Evidence map›Paper›PMID 38890774›Full record

Trial reportNicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco2024

The Effect of Adult Smoking Behavior on Children's Exposure to Secondhand Smoke. An Analysis Based on Salivary Cotinine Levels Among Children in Dhaka and Karachi.

Kamran Siddiqi, Charlie Welch, Rumana Huque, Romania Iqbal, Mona Kanaan, Masuma Pervin Mishu, Mariam Ahmad Khokhar, Sean Semple, CLASS III Trial Team

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Kamran SiddiqiDepartment of Health Sciences, University of York, York, UK.ORCID 0000-0003-1529-7778
Charlie WelchDepartment of Health Sciences, University of York, York, UK.
Rumana HuqueARK Foundation, Dhaka, Bangladesh.ORCID 0000-0002-7616-9596
Romania IqbalDepartment of Community Health Sciences, Aga Khan University, Karachi, Pakistan.
Mona KanaanDepartment of Health Sciences, University of York, York, UK.ORCID 0000-0001-7956-7576
Masuma Pervin MishuDepartment of Epidemiology and Public Health, University College London, London, UK.ORCID 0000-0002-6545-9117
Mariam Ahmad KhokharDepartment of Health Sciences, University of York, York, UK.
Sean SempleInstitute for Social Marketing and Health, University of Stirling, Stirling, UK.ORCID 0000-0002-0462-7295
CLASS III Trial Team

Funding

Medical Research Council MR/T004959/1Medical Research Council UK MR/T004959
6 · The paper itself

Abstract

introductionExposure to secondhand smoke (SHS) risks children's health. However, biomarkers are rarely used to study SHS exposure among children in low- and middle-income countries. AIMS AND

methodsWe analyzed cross-sectional data collected between March and November 2022 for a cluster-randomized controlled trial investigating a Smoke-Free Intervention in 2769 children aged 9-15 in 74 schools (34 in Dhaka, Bangladesh, and 40 in Karachi, Pakistan). Children's saliva was tested for the concentration of cotinine-a highly sensitive and specific biomarker for SHS exposure. Based on their reports, children's homes were categorized as Nonsmoking Homes (NSH) when residents were nonsmokers; Smoke-free Homes (SFH) when residents and visitors smoked outdoors only; and Smoke-permitted Homes (SPH) when either residents or visitors smoked indoors. We compared cotinine concentrations across these home types and the two cities using a proportional odds model.

resultsOverall, 95.7% of children (92% in Dhaka; and 99.4% in Karachi) had cotinine levels between 0.1 and 12 ng/mL, indicating SHS exposure. Median cotinine levels were higher in Karachi (0.58 ng/mL, IQR 0.37 to 0.93) than in Dhaka (0.27 ng/mL, IQR 0.16 to 0.49). Median cotinine concentration was also higher among children living in SPH than those in either NSH or SFH; with absolute differences of approximately 0.1-0.3 and 0.05 ng/mL, respectively.

conclusionsThe level of SHS exposure in Dhaka and Karachi indicates widespread and unrestricted smoking. Smoking restrictions in households and enforcement of smoking bans are urgently needed. IMPLICATIONS: The high levels of SHS exposure in children living in SFH suggest parental behavior to hide their smoking and/or exposure in private vehicles or public spaces. It is important to advocate for SFH and cars to protect children from SHS exposure. However, these initiatives alone may not be enough. There is a need to enforce smoking bans in enclosed public places and transportation, as well as extend these bans to playgrounds, parks, fairgrounds, and other public spaces that children frequently visit. It is essential to complement smoking restrictions with tobacco cessation advice and support in these settings.

Indexed as

CotinineEnvironmental ExposureSalivaSmokingTobacco Smoke PollutionAdolescentAdultBangladeshBiomarkersChildCross-Sectional StudiesFemaleHumansMalePakistanBiomarkersCotinineTobacco Smoke Pollution

Identifiers

PMID38890774
PMCPMC11494616

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.