Environmental tobacco smoke exposure in children: Household and community determinants

To determine the most important sources of environmental tobacco smoke expo sure to young children, the authors studied the associations among urinary cotinine, reported household smoking habits, and socioeconomic variables in 575 schoolchildren aged 6-11 y. The school children were among a populatio n of prodigious smokers in Cape Town, South Africa. Eighty percent of the c hildren were exposed to environmental tobacco smoke. Maternal smoking, whic h was adjusted for creatinine, accounted for 21.8% of the variation in urin ary cotinine-more than all other sources combined. The male parent and othe r household smokers accounted for 12.7% of the variation, and socioeconomic indicators explained an additional 4.8%. By defining the ecological variab le of smoking prevalence per school, the authors estimated a "community" co ntribution of 3.3%. The relative importance of different sources of smoke s hould be taken into account in the prevention of environmental tobacco smok e exposure in young children. Most importantly, of all the sources of envir onmental tobacco smoke, mothers' smoking habits had the greatest impact on exposure to children.