A passive smoking screening program for children

Background. There has been no report to date on mass screening of passive smoking in children using biomarkers. Method. To identify children exposed to actual environmental tobacco smoke (ETS), 261 children were divided into the following 3 groups: (A) both parents smoke; (B) one parent smokes; and (C) no parent smokes. Child urinary cotinine measurement and a parent questionnaire were obtained. Results. Urinary cotinine was positive (> 10 ng/ml) in 92 (35.2%) of the 261 children. Of the 92 children, 29 were classified into group A, 47 into group B, and 16 into group C. The percentages of children who tested positive for urinary cotinine in groups A, B, and C were 56.9%, 31.1%, and 27.1%, respectively. However, in group B, the percentage of children who tested positive for urinary cotinine was significantly higher if only the mother smoked (47.1%) than if only the father smoked (29.1%) (P < 0.05). The mean + SD urinary cotinine level in group A was 12.9 ± 6.5 ng/ml, and that in group B was 10.4 ± 3.8 ng/ml if the mother smoked and 5.4 ± 2.6 ng/ml if the father smoked. Conclusions. This smoking screening program may be useful in identifying children with actual ETS exposure and motivating their parents to either quit smoking or modify their smoking behavior around children.