ArticleEnvironmental research2021
Differential associations of hand nicotine and urinary cotinine with children's exposure to tobacco smoke and clinical outcomes.
Article in Environmental research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
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Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 31 citations in OpenAlex.
- Analysis of Assessment Methods for Detecting Nicotine Residue and Its Impact on Humans: A Systematic Review.International journal of environmental research and public health · 2025Pooled it
- Quantitative reference levels for thirdhand smoke residue from tobacco products in indoor environments: a systematic review and meta-analysis.Journal of exposure science & environmental epidemiology · 2026Review
- Environmental tobacco smoke is a major contributor to lead, cadmium, and arsenic in settled house dust.Chemosphere · 2026Article
- Invisible smoke, real threat: can education protect pregnant women from thirdhand smoke exposure? (a protocol study).BMC pregnancy and childbirth · 2025Article
- Adverse childhood experiences and tobacco smoke exposure among U.S. school-aged children.Child protection and practice · 2025Article
- Assessment, detection, and validation of clinical associations of thirdhand smoke exposure (ADVOCATE) study protocol.Pediatric research · 2025Article
- Assessing parental awareness and concerns about children's tobacco smoke exposure: a community-based analysis.Archives of public health = Archives belges de sante publique · 2025Article
- Policy-relevant differences between secondhand and thirdhand smoke: strengthening protections from involuntary exposure to tobacco smoke pollutants.Tobacco control · 2024Article
- Cotton pillow samplers for assessment of thirdhand smoke in homes of smokers and nonsmokers with children.Journal of environmental exposure assessment · 2024Article
- Assessment of the Smoke Free Families Tobacco Screening, Counseling, and Referral Program in Pediatric Primary Care Practices.Academic pediatrics · 2024Article
- Article
- Tobacco Smoke Exposure and Gastrointestinal Problems Among US Children.Clinical pediatrics · 2023Article
- Associations of household tobacco smoking status with childhood temperament among U.S. preschool-aged children.Journal of affective disorders · 2023Article
- 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
- Thirdhand tobacco smoke exposure increases the genetic background-dependent risk of pan-tumor development in Collaborative Cross mice.Environment international · 2023Article
- Distinguishing Exposure to Secondhand and Thirdhand Tobacco Smoke among U.S. Children Using Machine Learning: NHANES 2013-2016.Environmental science & technology · 2023Article
- Tobacco Smoke Exposure, School Engagement, School Success, and Afterschool Activity Participation Among US Children.The Journal of school health · 2022Article
- Hand nicotine as an independent marker of thirdhand smoke pollution in children's environments.The Science of the total environment · 2022Article
- Financial Insecurity and Food Insecurity among U.S. Children with Secondhand and Thirdhand Smoke Exposure.International journal of environmental research and public health · 2022Article
- Disparities in Neighborhood Characteristics among U.S. Children with Secondhand and Thirdhand Tobacco Smoke Exposure.International journal of environmental research and public health · 2022Article
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundChildren's overall tobacco smoke exposure (TSE) consists of both inhalation of secondhand smoke (SHS) and ingestion, dermal uptake, and inhalation of thirdhand smoke (THS) residue from dust and surfaces in their environments.
objectivesOur objective was to compare the different roles of urinary cotinine as a biomarker of recent overall TSE and hand nicotine as a marker of children's contact with nicotine pollution in their environments. We explored the differential associations of these markers with sociodemographics, parental smoking, child TSE, and clinical diagnoses.
methodsData were collected from 276 pediatric emergency department patients (Median age = 4.0 years) who lived with a cigarette smoker. Children's hand nicotine and urinary cotinine levels were determined using LC-MS/MS. Parents reported tobacco use and child TSE. Medical records were reviewed to assess discharge diagnoses.
resultsAll children had detectable hand nicotine (GeoM = 89.7ng/wipe; 95 % CI = [78.9; 102.0]) and detectable urinary cotinine (GeoM = 10.4 ng/ml; 95%CI = [8.5; 12.6]). Although hand nicotine and urinary cotinine were highly correlated (r = 0.62, p < 0.001), urinary cotinine geometric means differed between racial groups and were higher for children with lower family income (p < 0.05), unlike hand nicotine. Independent of urinary cotinine, age, race, and ethnicity, children with higher hand nicotine levels were at increased risk to have discharge diagnoses of viral/other infectious illness (aOR = 7.49; 95%CI = [2.06; 27.24], p = 0.002), pulmonary illness (aOR = 6.56; 95%CI = [1.76; 24.43], p = 0.005), and bacterial infection (aOR = 5.45; 95%CI = [1.50; 19.85], p = 0.03). In contrast, urinary cotinine levels showed no associations with diagnosis independent of child hand nicotine levels and demographics. DISCUSSION: The distinct associations of hand nicotine and urinary cotinine suggest the two markers reflect different exposure profiles that contribute differentially to pediatric illness. Because THS in a child's environment directly contributes to hand nicotine, additional studies of children of smokers and nonsmokers are warranted to determine the role of hand nicotine as a marker of THS exposure and its potential role in the development of tobacco-related pediatric illnesses.
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Registered trials
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