title: Can parents of children with cancer accurately report their child's passive smoking exposure?
abstract: BACKGROUND
  This study examined whether children with cancer are exposed to measurable levels of passive smoke as assessed by parent report and laboratory measures of urine cotinine, an established biomarker of passive smoke exposure (PSE). It also determined whether parents/caretakers of young cancer patients can provide valid reports of their child's PSE during the child's treatment, by examining their association with urine cotinine measures.
  
  
  METHODS
  Participants included 124 parents of a child with cancer who lived with at least one adult smoker in the home and was exposed to tobacco smoke in the home and/or car. Eligible patients were younger than 18 years of age, were receiving active treatment for cancer at a large pediatric oncology institution, were at least 30 days postdiagnosis, and did not smoke. Parents provided information about smoking and their child's PSE by responding to a series of questionnaires. Patients provided urine samples for cotinine analyses.
  
  
  RESULTS
  Findings showed that parents provided valid short-term accounts of their child's PSE in the context of their child's cancer treatment. Parent reports of PSE showed moderately strong positive relationships with urine cotinine levels which were stronger for reports provided by parents who smoked compared with nonsmoking parents.
  
  
  CONCLUSIONS
  Parent reports of PSE were validated by positive and significant associations with urine cotinine. Reports provided in the context of possible verification by biomarker assays can provide sufficiently accurate estimates of PSE to serve as outcome measures for clinical research and clinical care in a pediatric cancer setting.
authors.affiliation: Department of Behavioral Medicine, St. Jude Children's Research Hospital, 262 Danny Thomas Place--MS 740, Memphis, TN 38105, USA. vida.tyc@stjude.org
authors.forename: Vida L
authors.initials: VL
authors.lastname: Tyc
authors.forename: Shelly
authors.initials: S
authors.lastname: Lensing
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Vukadinovich
authors.forename: Melbourne F
authors.initials: MF
authors.lastname: Hovell
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003367:Cotinine / Q000652:urine; D004781:Environmental Exposure; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009369:Neoplasms / Q000453:epidemiology / Q000652:urine; D010290:Parents; D012907:Smoking / Q000009:adverse effects*; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*
chemical_list: D014028:Tobacco Smoke Pollution; D003367:Cotinine
references.citation: Pediatrics. 1996 Apr;97(4):560-8
references.pmid: 8632946
references.citation: J Child Health Care. 2004 Dec;8(4):288-300
references.pmid: 15507466
references.citation: MMWR Morb Mortal Wkly Rep. 2008 Jul 11;57(27):744-7
references.pmid: 18614993
references.citation: Am J Public Health. 1992 Jan;82(1):24-8
references.pmid: 1536329
references.citation: Health Psychol. 1994 Nov;13(6):516-20
references.pmid: 7889906
references.citation: N Engl J Med. 1990 Aug 9;323(6):378-82
references.pmid: 2370889
references.citation: Tob Control. 2000;9 Suppl 3:III22-8
references.pmid: 10982901
references.citation: Pediatrics. 2002 Nov;110(5):946-56
references.pmid: 12415035
references.citation: Health Psychol. 2000 May;19(3):232-41
references.pmid: 10868767
references.citation: J Pediatr Psychol. 2008 Mar;33(2):156-75
references.pmid: 18079169
references.citation: N Engl J Med. 1991 Mar 21;324(12):808-15
references.pmid: 1997853
references.citation: Curr Probl Pediatr. 1993 Mar;23(3):102-31
references.pmid: 8513680
references.citation: Lancet. 1986 Feb 8;1(8476):307-10
references.pmid: 2868172
references.citation: Thorax. 1982 Mar;37(3):175-80
references.pmid: 6285541
references.citation: N Engl J Med. 1991 Nov 7;325(19):1330-6
references.pmid: 1922234
references.citation: Tob Control. 1999 Autumn;8(3):282-9
references.pmid: 10599573
references.citation: Thorax. 1999 Apr;54(4):357-66
references.pmid: 10092699
references.citation: Nicotine Tob Res. 2007 Jan;9(1):83-92
references.pmid: 17365739
references.citation: J Clin Epidemiol. 1995 Oct;48(10):1251-9
references.pmid: 7561987
references.citation: Hematol Oncol Clin North Am. 1993 Apr;7(2):401-15
references.pmid: 8468273
references.citation: Clin Chem. 1997 Dec;43(12):2281-91
references.pmid: 9439445
references.citation: BMJ. 1996 Jun 29;312(7047):1654
references.pmid: 8664723