HOUSEHOLD AND COMMUNITY DETERMINANTS OF EXPOSURE TO INVOLUNTARY SMOKING - A STUDY OF URINARY COTININE IN CHILDREN AND ADOLESCENTS

The study examines the role of several potential predictors of urinary cotinine levels in a cross-sectional sample of 1,072 nonsmoking child ren and adolescents in Latium, Italy, during 1990-1991. As expected, t here was a strong relation between passive exposure to smoking and the amount of maternal and paternal self-reported smoking, The urinary co tinine level increased with a decreasing level of paternal education a nd with an increasing index of household crowding; self-report of rece nt exposure to smoking outside the home was a strong predictor of the biologic marker. The analysis was then restricted to 346 subjects whos e parents claimed that they were nonsmokers and that there were no smo kers at home, In this group, however, 57 children reported some active smoking at home by their parents, Those with parents suspected to be ''deceivers'' had higher level of urinary cotinine than did those trul y not exposed, In addition, urinary cotinine in this group was clearly associated with duration of exposure to smoking outside home. The stu dy indicates that both factors related to family circumstances and exp osure outside the household setting are strong determinants of urinary cotinine levels, The finding may be considered a direct confirmation that passive smoking among children should be viewed as a specific com munity responsibility.