Abstract
Environmental tobacco smoke (ETS) is a major public health problem for all ages. Despite the high prevalence of smoking among the Saudi population, there is limited information about levels of urinary cotinine in Saudi children exposed to SHS. The aim of the study was to assess the exposure of schoolchildren to ETS, and measure their urinary cotinine levels. Multistage cluster sampling was carried out, where schoolchildren from 4 schools were randomly chosen from primary schools in Taif city. A questionnaire including questions on SHS exposure and smoking rules in the residence were sent to students parents/guardians. Urine samples were taken and analyzed for total cotinine using chemiluminescent immunoassay. Of the studied children, 38.4% had a smoking father, 61.8%, 41.2% and 49.3% of them were exposed to ETS indoors, outdoors and both indoors and outdoors respectively. The mean urinary cotinine was significantly higher among children exposed to ETS compared to unexposed children. Urinary cotinine levels in children with both indoor and outdoor exposure was significantly higher compared with its level in children with single exposure. A significant positive correlation was found between urinary cotinine concentrations and the number of cigarette packs smoked by parents, and the number of smokers in the residence. The mean urinary cotinine level was significantly higher in children who reported no smoking rules at the residence.. The study revealed a high exposure of Saudi children to ETS. An antismoking media awareness campaign on the harmful effects of ETS should be carried out, in addition to family counseling programs targeted to parents to protect their children from ETS.
Highlights
Environmental Tobacco Smoke (ETS) is referred to as Secondhand Smoke (SHS), is the smoke burnt at the end of a cigarette, pipe, or cigar, in addition to the smoke exhaled out of the smoker’s lungs (CDC, 2015)
As regards application of smoking rules at residence, 39.5% of the exposed group reported complete restriction of smoking at the residence, 38.3% reported that smoking is allowed in some times and some places, and 22% reported that there are no restrictions on smoking in the residence at all
(Table 4) shows that the mean urinary cotinine was significantly higher among children exposed to SHS compared to unexposed children (58.60±104.64 ng/ml vs 7.32±4.54 ng/ml) (p-value=
Summary
Environmental Tobacco Smoke (ETS) is referred to as Secondhand Smoke (SHS), is the smoke burnt at the end of a cigarette, pipe, or cigar, in addition to the smoke exhaled out of the smoker’s lungs (CDC, 2015). Children are more vulnerable to the health effects of SHS (Martins-Green et al, 2014). This could be attributed to the sensitivity of their developing respiratory tract to environmental pollutants, the inhalation of more air per body volume compared to adults, the higher breathing frequency, and their inability to avoid SHS exposure as they have no free choice with respect to their environment (Öberg et al, 2010). Children often sit closer to their parents, family members, or caregivers making them closer to the source of pollutants than other passive smokers (Abou El-Ellaa et al, 2014)
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