PMID- 36567673 OWN - NLM STAT- MEDLINE DCOM- 20230411 LR - 20231227 IS - 1469-994X (Electronic) IS - 1462-2203 (Print) IS - 1462-2203 (Linking) VI - 25 IP - 5 DP - 2023 Apr 6 TI - Sources of Tobacco Smoke Exposure and Their Associations With Serum Cotinine Levels Among US Children and Adolescents. PG - 1004-1013 LID - 10.1093/ntr/ntac293 [doi] AB - INTRODUCTION: We assessed tobacco smoke exposure (TSE) levels based on private and public locations of TSE according to race and ethnicity among US school-aged children ages 6-11 years and adolescents ages 12-17 years. AIMS AND METHODS: Data were from 5296 children and adolescents who participated in the National Health and Nutrition Examination Survey (NHANES) 2013-2018. Racial and ethnic groups were non-Hispanic white, black, other or multiracial, and Hispanic. NHANES assessed serum cotinine and the following TSE locations: homes and whether smokers did not smoke indoors (home thirdhand smoke [THS] exposure proxy) or smoked indoors (secondhand [SHS] and THS exposure proxy), cars, in other homes, restaurants, or any other indoor area. We used stratified weighted linear regression models by racial and ethnic groups and assessed the variance in cotinine levels explained by each location within each age group. RESULTS: Among 6-11-year-olds, exposure to home THS only and home SHS + THS predicted higher log-cotinine among all racial and ethnic groups. Non-Hispanic white children exposed to car TSE had higher log-cotinine (beta = 1.64, 95% confidence interval [CI] = 0.91% to 2.37%) compared to those unexposed. Non-Hispanic other/multiracial children exposed to restaurant TSE had higher log-cotinine (beta = 1.13, 95% CI = 0.23% to 2.03%) compared to those unexposed. Among 12-17-year-olds, home SHS + THS exposure predicted higher log-cotinine among all racial and ethnic groups, except for non-Hispanic black adolescents. Car TSE predicted higher log-cotinine among all racial and ethnic groups. Non-Hispanic black adolescents with TSE in another indoor area had higher log-cotinine (beta = 2.84, 95% CI = 0.85% to 4.83%) compared to those unexposed. CONCLUSIONS: TSE location was uniquely associated with cotinine levels by race and ethnicity. Smoke-free home and car legislation are needed to reduce TSE among children and adolescents of all racial and ethnic backgrounds. IMPLICATIONS: Racial and ethnic disparities in TSE trends have remained stable among US children and adolescents over time. This study's results indicate that TSE locations differentially contribute to biochemically measured TSE within racial and ethnic groups. Home TSE significantly contributed to cotinine levels among school-aged children 6-11 years old, and car TSE significantly contributed to cotinine levels among adolescents 12-17 years old. Racial and ethnic differences in locations of TSE were observed among each age group. Study findings provide unique insight into TSE sources, and indicate that home and car smoke-free legislation have great potential to reduce TSE among youth of all racial and ethnic backgrounds. CI - Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco 2022. FAU - Merianos, Ashley L AU - Merianos AL AUID- ORCID: 0000-0002-5640-7227 AD - School of Human Services, University of Cincinnati, Cincinnati, OH, USA. FAU - Stone, Timothy M AU - Stone TM AD - Division of Biostatistics and Bioinformatics, Department of Environmental and Public Health Sciences, College of Medicine, University of Cincinnati, Cincinnati, OH, USA. FAU - Jandarov, Roman A AU - Jandarov RA AD - Division of Biostatistics and Bioinformatics, Department of Environmental and Public Health Sciences, College of Medicine, University of Cincinnati, Cincinnati, OH, USA. FAU - Mahabee-Gittens, E Melinda AU - Mahabee-Gittens EM AD - Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, University of Cincinnati, College of Medicine, Cincinnati, OH, USA. FAU - Choi, Kelvin AU - Choi K AUID- ORCID: 0000-0002-6753-2883 AD - Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, MD, USA. LA - eng GR - K01 DA044313/DA/NIDA NIH HHS/United States GR - R01 ES027815/ES/NIEHS NIH HHS/United States GR - R01 ES030743/ES/NIEHS NIH HHS/United States GR - R21 ES032161/ES/NIEHS NIH HHS/United States GR - K01DA044313/DA/NIDA NIH HHS/United States GR - R21ES032161/ES/NIEHS NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, N.I.H., Intramural PL - England TA - Nicotine Tob Res JT - Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco JID - 9815751 RN - K5161X06LL (Cotinine) RN - 0 (Tobacco Smoke Pollution) SB - IM MH - Adolescent MH - Child MH - Humans MH - *Cotinine/blood MH - Hispanic or Latino/statistics & numerical data MH - Nutrition Surveys/statistics & numerical data MH - *Tobacco Smoke Pollution/analysis/statistics & numerical data MH - United States/epidemiology MH - Environmental Exposure/analysis/statistics & numerical data MH - *Inhalation Exposure/analysis/statistics & numerical data MH - White/statistics & numerical data MH - Black or African American/statistics & numerical data MH - Automobiles/statistics & numerical data MH - Housing/statistics & numerical data MH - Housing Quality MH - Restaurants/statistics & numerical data PMC - PMC10077940 COIS- The authors declare that they have no competing interests related to this research. EDAT- 2022/12/27 06:00 MHDA- 2023/04/10 06:42 PMCR- 2023/12/26 CRDT- 2022/12/26 03:32 PHST- 2022/04/13 00:00 [received] PHST- 2022/11/11 00:00 [revised] PHST- 2022/12/25 00:00 [accepted] PHST- 2023/04/10 06:42 [medline] PHST- 2022/12/27 06:00 [pubmed] PHST- 2022/12/26 03:32 [entrez] PHST- 2023/12/26 00:00 [pmc-release] AID - 6960809 [pii] AID - ntac293 [pii] AID - 10.1093/ntr/ntac293 [doi] PST - ppublish SO - Nicotine Tob Res. 2023 Apr 6;25(5):1004-1013. doi: 10.1093/ntr/ntac293.