{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T08:06:55Z","timestamp":1769242015053,"version":"3.49.0"},"reference-count":36,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2014,2,1]]},"abstract":"<jats:sec><jats:title>OBJECTIVE:<\/jats:title><jats:p>To explore the relationship between tobacco smoke exposure (reported versus biomarker) and rates of readmission for children hospitalized for asthma.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS:<\/jats:title><jats:p>We enrolled a prospective cohort of 774 children aged 1 to 16 years admitted for asthma or bronchodilator-responsive wheezing. The primary outcome was at least 1 asthma- or wheeze-related readmission within 1 year. Caregivers reported any tobacco exposure at home, in a secondary residence, or in the car. We measured serum and saliva cotinine levels with mass spectrometry. We used logistic regression to evaluate associations between tobacco exposure and readmissions.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS:<\/jats:title><jats:p>A total of 619 children had complete tobacco exposure data; 57% were African American and 76% had Medicaid. Seventeen percent of children were readmitted within 1 year. Tobacco exposure rates were 35.1%, 56.1%, and 79.6% by report, serum, and saliva measures, respectively. Caregiver report of any tobacco exposure was not associated with readmission (adjusted odds ratio: 1.18; 95% confidence interval: 0.79\u20131.89), but having detectable serum or salivary cotinine was associated with increased odds of readmission (adjusted odds ratio [95% confidence interval]: 1.59 [1.02\u20132.48] and 2.35 [1.22\u20134.55], respectively). Among children whose caregivers reported no tobacco exposure, 39.1% had detectable serum cotinine and 69.9% had detectable salivary cotinine. Of the children with reported exposure, 87.6% had detectable serum cotinine and 97.7% had detectable salivary cotinine.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS:<\/jats:title><jats:p>Detectable serum and salivary cotinine levels were common among children admitted for asthma and were associated with readmission, whereas caregiver report of tobacco exposure was not.<\/jats:p><\/jats:sec>","DOI":"10.1542\/peds.2013-2422","type":"journal-article","created":{"date-parts":[[2014,1,21]],"date-time":"2014-01-21T02:09:09Z","timestamp":1390270149000},"page":"e355-e362","source":"Crossref","is-referenced-by-count":72,"title":["Cotinine in Children Admitted for Asthma and Readmission"],"prefix":"10.1542","volume":"133","author":[{"given":"Judie A.","family":"Howrylak","sequence":"first","affiliation":[{"name":"Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam J.","family":"Spanier","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bin","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, Ohio; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roy W. A.","family":"Peake","sequence":"additional","affiliation":[{"name":"Clinical Epidemiologic Research Laboratory, Boston Children\u2019s Hospital, Boston, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark D.","family":"Kellogg","sequence":"additional","affiliation":[{"name":"Clinical Epidemiologic Research Laboratory, Boston Children\u2019s Hospital, Boston, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hadley","family":"Sauers","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, Ohio; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert S.","family":"Kahn","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, Ohio; and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2014,2,1]]},"reference":[{"issue":"5","key":"2021120900292368200_B1","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1378\/chest.80.5.530","article-title":"Passive smoking: effects on bronchial asthma.","volume":"80","author":"Dahms","year":"1981","journal-title":"Chest"},{"issue":"3 pt 1","key":"2021120900292368200_B2","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1164\/ajrccm.154.3.8810605","article-title":"Risk factors for childhood asthma and wheezing: importance of maternal and household smoking.","volume":"154","author":"Ehrlich","year":"1996","journal-title":"Am J Respir Crit Care Med"},{"issue":"3","key":"2021120900292368200_B3","doi-asserted-by":"crossref","first-page":"194","DOI":"10.5694\/j.1326-5377.1985.tb133098.x","article-title":"Passive cigarette smoking and patients with asthma.","volume":"142","author":"Knight","year":"1985","journal-title":"Med J Aust"},{"issue":"2","key":"2021120900292368200_B4","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1016\/0091-6749(92)90323-T","article-title":"Passive cigarette smoke-challenge studies: increase in bronchial hyperreactivity.","volume":"89","author":"Menon","year":"1992","journal-title":"J Allergy Clin Immunol"},{"issue":"3 pt 1","key":"2021120900292368200_B5","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1016\/0091-6749(88)90003-6","article-title":"Cigarette smoke-sensitive asthma: challenge studies.","volume":"82","author":"Stankus","year":"1988","journal-title":"J Allergy Clin Immunol"},{"issue":"12","key":"2021120900292368200_B6","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1056\/NEJM198309223091204","article-title":"Longitudinal