Racial differences in exposure to environmental tobacco smoke among children

Stephen E Wilson, Robert S Kahn, Jane Khoury, Bruce P Lanphear, Stephen E Wilson, Robert S Kahn, Jane Khoury, Bruce P Lanphear

Abstract

Exposure to environmental tobacco smoke (ETS) is a major cause of morbidity and mortality among U.S. children. Despite African-American children's having a lower reported exposure to tobacco compared to whites, they suffer disproportionately from tobacco-related illnesses and have higher levels of serum cotinine than white children. The goal of this study was to test whether African-American children have higher levels of serum and hair cotinine, after accounting for ETS exposure and various housing characteristics. We investigated the level of cotinine in both hair and serum in a sample of 222 children with asthma. Using a previously validated survey for adult smokers, we assessed each child's exposure to ETS. We collected detailed information on the primary residence, including home volume, ventilation, and overall home configuration. Despite a lower reported ETS exposure, African-American children had higher mean levels of serum cotinine (1.41 ng/mL vs. 0.97 ng/mL; p = 0.03) and hair cotinine (0.25 ng/mg vs. 0.07 ng/mg; p < 0.001) compared with white children. After adjusting for ETS exposure, housing size, and other demographic characteristics, serum and hair cotinine levels remained significantly higher in African-American children (ss = 0.34, p = 0.03) than in white children (ss = 1.06, p < 0.001). Housing volume was significantly associated with both serum and hair cotinine but did not fully explain the race difference. Our results demonstrate that, despite a lower reported exposure to ETS, African-American children with asthma had significantly higher levels of both serum and hair cotinine than did white children. Identifying causes and consequences of increased cotinine may help explain the striking differences in tobacco-related illnesses.

Figures

Figure 1. Geometric mean values of serum…
Figure 1. Geometric mean values of serum cotinine stratified by home ETS exposure (as measured by the reported number of cigarettes smoked per day in or around the home) for children with asthma stratified by race. : *p < 0.05.
Figure 2. Geometric mean values for hair…
Figure 2. Geometric mean values for hair cotinine stratified by home ETS exposure (as measured by the reported number of cigarettes smoked per day in or around the home) for children with asthma stratified by race. : *p < 0.05.

