Association between children’s secondhand co-exposure to tobacco and cannabis smoke and elevated urinary cotinine levels: a cross-sectional analysis
Abstract
Background: Cannabis use is far more common among adults who smoke tobacco than adults who do not, and its use is increasing among people who smoke tobacco with children living in the home. Given the well-established evidence that caregiver smoking is the primary source of children's secondhand exposures to these products, the increasing trend in caregiver co-use is raising public health concerns about children's co-exposure. Emerging data indicates that adult co-use is linked to additive health consequences, such as elevated nicotine and other tobacco-related toxicant blood levels, relative to use of only tobacco. It is unknown whether children's co-exposure leads to similar additive consequences. This study examined whether children's co-exposure to secondhand tobacco and cannabis smoke related to higher urinary levels of cotinine (the primary nicotine metabolite) relative to children exposed to only tobacco smoke. Methods: This study performed a cross-sectional analysis of baseline data from the 'Babies Living Safe and Smokefree' tobacco intervention randomised controlled trial. All participants (N=396) included low-income mothers who smoked tobacco daily and were primary caretakers of young children (<6 years old). Multivariable regression was performed to test the hypothesis that maternal co-smoking would relate to children's elevated cotinine levels in a model including potential confounding variables (eg, children's mean daily tobacco smoke exposure, maternal nicotine…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 396 participants or records.
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