Cross-sectional study of urinary biomarkers of environmental tobacco and e-cigarette exposure and asthma morbidity.

Introduction:
This text presents the results of a cross-sectional study examining the relationship between urinary biomarkers of environmental tobacco and e-cigarette exposure and asthma morbidity in a diverse pediatric population. The study aims to establish whether urinary cotinine and total NNaL levels, which serve as biomarkers of exposure to tobacco smoke, are independently associated with asthma morbidity. Furthermore, the study investigates the interaction between tobacco biomarkers and asthma morbidity by allergen sensitization, as a potential effect modifier.

Key Points:

* The study included 133 students aged 4 to 14 years, primarily identifying as hispanic or Latinx (62.4%) and Black/african american (24.1%).
* The annual household income was less than $45,000 for 35.3% of the cohort.
* Caregivers reported that 15 children were exposed to e-cigarette vapor, and virtually all of them (14/15) were also exposed to cigarettes.
* 50.4% of participants (n = 67) and 21.8% (n = 29) had cotinine and NNaL measures above the LOD, respectively.
* In multivariate models, for every log 10 increase in cotinine level, maximum symptom days increased by 15.9% (P = .08).
* Similar trends were seen for every log 10 increase in NNaL levels, although these estimates were not statistically significant (P = .13, P = .58).
* For every log 10 increase in cotinine level, there was a 34.7% increased odds of hospitalization over the previous year (P < .05) and a 172% increased odds of hospitalization for every log 10 increase in NNaL level (P < .01).

Main Message:
The study highlights the significant impact of environmental tobacco smoke exposure on asthma morbidity in a pediatric population. The presence of allergen sensitization exacerbates this relationship, emphasizing the importance of cessation efforts in households with children suffering from asthma and aeroallergen sensitization. Strategic interventions and educational initiatives should be implemented to reduce smoke exposure and tobacco-related health disparities in children, prioritizing measures aimed at reducing smoke or vape use around children with asthma and aeroallergen sensitization.

Ruran hB, Maciag MC, Murphy SE, Phipatanakul W, hauptman M. Cross-sectional study of urinary biomarkers of environmental tobacco and e-cigarette exposure and asthma morbidity. annals of allergy, asthma & immunology : official publication of the american College of allergy, asthma, & Immunology. 2022;129(3):378-380. doi:10.1016/j.anai.2022.06.001