PARENTAL SMOKING-BEHAVIOR AND PASSIVE SMOKE EXPOSURE IN CHILDREN WITHASTHMA

Background: Smoking parents of children with asthma frequently report modifying their smoking behavior to reduce their child's smoke exposur e, Research has not analyzed the association between parental efforts and the child's smoke exposure. Objective: To determine passive smoke exposure and the relationship of self-reported parental modifications in smoking behavior to smoke exposure in children with asthma. Methods : Parents of children seen in an inner-city Asthma and Allergy Outpati ent Clinic completed questionnaires to evaluate their smoking behavior and modifications they made to decrease their child's exposure to cig arette smoke. Urine specimens were collected from the children to dete rmine smoke exposure as measured by urinary cotinine/creatinine ratios . Results: Children from homes with smokers had higher mean urinary co tinine/ creatine ratios than children from smoke free homes (30 versus 4 ng/mg; P = .0005), Cotinine/creatinine ratios increased with the nu mber of smokers in the home. When the parent was the only smoker in th e home, the mean urinary cotinine/creatine ratio of children whose par ent smoked outside the house was lower than the mean of children whose parent smoked inside (21 versus 51 ng/mg; P = .038), With only one sm oker in the home, there was no difference in mean cotinine/creatinine ratios when the primary caregiver was the smoker versus when the prima ry caregiver was not the smoker (27 versus 15 ng/mg; P = .10). Conclus ion: Smoking outside the house was associated with lower urinary cotin ine/creatinine ratio only when the parent was the only smoker in the h ome.