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Passive cigarette smoke exposure of infants: importance of nonparental sources
D R Ownby1, C C Johnson, E L Peterson
1Section of Allergy and Immunology, Medical College of Georgia, Augusta, GA 30912-3790, USA.
Insights
Infants exposed to environmental tobacco smoke (ETS) are significantly affected by smoking from non-parental adults. Reducing ETS exposure requires addressing smoking by all individuals in an infant's environment, not just parents.
Area of Science:
- Pediatrics
- Environmental Health
- Public Health
Background:
- Environmental tobacco smoke (ETS) exposure is a significant health concern for infants.
- Parental smoking is a primary source of ETS, but exposure from other sources is less understood.
Purpose of the Study:
- To determine if cigarette smoking by individuals other than parents contributes to passive ETS exposure in infants.
- To identify the sources of ETS exposure beyond parental smoking.
Main Methods:
- A prospective cohort study followed 97 infants from birth to 2 years.
- Monthly questionnaires tracked smoking by various adult categories interacting with infants.
- Urinary cotinine-creatinine ratios (CCRs) were measured bimonthly to assess ETS exposure.
Main Results:
- Significant correlations were found between infant ETS exposure (measured by CCRs) and smoking by all 7 adult categories studied.
- Multivariable analysis confirmed that smoking by non-parental adults (daycare workers, visitors, other household members) significantly contributed to infant ETS exposure.
- Parental smoking was also a significant factor, but non-parental sources explained a substantial portion of the variance in ETS exposure.
Conclusions:
- Non-parental smoking is a significant contributor to infant environmental tobacco smoke exposure.
- Reducing adverse health effects of ETS in infants necessitates interventions targeting smoking by all individuals in their environment, not solely parents.
- These findings highlight the importance of a comprehensive approach to mitigating ETS risks for vulnerable populations.
Objective:
To learn whether cigarette smoking by persons other than parents significantly contributes to the passive environmental tobacco smoke (ETS) exposure of infants.
Study Design:
A cohort of infants prospectively followed up from birth to age 2 years with monthly questionnaires concerning smoking by different categories of adults coming into contact with the infants.
Setting:
Health maintenance organization members residing in several suburban communities of Detroit, Mich, defined by contiguous ZIP codes.
Subjects:
Ninety-seven (83%) of 117 healthy, full-term infants, thought to be at high risk of allergic disease based on cord blood IgE, who were born to eligible mothers and who completed 24 months of follow-up.
Main Outcome Measures:
Average of bimonthly urinary cotinine-creatinine ratios (CCRs) during the 2 years of the study.
Results:
There were significant correlations (r
Conclusions:
Smoking by multiple individuals, other than the parents, significantly contributes to the ETS exposure of infants. These findings suggest that, at least for infants, efforts to reduce the adverse health effects of ETS exposure should extend beyond curtailing parental smoking. Arch Pediatr Adolesc Med. 2000;154:1237-1241.