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Assessing pediatric tobacco exposure using parent report: comparison with hair nicotine

Journal of Exposure Science & Environmental Epidemiologyvolume 28pages530537 (2018) | Download Citation

Subjects

Abstract

Introduction

The purpose of this study was to examine the relationships between screening questions for secondhand smoke (SHS) exposure and biomarker results using hair nicotine levels. Our ultimate goal was to develop sensitive and valid screening tools in pediatric clinical settings for SHS exposure.

Methods

Investigators developed a core set of questions regarding exposure. Data from two separate ongoing studies of well children and those with bronchopulmonary dysplasia (BPD) were used to assess the concordance between responses and hair nicotine levels. Sensitivity, a positive predictive value, and accuracy were examined.

Results

There was no single question with similar sensitivity in both populations. The question with the highest positive predictive value (90.8% well-cohort and 84.6% BPD cohort) for both the groups was whether the child had been exposed to in-home smoking in the last 7 days. The question with the highest accuracy for both groups was the number of smokers at home (0 vs ≥ 1), with an accuracy of 72.4% for well children and 79.0% for the BPD cohort.

Conclusions

There was a wide variability in the performance of specific questions. These data demonstrate that a “one-size-fits-all” approach to screening for secondhand tobacco smoke exposure may not be appropriate for all pediatric populations.

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Acknowledgements

This work was supported by the American Academy of Pediatrics Julius B. Richmond Center of Excellence through a Center of Excellence grant from the Flight Attendant Medical Research Institute and by grants from the Truth Initiative (formerly American Legacy Foundation). The findings and conclusions are those of the authors and do not necessarily represent the official position of any of these institutions.

Author information

Affiliations

  1. AAP Julius B. Richmond Center of Excellence, Elk Grove Village, IL, USA

    • Judith A. Groner
    • , Ana M. Rule
    • , Sharon A. McGrath-Morrow
    • , Joseph M. Collaco
    • , Susanne E. Tanski
    • , Robert McMillen
    • , Regina M. Whitmore
    • , Jonathan D. Klein
    • , Jonathan P. Winickoff
    •  & Karen Wilson
  2. Department of Pediatrics, Nationwide Children’s Hospital, Columbus, OH, USA

    • Judith A. Groner
  3. Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    • Ana M. Rule
  4. Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    • Sharon A. McGrath-Morrow
    •  & Joseph M. Collaco
  5. Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Denver, Aurora, CO, USA

    • Angela Moss
  6. Geisel School of Medicine at Dartmouth, Lebanon, NH, USA

    • Susanne E. Tanski
  7. Social Science Research Center, Mississippi State University, Starkville, MS, USA

    • Robert McMillen
  8. Department of Pediatrics, University of Illinois at Chicago, Chicago, IL, USA

    • Jonathan D. Klein
  9. Harvard Medical School, Massachusetts General Hospital Division of General Pediatrics, Boston, MA, USA

    • Jonathan P. Winickoff
  10. Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    • Karen Wilson

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Conflict of interest

The authors declare that they have no conflict of interest.

Corresponding author

Correspondence to Judith A. Groner.

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DOI

https://doi.org/10.1038/s41370-018-0051-z