Reported measures of environmental tobacco smoke exposure: trials and tribulations.
OBJECTIVE
This report extends previous summaries of reported environmental tobacco smoke (ETS) exposure measures, reviews the empirical evidence of their validity for children's exposure, and discusses future research.


METHODS
Studies were identified by computer search and from the authors' research.


METHODS
Studies were selected for inclusion of nicotine and/or cotinine and quantitative reported measures of ETS exposure.


RESULTS
Five studies found significant associations between reported quantitative exposure of children to ETS and either environmental nicotine or urine cotinine assays. Correlation coefficients between parent reports and nicotine ranged from 0.22 to 0.75. Coefficients for cotinine ranged from 0.28 to 0.71. Correlations increased over time and were stronger for parents' reports of their own smoking as a source of children's exposure than for reports of exposure from others.


CONCLUSIONS
Empirical studies show general concordance of reported and either environmental or biological measures of ETS exposure. Relationships were moderate, and suggest sufficient validity to be employed in research and service programs. Future studies need to identify the differences in types of reported or objective measures, population characteristics, etc, contributing to observed variability in order to understand better the conditions under which more valid reported ETS exposure and other measures can be obtained. Reported and either environmental or biological measures should be used in combination, and existing measures should be directed to interventions that may reduce ETS exposure among children.
Hovell
M F
MF
Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, San Diego State University, San Diego, California, USA. behepi@rohan.sdsu.edu
Zakarian
J M
JM
Wahlgren
D R
DR
Matt
G E
GE
Emmons
K M
KM
D002648:Child; D002669:Child Welfare; D002675:Child, Preschool; D003367:Cotinine / Q000652:urine; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009538:Nicotine / Q000652:urine; D012907:Smoking / Q000009:adverse effects*; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*
D014028:Tobacco Smoke Pollution; D009538:Nicotine; D003367:Cotinine