title: Screening for secondhand smoke in schoolchildren in Japan.
abstract: BACKGROUND
  There is no systematic screening for secondhand smoke exposure in children.
  
  
  METHODS
  In 2002, we began a secondhand smoke screening (SSS) program for grade 4 elementary schoolchildren with the cooperation of public administration. The SSS program consisted of urinary cotinine measurement in children and a questionnaire survey of their parents.
  
  
  RESULTS
  More than 1200 schoolchildren were enrolled in this program annually. The level of urinary cotinine in 30% of the children was >5 ng/mL, whereas in half of them it was undetectable. The major risk factor affecting cotinine level was mother's smoking. Average cotinine was significantly high in children who had a history of "short stature", "decayed tooth and/or periodontal disease," and "frequent stridor". In addition, the highest level of cotinine was detected in children whose father and/or mother smoked in the living room and the lowest level of cotinine was detected in children whose father and/or mother smoked on the veranda or outside the door. These levels, however, were two-fivefold higher than in children whose parents did not smoke. On follow-up questionnaire survey 4 years after initial SSS, significant elevated motivation for smoking cessation was noted.
  
  
  CONCLUSIONS
  The SSS program is a very simple mass screen that can be done using only a urine test and is very effective for motivating parents to stop smoking with regard to cost benefit.
authors: Gunma Paz College, Faculty of Health Science, Takasaki, Gunma.|Ino Clinic, Kumagaya, Saitama, Japan.
authors: Toshihiro
authors: T
authors: Ino
authors: Gunma Paz College, Faculty of Health Science, Takasaki, Gunma.
authors: Kazuo
authors: K
authors: Kurosawa
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003367:Cotinine / Q000032:analysis*; D004781:Environmental Exposure / Q000009:adverse effects* / Q000032:analysis; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D010290:Parents; D012189:Retrospective Studies; D012463:Saliva / Q000737:chemistry*; D012907:Smoking / Q000453:epidemiology* / Q000378:metabolism; D011795:Surveys and Questionnaires; D014028:Tobacco Smoke Pollution / Q000009:adverse effects* / Q000032:analysis; D055815:Young Adult
chemical_list: D014028:Tobacco Smoke Pollution; D003367:Cotinine
keywords: biomarker; carcinogen; cotinine; screening; secondhand smoke