ArticleAmerican journal of preventive medicine2021
High Cotinine and Healthcare Utilization Disparities Among Low-Income Children.
Article in American journal of preventive medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 10 citations in OpenAlex.
- Tobacco Smoke Exposure Biomarker Profiles and Healthcare Utilization Patterns Among U.S. Children.Toxics · 2025Article
- Article
- Sources of Tobacco Smoke Exposure and Their Associations With Serum Cotinine Levels Among US Children and Adolescents.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2023Article
- Barriers to implementation of pediatric emergency department interventions for parental tobacco use and dependence: a qualitative study using the theoretical domains framework.Implementation science communications · 2022Article
- High Levels of the Carcinogenic Tobacco-Specific Nitrosamine NNAL and Associated Findings in Children of Smokers: A Case Series.Biomarker insights · 2022Article
- Tobacco smoke exposure and fractional exhaled nitric oxide levels among U.S. adolescents.Nitric oxide : biology and chemistry · 2021Article
- Comparison of Levels of Three Tobacco Smoke Exposure Biomarkers in Children of Smokers.International journal of environmental research and public health · 2021Article
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
introductionThis study assesses the associations of child salivary cotinine, parent-reported smoking, and child tobacco smoke exposure with the number of child healthcare visits and hospital admissions over a 6-month period. This study also assesses the relationships between participant characteristics and child cotinine.
methodsLongitudinal data were evaluated from a sample of 313 clinically ill children aged 0-9 years who lived with a smoker and presented to a pediatric emergency department or urgent care in 2016-2018. In 2020, cotinine measurements were log transformed, and Poisson and linear regression were performed.
resultsThe majority of the children came from low-income homes (66.1%) and had public insurance/self-pay (95.5%). Child cotinine concentrations ranged from 0.1 to 332.0 ng/mL (geometric mean=4.8 ng/mL, 95% CI=4.1, 5.5). Poisson regression results indicated that each 1-unit increase of log-cotinine concentration was associated with an increase in pediatric emergency department visits over a 6-month period after the baseline visit, with an adjusted RR of 1.16 (95% CI=1.01, 1.34). Each 1-unit increase of log-cotinine concentration was associated with an increase in the frequency of hospital admissions over the 6-month period, with an adjusted RR of 1.50 (95% CI=1.08, 2.09). No differences were found between parent-reported smoking or child tobacco smoke exposure and healthcare utilization. Linear regression results indicated that children who were younger (β= -0.227, p=0.049), were White (geometric mean=5.5 ng/mL), had a medical history of prematurity (geometric mean=8.1 ng/mL), and had a winter baseline visit (geometric mean=6.5 ng/mL) had higher cotinine concentrations. Children living in apartments (geometric mean=5.5 ng/mL) and multiunit homes (geometric mean=5.5 ng/mL) had higher cotinine concentrations than those in single-family homes (geometric mean=3.6 ng/mL).
conclusionsRoutine biochemical screening could identify children who are in need of intensive tobacco smoke exposure reduction interventions.
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