Results Hair samples and questionnaire data were obtained from children. Maternal report of smoking outside only or smoking few cigarettes per day had no impact on child hair cotinine levels. Conclusions It was possible to derive a simple, specific, and valid screening tool that can be used in pediatric offices to identify children at risk for ETS exposure.
Further research is needed to test this tool prospectively. The American Academy of Pediatrics Elk Grove Village, Ill advised physicians that tobacco prevention and control activities should ideally begin at the first pediatric visit. Despite these recommendations, simple, specific, and validated screening procedures for ETS exposure in the pediatric office setting have not been developed. Screening for ETS exposure needs to be simple and fast in order to be implemented in busy office settings.
The specific question s most likely to identify children with high ETS exposure are not known. Hair nicotine is also used to quantify ETS exposure. Cotinine in hair is derived only from what an individual has actually inhaled and metabolized, and therefore, it measures actual systemic exposure to nicotine. In a cross-sectional study, elevated hair cotinine levels have been linked to childhood asthma.
While hair cotinine is an outstanding source for measuring child ETS exposure, it is often available only in academic settings and is expensive. Thus, it is not likely to be adapted as a useful screening tool. Hair cotinine level does, however, represent an objective standard with which questions about child ETS exposure can be compared. The upper age cutoff of 3 years for study eligibility was chosen because children younger than 3 years are those at the greatest risk for the diseases associated with ETS exposure.
Data were collected from June to July Children of both self-reported smokers and nonsmokers were recruited for the study. Ten shafts of hair or more, 2 to 5 cm in length, were cut at the root in the occipital area and were analyzed for cotinine by radioimmunoassay according to the methods described by Eliopoulos et al.
Hair concentrations of cotinine are expressed as nanogram per milligram of hair. Primary caregivers were asked if they were smokers, defined as smoking 1 cigarette per day in the previous 7 days. Other household exposure was determined by asking the primary caregiver if other smokers live or visit with the child frequently.
If so, the relationship of the smoker to the child was noted. Mothers or primary caregivers who were self-reported smokers were asked to rate the 3 locations where they were likely to smoke, in order of frequency. Mothers or primary caregivers completed questionnaires. Hair samples were collected from children. The reasons for not collecting hair samples from every child were that the mother or primary caregiver refused to consent or the child did not have enough hair to sample. The excluded cases were not different from the included cases in terms of smoking status, race, and income.
For smokers, the mean SD number of cigarettes per day was The mean SD age of the mothers was An increased awareness of the harmful effects of ETS on children's health is warranted.
Abstract Environmental tobacco smoke ETS is a major risk factor for poor lung health in children. Tobacco smoke consists of solid particles and gases. More than 7, different chemicals have been identified in tobacco smoke. The number of these chemicals that are known to cause cancer in animals, humans, or both are reported to be about The solid particles make up about 10 percent of tobacco smoke and include "tar" and nicotine.
The gases or vapours make up about 90 percent of tobacco smoke. The major gas present is carbon monoxide. Others include formaldehyde, acrolein, ammonia, nitrogen oxides, pyridine, hydrogen cyanide, vinyl chloride, N-nitrosodimethylamine, and acrylonitrile.
Of these, formaldehyde, N- nitrosodimethylamine and vinyl chloride are suspected or known carcinogens in humans. Acrylonitrile has been shown to cause cancer in animals. The e-cigarette is the most widely used form of non-tobacco nicotine NTN which consists of a device containing a heating element that atomizes a solution containing water, nicotine, propylene glycol, vegetable glycerine, and usually some flavouring.
The devices have evolved over time and those containing nicotine deliver nicotine more effectively. The puffing vaping technique and puffing regimen also affect the nicotine delivery to the user. Compared with traditional cigarettes, e-cigarettes emit lower levels of many of the chemicals found in tobacco smoke. The concentration of nicotine, propylene glycol, glycerine, and flavouring in solution e-liquid can vary significantly; particularly in relation to nicotine concentration.
The e-cigarette solution may be nicotine-free. Similar to tobacco smoke, vapour generated by e-cigarettes consists of potentially harmful chemicals including volatile organic compounds, aldehydes, tobacco-specific nitrosamines TSNAs carbonyls, and metal particles, but at much lower levels than in cigarette smoke.
Vaporisation at high temperatures can produce relatively higher levels of formaldehyde and other aldehydes. The long-term adverse effects for e-cigarette users and from passive exposure to e-cigarettes vapour are less well understood than long-term effects from ETS because e-cigarettes have only been in use since around Passive exposure varies according to device, e-liquid constituents, and vaping technique.
One study found that nicotine from exhaled vapour can be deposited on surfaces but at levels so low that is unlikely that nicotine could enter the body at a dose capable of causing health effects. The smoke that is inhaled and then exhaled from the smoker's lungs is called mainstream smoke MS. Sidestream smoke SS is the smoke that enters the air directly from the burning end of a cigarette, cigar, or pipe.
The burning end of a cigarette is not usually hot enough for complete combustion of the tobacco to occur. Since some chemicals are favoured by this incomplete burning, undiluted sidestream smoke contains higher concentrations of several chemicals than the mainstream smoke inhaled by the smoker. These chemicals include 2-naphthylamine, N-nitrosodimethylamine, 4-aminobiphenyl, and carbon monoxide.
Environmental tobacco smoke ETS is composed of both mainstream and sidestream smoke. ETS is diluted by the air in the room before it is inhaled and is therefore less concentrated than mainstream or sidestream smoke.
Every person — both smokers and non-smokers — in a room with ETS will have similar exposure because nearly 85 percent of ETS in a room comes from sidestream smoke. Women who smoke are at greater risk of ectopic pregnancy. When a non-smoking pregnant woman is exposed to second-hand smoke in the home — for example, if her partner smokes — it increases the risk for:. Active smoking by men can damage their sperm. These include:. Children are especially vulnerable to the damaging effects of second-hand smoke.
Some of the many health risks include:. People who have never smoked who live with people who do smoke are at increased risk of a range of tobacco-related diseases and other health risks, including:. When you stop smoking, you are not only doing great things for your own health, but for your loved ones. Help is available if you want to stop smoking. To find out all your options, call Quitline Tel. If you smoke but you are unwilling or unable to stop immediately, there are various ways to help protect the health of the people you live with.
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