study of the effects of maternal smoking on pulmonary function in children.","volume":"309","author":"Tager","year":"1983","journal-title":"N Engl J Med"},{"issue":"4","key":"2021120900292368200_B7","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1542\/peds.85.4.505","article-title":"Maternal smoking and childhood asthma.","volume":"85","author":"Weitzman","year":"1990","journal-title":"Pediatrics"},{"issue":"2","key":"2021120900292368200_B8","doi-asserted-by":"crossref","DOI":"10.1542\/peds.101.2.e8","article-title":"The burden of environmental tobacco smoke exposure on the respiratory health of children 2 months through 5 years of age in the United States: Third National Health and Nutrition Examination Survey, 1988 to 1994.","volume":"101","author":"Gergen","year":"1998","journal-title":"Pediatrics"},{"issue":"2","key":"2021120900292368200_B9","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1378\/chest.122.2.409","article-title":"Involuntary smoking and asthma severity in children: data from the Third National Health and Nutrition Examination Survey.","volume":"122","author":"Mannino","year":"2002","journal-title":"Chest"},{"issue":"1","key":"2021120900292368200_B10","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1001\/archpedi.155.1.36","article-title":"Health effects related to environmental tobacco smoke exposure in children in the United States: data from the Third National Health and Nutrition Examination Survey.","volume":"155","author":"Mannino","year":"2001","journal-title":"Arch Pediatr Adolesc Med"},{"issue":"7","key":"2021120900292368200_B11","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1023\/A:1015500508261","article-title":"The ecological relationship of tobacco smoking to the prevalence of symptoms of asthma and other atopic diseases in children: the International Study of Asthma and Allergies in Childhood (ISAAC).","volume":"17","author":"Mitchell","year":"2001","journal-title":"Eur J Epidemiol"},{"issue":"7","key":"2021120900292368200_B12","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1002\/ppul.20637","article-title":"Exposure to environmental tobacco smoke among children presenting to the emergency department with acute asthma: a multicenter study.","volume":"42","author":"Vargas","year":"2007","journal-title":"Pediatr Pulmonol"},{"issue":"47","key":"2021120900292368200_B13","article-title":"A longitudinal study of environmental tobacco smoke exposure in children: parental self reports versus age dependent biomarkers.","volume":"8","author":"Puig","year":"2008","journal-title":"BMC Public Health"},{"issue":"5","key":"2021120900292368200_B14","doi-asserted-by":"crossref","first-page":"776","DOI":"10.1016\/j.jpeds.2011.04.025","article-title":"Comparison of biomarkers and parent report of tobacco exposure to predict wheeze.","volume":"159","author":"Spanier","year":"2011","journal-title":"J Pediatr"},{"issue":"1","key":"2021120900292368200_B15","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1093\/ntr\/ntn010","article-title":"The accuracy of self-reported smoking: a systematic review of the relationship between self-reported and cotinine-assessed smoking status.","volume":"11","author":"Connor Gorber","year":"2009","journal-title":"Nicotine Tob Res"},{"issue":"2","key":"2021120900292368200_B16","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1016\/j.jpeds.2013.01.064","volume":"163","year":"2013","journal-title":"J Pediatr"},{"key":"2021120900292368200_B17","unstructured":"US Food and Drug Administration; Department of Health and Human Services. Guidance for industry, bioanalytical method validation. Available at: www.fda.gov\/downloads\/Drugs\/Guidances\/ucm070107.pdf. Accessed November 20, 2013"},{"issue":"5","key":"2021120900292368200_B18","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1111\/j.1552-6909.2010.01169.x","article-title":"The effects of prenatal secondhand smoke exposure on preterm birth and neonatal outcomes.","volume":"39","author":"Ashford","year":"2010","journal-title":"J Obstet Gynecol Neonatal Nurs"},{"issue":"12","key":"2021120900292368200_B19","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1016\/j.arbres.2009.09.004","article-title":"Perinatal exposure to tobacco and respiratory and allergy symptoms in first years of life [in Spanish]","volume":"45","author":"Fr\u00edguls","year":"2009","journal-title":"Arch Bronconeumol"},{"issue":"6","key":"2021120900292368200_B20","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1002\/ppul.20019","article-title":"Tobacco smoke exposure, wheeze, and atopy.","volume":"37","author":"Murray","year":"2004","journal-title":"Pediatr Pulmonol"},{"issue":"4","key":"2021120900292368200_B21","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1164\/ajrccm\/147.4.811","article-title":"Lung function, pre- and post-natal smoke exposure, and wheezing in the first year of life.","volume":"147","author":"Tager","year":"1993","journal-title":"Am Rev Respir Dis"},{"issue":"12","key":"2021120900292368200_B22","article-title":"Directly measured secondhand smoke exposure and COPD health