The impact of secondhand marijuana smoke exposure on children is unknown. New methods allow detection of secondhand marijuana smoke in children.
We studied children ages 1 mo to 2 y hospitalized with bronchiolitis in Colorado from 2013 to 2015. Parents completed a survey, and urine samples were analyzed for cotinine using LC/MS/MS (limits of detection 0.03 ng/ml) and marijuana metabolites including COOH-THC (limits of detection 0.015 ng/ml).
A total of 43 subjects had urine samples available for analysis. Most (77%) of the subjects were male, and 52% were less than 1 y of age. COOH-THC was detectable in 16% of the samples analyzed (THC+); the range in COOH-THC concentration was 0.03–1.5 ng/ml. Two subjects had levels >1 ng/ml. Exposure did not differ by gender or age. Non-white children had more exposure than white children (44 vs. 9%; P < 0.05). 56% of children with cotinine >2.0 ng/ml were THC+, compared with 7% of those with lower cotinine (P < 0.01).
Metabolites of marijuana smoke can be detected in children; in this cohort, 16% were exposed. Detectable COOH-THC is more common in children with tobacco smoke exposure. More research is needed to assess the health impacts of marijuana smoke exposure on children and inform public health policy.
- Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings. NSDUH Series H-48, HHS Publication No. (SMA) 14–4863. 2014. http://www.samhsa.gov/data/sites/default/files/NSDUHresultsPDFWHTML2013/Web/NSDUHresults2013.pdf. .
- Toking, vaping, and eating for health or fun: marijuana use patterns in adults, U.S., 2014.Am J Prev Med 2016; 50:1–8. , , , ,
- Urinary concentrations of PAH and VOC metabolites in marijuana users. Environ Int 2016;88:1–8. , , , et al.
- The 2006 Report of the Surgeon General: the health consequences of involuntary exposure to tobacco smoke. Am J Prev Med 2007:32:542–543.
- A comparison of mainstream and sidestream marijuana and tobacco cigarette smoke produced under two machine smoking conditions. Chem Res Toxicol 2008;21:494–502. , , , et al.
- Marijuana: respiratory tract effects. Clin Rev Allergy Immunol 2014;46:65–81. , ,
- One minute of marijuana secondhand smoke exposure substantially impairs vascular endothelial function. J Am Heart Assoc 2016; 5:e003858. , , , et al.
- Nonsmoker exposure to secondhand cannabis smoke. III. Oral fluid and blood drug concentrations and corresponding subjective effects. J Anal Toxicol 2015;39:497–509. , , , et al.
- Households contaminated by environmental tobacco smoke: sources of infant exposures. Tob Control 2004;13:29–37. , , , et al.
- Assessing the overlap between tobacco and marijuana: Trends in patterns of co-use of tobacco and marijuana in adults from 2003–2012. Addict Behav 2015;49:26–32. , , , ,
- The impact of marijuana policies on youth: clinical, research, and legal update. Pediatrics 2015;135:e769–85. , , ; .
- Analysis of cannabinoids and their metabolites in human urine. Anal Chem 2015;87:10183–7. , ,
- Development and validation of sensitive method for determination of serum cotinine in smokers and nonsmokers by liquid chromatography/atmospheric pressure ionization tandem mass spectrometry. Clin Chem 1997;43:2281–91. , , , et al.
- Multi-rule quality control for the age-related eye disease study. Stat Med 2008;27:4094–106. , ,
- Exposure to environmental tobacco smoke and cognitive abilities among U.S. children and adolescents. Environ Health Perspect 2005;113:98–103. , , , ,