Declaration of Interests None declared.
Despite better an overall decrease in the rates of smoking, a significant proportion of children in the United States remain exposed to secondhand smoke (SHS). Like active smoking, SHS remains a class-based health risk since exposure among low-income children in urban areas ranges from 30% to 79% (Cornelius, Goldschmidt, & Dempsey, 2003) and varies inversely with family income and parental education (Marano, Schober, Brody, & Zhang, 2009; Soliman, Pollack, & Warner, 2004). While there have been general trends in the United States in reduced tobacco use over the past decade, smoking among adults from lower socioeconomic groups remains prevalent and has changed less than other groups (CDC, 2010).
A group of vulnerable children persists, despite national trends of reduced smoking prevalence in adults (Singh, Siahpush, & Kogan, 2010). Therefore, SHS-related morbidities in children could be considered a health risk disparity. We report on relationships observed between parental report of their child��s SHS exposure with a biological marker of long-term SHS exposure (hair nicotine levels) in two age groups of children (ages 2�C5 or 9�C14 years) from low-income families. This datum was obtained as part of a larger study on SHS exposure and markers of cardiovascular risk in children. These two age groups were of interest because of the high SHS exposure of the younger children based on our previous work (Groner et al., 2004) and the ability of the older group to cooperate with additional cardiovascular testing as part of the larger study.
Methods Recruitment Participants were recruited via convenience sampling through recruiting in Nationwide Children��s Hospital (NCH, Columbus, OH) Primary Care Network and via advertising in the NCH internal hospital E-mail system. The Network serves low-income, urban children in Columbus, OH. The inclusion criteria were healthy children in two age groups (between 2 and 5 years and between 9 and 14 years), both exposed and unexposed to SHS by parental report. The exclusion criteria were presence of one or more of the following: active smoker (referring to child or teen), acute febrile illness or other active infections, congenital heart disease, diabetes (Type 1 or 2) (elevated fasting glucose [>100 mg/dl]), concurrent daily anti-inflammatory prescription or nonprescription medications, and not having enough hair for hair sampling.
The project was approved by the NCH IRB; informed consent was obtained by parents and written assent by youth over 9 years old. SHS Exposure Assessment The presence and extent of SHS exposure were assessed by both by questionnaire and by hair sampling for nicotine determination. A ��smoker�� was defined as an individual who has smoked at least 1 cigarette/day during the Anacetrapib previous 7 days.