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Sources and Biomarkers of Secondhand Tobacco Smoke Exposure in Urban Adolescents

  • Natalie Nardone
    Correspondence
    Address correspondence to Natalie Nardone, PhD, Division of Clinical Pharmacology, Department of Medicine, University of California, 1001 Potrero Ave, San Francisco, CA 94110
    Affiliations
    Division of Cardiology, Department of Medicine, Program in Clinical Pharmacology, University of California San Francisco (N Nardone, N Addo, and G St.Helen)
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  • Shonul Jain
    Affiliations
    Department of Pediatrics, University of California San Francisco (S Jain)
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  • Newton Addo
    Affiliations
    Division of Cardiology, Department of Medicine, Program in Clinical Pharmacology, University of California San Francisco (N Nardone, N Addo, and G St.Helen)
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  • Gideon St.Helen
    Affiliations
    Division of Cardiology, Department of Medicine, Program in Clinical Pharmacology, University of California San Francisco (N Nardone, N Addo, and G St.Helen)

    Center for Tobacco Control Research and Education, University of California San Francisco (G St.Helen and NL Benowitz)
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  • Peyton Jacob III
    Affiliations
    Division of Cardiology, Departments of Medicine and Psychiatry, Clinical Pharmacology Research Laboratory, University of California San Francisco (P Jacob)
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  • Neal L. Benowitz
    Affiliations
    Center for Tobacco Control Research and Education, University of California San Francisco (G St.Helen and NL Benowitz)

    Department of Medicine and Bioengineering and Therapeutic Sciences, University of California San Francisco (NL Benowitz)
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Published:December 19, 2019DOI:https://doi.org/10.1016/j.acap.2019.12.006

      Abstract

      Objective

      In an urban adolescent population, we evaluated sources of exposure to secondhand smoke exposure (SHS), examined differences in exposure by race/ethnicity, age and sex, and determined the relationship between exposure source(s) and the biomarkers cotinine and NNAL.

      Methods

      Participants were recruited from a public hospital-based outpatient clinic in San Francisco, CA, USA.

      Results

      Of a sample of N = 298 adolescents screened, 235 were biologically confirmed to be exposed to tobacco smoke. Of those, N = 16 were active smokers and N = 219 were exposed to SHS; 91 (39%) were heavily SHS exposed (median cotinine = 0.76 ng/mL) and 128 (54%) had light SHS exposure (median cotinine = 0.11 ng/mL). Within those SHS exposed, the most common source of exposure was in a public area. No significant racial/ethnic differences were found, although African American adolescents were more likely to live in a home that allowed smoking. Older adolescents were more likely to be exposed across several difference sources, and females more likely to be exposed in a car and in public areas. Past 7-day exposure in the home, in a car, and current blunt use were significantly related to biomarkers of exposure.

      Conclusions

      Urban adolescents are exposed to SHS across a variety of sources. Although exposure in a public area is most common, exposure in the home and in cars significantly influences tobacco biomarker levels. Interventions to reduce exposure would have the greatest impact in this population if they focused on reducing exposure in the home and in cars. History of blunt use is a strong determinant of tobacco exposure.

      Keywords

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