The Evaluation Of The Effects Of Passive Smoking On Children's Health With Detection Of Urine Cotinine Levels

Background: Passive smoking exposure is an important public health problem that causes pneumonia, bronchiolitis, bronchopneumonia, asthma formation and exacerbation, middle ear inflammation, tooth decay, growth retardation and development in children.Objectives: In this study, it was aimed to evaluate passive smokers objectively by cotinine level in urine.Method: Eighty children with at least one active smoker at home and 80 children who were not active smoker at home were admitted to the Ankara Education and Research Hospital . Parents were asked a questionnaire to the sociodemographic characteristics of their children and their families, the habits of smoking and the illnesses they had in a year. To assess passive smoking exposures, the first urine of children was collected and the level of cotinine, the main metabolite of nicotine in the urine, was measured using the solid phase competitive chemiluminescence immunoassay method on the Immulite 2000 Analyzer. A cut-off value of 10 ng / ml was obtained for diagnosis of passive smoking. Patients with cotinine levels above this value were assessed as "exposed to passive smoking".Results: In passive smoking exposures, the number of illnesses and wheezing has increased in the last year. The preterm birth and wheezing frequency of the smokers were significantly higher in the pregnant women (p <0, 05). Median cotinine level was found to be 10 ng / ml in the passive smoking group but median cotinine level was found to be 20,8 ng / ml in the cigarette group (p <0,01). The group with only mother smokers had significantly increased incidence of tooth decay compared with other groups (p <0.05). No relationship was found between birth weigth of infant and smoking behaviour during pregnancy (p=0,53), however the frequency of prematurity was found to be higher  (p=0.03).The cotinine level of 68.7% of patients in the passive smoking group and 25% of the control group was above the threshold value of 10 ng / ml. The most sensitive and specific threshold level of cotinine was found as 14.75 ng/ml. Conclusions: Our study showed that 25% of children who do not smoke at home are exposed to passive smoking. This finding suggests that families are biased towards reporting smoking cessation alongside their sick children and those children are also exposed to cigarette smoke in out-of-home settings.