Exploring children's secondhand smoke exposure with early child care providers

Background Exposure to secondhand smoke (SHS) is a contributor to the increased morbidity and mortality experienced by inner-city African-American children. Limited evidence-based programming exists regarding how to address the negative effects of SHS in this community. Purpose A collaboration with an early child care center provided an opportunity to explore factors related to young children's SHS exposure as the first step in developing strategies to reduce exposure. Methods Survey data were obtained between 2008 and 2009 from 63 African-American parents of infants and children aged ≤5 years at two early child care centers located in an urban Minneapolis neighborhood. Forty-three of these children had salivary cotinine levels assessed. Results Parents living below the poverty level were more likely to report that their children were regularly exposed to SHS by family/friends (p=0.01). Sixty-eight percent of participants reported complete home smoking restrictions, which was significantly correlated with advice from the child's health provider (p=0.001). Nonsmokers and older parents were less likely to receive advice (p=0.03). Of the 43 children in whom cotinine levels were assessed, 39.5% had levels >0.64 ng/ml, which suggests high SHS exposure. Lower cotinine levels were significantly correlated with living in detached houses. Conclusions Exposure to SHS was common for children in this study. These findings, if supported by additional research, can be used to develop and disseminate targeted health messages about childhood SHS sources/negative effects and strategies to reduce exposure.