References

    1. Ahijevych K, Garrett BE. Menthol pharmacology and its potential impact on cigarette smoking behavior. Nicotine Tob Res. 2004;6(suppl 1):S17–S28.
    1. Ahijevych K, Tyndale RF, Dhatt RK, Weed HG, Browning KK. Factors influencing cotinine half-life during smoking abstinence in African American and Caucasian women. Nicotine Tob Res. 2002;4:423–431.
    1. Al-Delaimy WK. Hair as a biomarker for exposure to tobacco smoke. Tob Control. 2002;11:176–182.
    1. Al-Delaimy WK, Crane J, Woodward A. Is the hair nicotine level a more accurate biomarker of environmental tobacco smoke exposure than urine cotinine? J Epidemiol Community Health. 2002;56:66–71.
    1. Al-Delaimy WK, Crane J, Woodward A. Passive smoking in children: effect of avoidance strategies, at home as measured by hair nicotine levels. Arch Environ Health. 2001;56:117–122.
    1. Audesirk T, Cabell L. Nanomolar concentrations of nicotine and cotinine alter the development of cultured hippocampal neurons via non-acetylcholine receptor-mediated mechanisms. Neurotoxicology. 1999;20:639–646.
    1. Balbach ED, Gasior RJ, Barbeau EM. R.J. Reynolds’ targeting of African Americans: 1988–2000. Am J Public Health. 2003;93:822–827.
    1. Beck AT, Steer RA, Brown GK. 1996. Beck Depression Inventory—II. San Antonio, TX:Harcourt Assessment, Inc.
    1. Benowitz NL, Herrera B, Jacob IP. Mentholated cigarette smoking inhibits nicotine metabolism. J Pharmacol Exp Ther. 2004;310:1208–1215.
    1. Benowitz NL, Perez-Stable EJ, Fong I, Modin G, Herrera B, Jacob P., III Ethnic differences in N-glucuronidation of nicotine and cotinine. J Pharmacol Exp Ther. 1999;291:1196–1203.
    1. Benowitz NL, Perez-Stable EJ, Herrera B, Jacob P., III Slower metabolism and reduced intake of nicotine from cigarette smoking in Chinese-Americans. J Natl Cancer Inst. 2002;94:108–115.
    1. Bernert JT, Jr, McGuffey JE, Morrison MA, Pirkle JL. Comparison of serum and salivary cotinine measurements by a sensitive high-performance liquid chromatographytandem mass spectrometry method as an indicator of exposure to tobacco smoke among smokers and nonsmokers. J Anal Toxicol. 2000;24:333–339.
    1. Bernert JT, Jr, Turner WE, Pirkle JL, Sosnoff CS, Akins JR, Waldrep MK, et al. 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;43:2281–2291.
    1. Cains T, Cannata S, Poulos R, Ferson MJ, Stewart BW. Designated “no smoking” areas provide from partial to no protection from environmental tobacco smoke. Tob Control. 2004;13:17–22.
    1. Caraballo R, Giovino G, Pechacek T. Self-reported cigarette smoking vs. serum cotinine among U.S. adolescents. Nicotine Tob Res. 2004;6:19–25.
    1. Caraballo RS, Giovino GA, Pechacek TF, Mowery PD. Factors associated with discrepancies between self-reports on cigarette smoking and measured serum cotinine levels among persons aged 17 years or older: Third National Health and Nutrition Examination Survey, 1988–1994. Am J Epidemiol. 2001;153:807–814.
    1. Caraballo RS, Giovino GA, Pechacek TF, Mowery PD, Richter PA, Strauss WJ, et al. Racial and ethnic differences in serum cotinine levels of cigarette smokers: Third National Health and Nutrition Examination Survey, 1988–1991. JAMA. 1998;280:135–139.
    1. Carty CS, Huribal M, Marsan BU, Ricotta JJ, Dryjski M. Nicotine and its metabolite cotinine are mitogenic for human vascular smooth muscle cells. J Vasc Surg. 1997;25:682–688.
    1. CDC 1998. Tobacco Use among U.S. Racial/Ethnic Minority Groups African Americans, American Indians and Alaska Natives, Asian Americans and Pacific Islanders, Hispanics: A Report of the Surgeon General. Atlanta, GA:Centers for Disease Control and Prevention.
    1. CDC 1998. Tobacco Use among U.S. Racial/Ethnic Minority Groups African Americans, American Indians and Alaska Natives, Asian Americans and Pacific Islanders, Hispanics: A Report of the Surgeon General. Atlanta, GA:Centers for Disease Control and Prevention.
    1. Clark PI, Gautam S, Gerson LW. Effect of menthol cigarettes on biochemical markers of smoke exposure among black and white smokers. Chest. 1996a;110:1194–1198.
    1. Clark PI, Gautam SP, Hlaing WM, Gerson LW. Response error in self-reported current smoking frequency by black and white established smokers. Ann Epidemiol. 1996b;6:483–489.
    1. Coghlin J, Hammond SK, Gann PH. Development of epidemiologic tools for measuring environmental tobacco smoke exposure. Am J Epidemiol. 1989;130:696–704.
    1. Cook DG, Strachan DP. Summary of effects of parental smoking on the respiratory health of children and implications for research. Thorax. 1999;54:357–365.
    1. Cooper RS. Race, genes, and health—new wine in old bottles? Int J Epidemiol. 2003;32:23–25.
    1. Cooper RS, Kaufman JS, Ward R. Race and genomics. N Engl J Med. 2003;348:1166–1170.
