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Original Research: ENVIRONMENTAL HEALTH |

The Role of Air Nicotine in Explaining Racial Differences in Cotinine Among Tobacco-Exposed Children*

Stephen E. Wilson, MD, MSc; Robert S. Kahn, MD, MPH; Jane Khoury, PhD; Bruce P. Lanphear, MD, MPH
Author and Funding Information

*From the Department of Medicine (Dr. Wilson), Division of General Internal Medicine, University of Cincinnati College of Medicine; and Cincinnati Children’s Environmental Health Center (Drs. Kahn, Khoury, and Lanphear), Cincinnati Children’s Hospital Medical Center, Cincinnati, OH.

Correspondence to: Stephen E. Wilson, MD, MSc, University of Cincinnati, 231 Albert Sabin Way, Room 6603, Cincinnati, OH 45267; e-mail: Stephen.wilson@uc.edu



Chest. 2007;131(3):856-862. doi:10.1378/chest.06-2123
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Objective: African-American children have higher rates of tobacco-associated morbidity. Few studies have objectively measured racial differences in the exposure of children to tobacco smoke. The objective of this study was to test whether African-American children have higher levels of cotinine compared to white children while accounting for ambient measures of tobacco smoke.

Setting: Community-based sample of asthmatic children (n = 220) enrolled in an environmental tobacco smoke (ETS) reduction trial.

Participants: A biracial sample (55% African American) of children with asthma aged 5 to 12 years who were routinely exposed to ETS.

Measurements: We measured cotinine levels in serum and hair samples at baseline, 6 months, and 12 months. We measured the level of ETS exposure over a 6-month period by placing air nicotine dosimeters in the homes of the children at baseline and at 6-month study visits.

Results: African-American children had significantly higher levels of cotinine at all time points in the study. At the 12-month visit, African-American children had higher levels of serum cotinine (1.39 μg/dL vs 0.80 μg/dL, p = 0.001) and hair cotinine (0.28 ng/mg vs 0.08 ng/mg, p < 0.0001) when compared with white children. In a repeated-measures analysis, African-American children had significantly higher levels of serum cotinine (β = 0.28, p = 0.04) and hair cotinine (β = 1.40, p < 0.0001) compared with white children. Air nicotine levels and housing volume were independently associated with higher levels of cotinine.

Conclusions: Among children with asthma, African-American children have higher levels of serum and hair cotinine compared with white children.

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