettes per day was 2.29 ng/mL (IQR: 1.90, 2.71), caregivers who smoked 1120 cigarettes per day was 4.15 ng/mL (IQR: 3.01, 5.85) and for caregivers who smoked more than 20 cigarettes per day
Significant differences of UC level in children were observed between caregiver smoked 11-20 cigarettes smokers in the household (χ 2 = 186.771, p < 0.001) and more than 20 cigarettes smoker groups in the household (χ 2 = 152.600, p < 0.001) (Table 1)
Summary
40% of children are regularly exposed to environmental tobacco smoke (ETS) resulting in 28% of deaths globally [1]. ETS exposure during childhood can contribute to the onset of adult diseases, especially pulmonary and cardiovascular diseases [3]. According to the World Health Organization (WHO), approximately 180 million children below 15 years were exposed to ETS daily in 2015 [7]. The government of the People’s Republic of China instigated a ban on smoking in all public indoor facilities on 14th February, 2011 [8] but this had an insignificant effect on the protection of children against exposure to ETS in homes. It is difficult to restrict children from accessing areas of ETS exposure, difficult to control inhalation of tobacco smoke. Children are more vulnerable to ETS exposure and the resulting negative outcomes. Studies conducted in the recent past have revealed that ETS exposure and oxidative stress are strongly associated with numerous diseases [9,10,11,12]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