    1. Eliopoulos C, Klein J, Phan MK, Knie B, Greenwald M, Chitayat D, et al. Hair concentrations of nicotine and cotinine in women and their newborn infants. JAMA. 1994;271:621–623.
    1. Federal Trade Commission 2000. “Tar,” Nicotine and Carbon Monoxide of the Smoke of 1294 Varieties of Domestic Cigarettes for the Year 1998. Washington, DC:Federal Trade Commission.
    1. Federal Trade Commission 2002. Federal Trade Commission Cigarette Report for 2000. Washington, DC:Federal Trade Commission.
    1. Hecht SS, Ye M, Carmella SG, Fredrickson A, Adgate JL, Greaves IA, et al. Metabolites of a tobacco-specific lung carcinogen in the urine of elementary school-aged children. Cancer Epidemiol Biomarkers Prev. 2001;10:1109–1116.
    1. Henschen M, Frischer T, Pracht T, Spiekerkotter E, Karmaus W, Meinert R, et al. The internal dose of passive smoking at home depends on the size of the dwelling. Environ Res. 1997;72:65–71.
    1. Kabat GC, Morabia A, Wynder EL. Comparison of smoking habits of blacks and whites in a case-control study. Am J Public Health. 1991;81:1483–1486.
    1. Klein J, Koren G. Hair analysis—a biological marker for passive smoking in pregnancy and childhood. Hum Exp Toxicol. 1999;18:279–282.
    1. Knight JM, Eliopoulos C, Klein J, Greenwald M, Koren G. Passive smoking in children. Racial differences in systemic exposure to cotinine by hair and urine analysis. Chest. 1996;109:446–450.
    1. Larsson ML, Frisk M, Hallstrom J, Kiviloog J, Lundback B. Environmental tobacco smoke exposure during childhood is associated with increased prevalence of asthma in adults. Chest. 2001;120:711–717.
    1. Mannino DM, Albalak R, Grosse S, Repace J. Second-hand smoke exposure and blood lead levels in U.S. children. Epidemiology. 2003;14:719–727.
    1. Mannino DM, Caraballo R, Benowitz N, Repace J. Predictors of cotinine levels in US children: data from the Third National Health and Nutrition Examination Survey. Chest. 2001a;120:718–724.
    1. Mannino DM, Homa DM, Redd SC. Involuntary smoking and asthma severity in children: data from the Third National Health and Nutrition Examination Survey. Chest. 2002;122:409–415.
    1. Mannino DM, Moorman JE, Kingsley B, Rose D, Repace J. Health effects related to environmental tobacco smoke exposure in children in the United States: data from the Third National Health and Nutrition Examination Survey. Arch Pediatr Adolesc Med. 2001b;155:36–41.
    1. Paschke T, Riefler M, Schuler-Metz A, Wolz L, Scherer G, McBride CM, et al. Comparison of cytochrome P450 2A6 polymorphism frequencies in Caucasians and African-Americans using a new one-step PCR-RFLP genotyping method. Toxicology. 2001;168:259–268.
    1. Perera FP, Mooney LA, Stampfer M, Phillips DH, Bell DA, Rundle A, et al. Associations between carcinogen-DNA damage, glutathione S-transferase genotypes, and risk of lung cancer in the prospective Physicians’ Health Cohort Study. Carcinogenesis. 2002;23:1641–1646.
    1. Perez-Stable EJ, Herrera B, Jacob P, III, Benowitz NL. Nicotine metabolism and intake in black and white smokers. JAMA. 1998;280:152–156.
    1. Pichini S, Altieri I, Pellegrini M, Pacifici R, Zuccaro P. Hair analysis for nicotine and cotinine: evaluation of extraction procedures, hair treatments, and development of reference material. Forensic Sci Int. 1997;84:243–252.
    1. Schuster MA, Franke T, Pham CB. Smoking patterns of household members and visitors in homes with children in the United States. Arch Pediatr Adolesc Med. 2002;156:1094–1100.
    1. Sexton K, Adgate JL, Church TR, Hecht SS, Ramachandran G, Greaves IA, et al. Children’s exposure to environmental tobacco smoke: using diverse exposure metrics to document ethnic/racial differences. Environ Health Perspect. 2004;112:392–397.
    1. Tang D, Phillips DH, Stampfer M, Mooney LA, Hsu Y, Cho S, et al. Association between carcinogen-DNA adducts in white blood cells and lung cancer risk in the physicians health study. Cancer Res. 2001;61:6708–6712.
    1. Tang D, Warburton D, Tannenbaum SR, Skipper P, Santella RM, Cereijido GS, et al. Molecular and genetic damage from environmental tobacco smoke in young children. Cancer Epidemiol Biomarkers Prev. 1999;8:427–431.
    1. Tricker AR. Nicotine metabolism, human drug metabolism polymorphisms, and smoking behaviour. Toxicology. 2003;183:151–173.
    1. U.S. DHHS 2000. Healthy People 2010: Tracking Healthy People 2010. Washington, DC:U.S. Department of Health and Human Services.
    1. Wallace LA, Mitchell H, O’Connor GT, Neas L, Lippmann M, Kattan M, et al. Particle concentrations in inner-city homes of children with asthma: the effect of smoking, cooking, and outdoor pollution. Environ Health Perspect. 2003;111:1265–1272.
    1. Wills TA, Cleary SD. The validity of self-reports of smoking: analyses by race/ethnicity in a school sample of urban adolescents. Am J Public Health. 1997;87:56–61.

Source: PubMed

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