Reported measures of environmental tobacco smoke exposure: trials and tribulations

Objective-This report extends previous summaries of reported environmental tobacco smoke (ETS) exposure measures, reviews the empirical evidence of th eir validity for children's exposure, and discusses future research. Data sources-Studies were identified by computer search and from the author s' research. Study selection-Studies were selected for inclusion of nicotine and/or coti nine and quantitative reported measures of ETS exposure. Data synthesis-Five studies found significant associations between reported quantitative exposure of children to ETS and either environmental nicotine or urine cotinine assays. Correlation coefficients between parent reports and nicotine ranged from 0.22 to 0.75. Coefficients for cotinine ranged fro m 0.28 to 0.71. Correlations increased over time and were stronger for pare nts' reports of their own smoking as a source of children's exposure than f or reports of exposure from others. Conclusions-Empirical studies general concordance of reported ana either en vironmental or biological measures of ETS exposure. Relationships were mode rate, and suggest sufficient validity to be employed in research and servic e programs. Future studies need to identify the differences in types of rep orted or objective measures, population characteristics, etc, contributing to observed variability in order to understand better the conditions under which more valid reported ETS exposure and other measures can be obtained. Reported and either environmental or biological measures should be used in combination, and existing measures should be directed to interventions that may reduce ETS exposure among children.