Evaluation of Environmental Tobacco Smoke Exposure of Pediatric Patients with Chronic Lung Diseases

Purpose: It is very important to minimize the environmental risks that may increase respiratory morbidity in children with chronic lung diseases (CLD). We aimed to determine environmental tobacco smoke (ETS) exposure in children with CLD. Methods: Two hundred and fifty patients with the diagnosis of CLD were included in this study. Parents of the children with CLD were asked about their smoking habits through a questionnaire. ETS exposure was also determined by the measurement of plasma cotinine level of these children, and levels ≥12 ng/ml were considered exposed to ETS. Results: Although according to parental reports 58% of patients lived in the same household with at least one smoker, 72% of patients had a plasma cotinine level of ≥12 ng/ml. Cotinine values of children who lived in the same house with at least one smoker, were exposed to ETS in the last 7 days and whose parents allowed smoking in their car were significantly higher than the opposite groups (34,76±28,16 versus 21,57±12,76; 42,58±33,61 versus 23,66±14,94; and 40,71±30,52 and 21,00±13,94 ng/ml respectively). Conclusions: This study revealed that children with CLD exhibited significantly elevated plasma cotinine levels. It emphasizes the critical need to reduce ETS exposure in CLD patients. Objective measures like plasma cotinine can provide reliable assessments of exposure, complementing parental reports which may underestimate actual exposure levels. Moving forward, efforts to mitigate ETS exposure among CLD patients should include targeted smoking cessation interventions and stricter enforcement of smoke-free policies in homes and public spaces.