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Which cut-off level of urine cotinine:creatinine ratio (CCR) should be used to determine passive smoking prevalence in children in community based studies?

¹ Dokuz Eylul University, School of Medicine, Department of Public Health, Turkey
² Dokuz Eylul University Hospital, Central Laboratory, Turkey
³ Dokuz Eylul University, School of Medicine, Department of Public Health, Turkey

Correspondence to:
Dr Pembe Keskinoglu
Dokuz Eylül University, School of Medicine, Department of Public Health, 35340, Inciralti/Izmir, Turkey; pembe.keskinoglu@gmail.com

Accepted 23 May 2007

Keywords: urine; cotinine:creatinine ratio; passive smoking; children

The first 150 words of the full text of this article appear below.

Environmental tobacco smoke (ETS) in the home is a major preventable health problem for children around the world. In children, ETS exposure (passive smoking) has been shown to be particularly associated with respiratory infection, especially lower respiratory tract infection (LRTI).^1–3 Exposure intensity of ETS among children shows a strong correlation with indoor parental and, especially, maternal smoking, the number of cigarettes smoked, the number and volume capacity of the rooms where cigarettes are smoked and individual metabolic diversities.⁴ The use of cotinine, a major metabolite of nicotine, as a biological marker of smoke absorption has been suggested as an approach to strengthen the evidence of the relation between passive smoking and respiratory illness. In several studies, a strong disagreement was present between parental self reports and quantitative measures. Epidemiological studies on ETS exposure report that cotinine measurement in body fluids (especially in urine) is a more powerful predictor of actual . . . [Full text of this article]