title: Parental smoking behavior and passive smoke exposure in children with asthma.
abstract: BACKGROUND
  Smoking parents of children with asthma frequently report modifying their smoking behavior to reduce their child's smoke exposure. Research has not analyzed the association between parental efforts and the child's smoke exposure.
  
  
  OBJECTIVE
  To determine passive smoke exposure and the relationship of self-reported parental modifications in smoking behavior to smoke exposure in children with asthma.
  
  
  METHODS
  Parents of children seen in an inner-city Asthma and Allergy Outpatient Clinic completed questionnaires to evaluate their smoking behavior and modifications they made to decrease their child's exposure to cigarette smoke. Urine specimens were collected from the children to determine smoke exposure as measured by urinary cotinine/creatinine ratios.
  
  
  RESULTS
  Children from homes with smokers had higher mean urinary cotinine/ creatine ratios than children from smoke free homes (30 versus 4 ng/mg; P = .0005). Cotinine/creatinine ratios increased with the number of smokers in the home. When the parent was the only smoker in the home, the mean urinary cotinine/creatine ratio of children whose parent smoked outside the house was lower than the mean of children whose parent smoked inside (21 versus 51 ng/mg; P = .038). With only one smoker in the home, there was no difference in mean cotinine/creatinine ratios when the primary caregiver was not the smoker versus when the primary caregiver was not the smoker (27 versus 15 ng/mg; P = .10).
  
  
  CONCLUSIONS
  Smoking outside the house was associated with lower urinary cotinine/creatinine ratio only when the parent was the only smoker in the home.
authors.affiliation: Maternal Child Health Department, University of Maryland School of Nursing, Baltimore, USA.
authors.forename: M L
authors.initials: ML
authors.lastname: Winkelstein
authors.forename: A
authors.initials: A
authors.lastname: Tarzian
authors.forename: R A
authors.initials: RA
authors.lastname: Wood
mesh_terms: D000328:Adult; D001249:Asthma / Q000209:etiology* / Q000652:urine; D001521:Behavior Therapy; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D010290:Parents; D012907:Smoking / Q000009:adverse effects*; D011795:Surveys and Questionnaires; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*
chemical_list: D014028:Tobacco Smoke Pollution