The 13th World Conference on Tobacco OR Health

Objective: Recent reports have found an association between exposure to secondhand tobacco smoke and elevated markers of inflammation such as C-reactive protein (CRP) in adults, but to date there have been no studies which have determined if such an association exists among children and adolescents using biochemical markers of nicotine exposure. This study examines the association of secondhand tobacco smoke exposure as determined by serum cotinine levels and CRP concentrations among youth participants aged 6-18 years using data from the National Health and Nutrition Examination Survey (NHANES) 1999-2002.

Methods: The association between serum cotinine and serum CRP was analyzed using multiple linear regression, with adjustment for age, gender, race/ethnicity, white blood cell count, high density lipoprotein concentration, and body mass index percentile. All analyses utilized weighted data and adjustments for design effects.

Results: Multiple regression analysis indicated that a change in serum cotinine of 0.5 ng/ml was associated with a 1.05 mg/dl change in CRP (95% confidence interval=1.03-1.09), even after adjustment for covariates. Although the association found in youth appears to be modest, the effect of secondhand smoke exposure over time may pose an important long-term cardiovascular risk for children and adolescents. Such exposure may be particularly important in children with other cardiovascular risk factors such as obesity, diabetes, hypertension or positive family history for cardiovascular disease. We recommend prospective studies examining the association between secondhand smoke exposure, as measured by serum cotinine concentration, and markers of chronic inflammation such as CRP and their relationship to cardiovascular outcomes in youth and young adults.