outcomes.","volume":"6","author":"Eisner","year":"2006","journal-title":"BMC Pulm Med"},{"issue":"1","key":"2021120900292368200_B23","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1164\/ajrccm\/146.1.66","article-title":"Relationship between urinary cotinine level and diagnosis in children admitted to hospital.","volume":"146","author":"Reese","year":"1992","journal-title":"Am Rev Respir Dis"},{"issue":"5","key":"2021120900292368200_B24","doi-asserted-by":"crossref","first-page":"970","DOI":"10.1016\/j.jpeds.2012.10.045","article-title":"Prenatal tobacco exposure, biomarkers for tobacco in meconium, and neonatal growth outcomes.","volume":"162","author":"Himes","year":"2013","journal-title":"J Pediatr"},{"issue":"1","key":"2021120900292368200_B25","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1111\/j.1479-828X.1990.tb03192.x","article-title":"Maternal smoking, urinary cotinine levels and birth-weight.","volume":"30","author":"Mathai","year":"1990","journal-title":"Aust N Z J Obstet Gynaecol"},{"issue":"12","key":"2021120900292368200_B26","doi-asserted-by":"crossref","first-page":"1315","DOI":"10.1093\/oxfordjournals.aje.a117599","article-title":"Measurement of exposure to environmental tobacco smoke in pregnant women.","volume":"142","author":"O\u2019Connor","year":"1995","journal-title":"Am J Epidemiol"},{"issue":"1","key":"2021120900292368200_B27","doi-asserted-by":"crossref","first-page":"86","DOI":"10.3109\/14767051003758887","article-title":"Smoking prevalence in early pregnancy: comparison of self-report and anonymous urine cotinine testing.","volume":"24","author":"Swamy","year":"2011","journal-title":"J Matern Fetal Neonatal Med"},{"issue":"1","key":"2021120900292368200_B28","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.amepre.2012.09.048","article-title":"Tobacco smoke exposure in a sample of Boston public housing residents.","volume":"44","author":"Levy","year":"2013","journal-title":"Am J Prev Med"},{"issue":"1","key":"2021120900292368200_B29","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1542\/peds.2010-2046","article-title":"Tobacco-smoke exposure in children who live in multiunit housing.","volume":"127","author":"Wilson","year":"2011","journal-title":"Pediatrics"},{"issue":"9","key":"2021120900292368200_B30","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1001\/archpediatrics.2012.170","article-title":"Determination of tobacco smoke exposure by plasma cotinine levels in infants and children attending urban public hospital clinics.","volume":"166","author":"Dempsey","year":"2012","journal-title":"Arch Pediatr Adolesc Med"},{"issue":"3","key":"2021120900292368200_B31","doi-asserted-by":"crossref","first-page":"856","DOI":"10.1378\/chest.06-2123","article-title":"The role of air nicotine in explaining racial differences in cotinine among tobacco-exposed children.","volume":"131","author":"Wilson","year":"2007","journal-title":"Chest"},{"key":"2021120900292368200_B32","article-title":"Racial and ethnic differences in serum cotinine levels of cigarette smokers: Third National Health and Nutrition Examination Survey","author":"Caraballo","journal-title":"JAMA"},{"issue":"2","key":"2021120900292368200_B33","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1093\/oxfordjournals.epirev.a017925","article-title":"Cotinine as a biomarker of environmental tobacco smoke exposure.","volume":"18","author":"Benowitz","year":"1996","journal-title":"Epidemiol Rev"},{"issue":"3","key":"2021120900292368200_B34","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1007\/BF00315031","article-title":"The pharmacokinetics of cotinine in plasma and saliva from non-smoking healthy volunteers.","volume":"38","author":"Curvall","year":"1990","journal-title":"Eur J Clin Pharmacol"},{"issue":"1","key":"2021120900292368200_B35","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1542\/peds.111.1.140","article-title":"A smoking cessation intervention for parents of children who are hospitalized for respiratory illness: the Stop Tobacco Outreach Program.","volume":"111","author":"Winickoff","year":"2003","journal-title":"Pediatrics"},{"issue":"3","key":"2021120900292368200_B36","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1542\/peds.2009-0356","article-title":"Using the postpartum hospital stay to address mothers\u2019 and fathers\u2019 smoking: the NEWS study.","volume":"125","author":"Winickoff","year":"2010","journal-title":"Pediatrics"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/133\/2\/e355\/1059201\/peds_2013-2422.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/133\/2\/e355\/1059201\/peds_2013-2422.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,24]],"date-time":"2022-03-24T05:53:07Z","timestamp":1648101187000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/133\/2\/e355\/30862\/Cotinine-in-Children-Admitted-for-Asthma-and"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,2,1]]},"references-count":36,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2014,2,1]]},"published-print":{"date-parts":[[2014,2,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2013-2422","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,2,1]]}}}