Wilkinson James D, Arheart Kristopher L, Lee David J
University of Miami Tobacco Research and Evaluation Coordinating Center, Department of Epidemiology & Public Health, University of Miami School of Medicine, Miami, FL 33101, USA.
Nicotine Tob Res. 2006 Aug;8(4):591-7. doi: 10.1080/14622200600790021.
The accuracy of parental reports of youth secondhand smoke exposure has received limited attention in the research literature. Such reports were compared to serum cotinine levels among participants of the National Health and Nutrition Examination Survey III who were aged 4-16 years. Likely smokers with serum cotinine values of 14 ng/ml or more and self-reported tobacco users were excluded from the analysis (n = 87), leaving 2,524 youth participants. One adult guardian, typically the parent, was asked to identify household smokers and estimate the number of cigarettes smoked in the home. Using cotinine levels of at least 0.2 ng/ml as the criterion, we found the sensitivity and specificity of any reported smokers in the home to be .65 and .92, respectively. Spearman correlations between cotinine levels and the number of smokers and the number of cigarettes consumed in the household were .67 and .68, respectively, and varied little across subgroups, including age, gender, and ethnicity of the child as well as household poverty status and educational attainment of the parent. Parental reports of household smoking alone fail to capture all youth secondhand smoke exposures, but they correlate well with cotinine levels when expressed as the number of household smokers or the number of cigarettes smoked in the household. Additional research is needed to determine whether reliance on parental reports of secondhand smoke exposure leads to bias in studies examining health outcomes in children and adolescents. Also, additional research is needed to better determine the level of secondhand smoke exposure that is biologically important in children and adolescents.
在研究文献中，父母关于青少年二手烟暴露情况报告的准确性受到的关注有限。将这些报告与第三次全国健康与营养检查调查中4至16岁参与者的血清可替宁水平进行了比较。血清可替宁值为14纳克/毫升或更高的可能吸烟者以及自我报告的烟草使用者被排除在分析之外（n = 87），剩下2524名青少年参与者。一名成年监护人，通常是父母，被要求识别家庭中的吸烟者并估计家中吸烟的数量。以至少0.2纳克/毫升的可替宁水平为标准，我们发现报告家中有任何吸烟者的敏感性和特异性分别为0.65和0.92。可替宁水平与家庭中吸烟者数量以及吸烟量之间的斯皮尔曼相关性分别为0.67和0.68，并且在包括孩子的年龄、性别和种族以及家庭贫困状况和父母教育程度在内的各个亚组中变化不大。仅父母关于家庭吸烟的报告未能涵盖所有青少年二手烟暴露情况，但当以家庭吸烟者数量或家庭吸烟量来表示时，它们与可替宁水平相关性良好。需要进一步研究以确定依赖父母关于二手烟暴露的报告是否会在研究儿童和青少年健康结果时导致偏差。此外，还需要进一步研究以更好地确定在儿童和青少年中具有生物学重要性的二手烟暴露水平。
