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Distinguishing Exposure to Secondhand and Thirdhand Tobacco Smoke and Electronic Cigarettes among U.S. Children Based on Multiple Biomarker Profiles

Principal Investigator: Ashley Merianos

Funding Mechanism: National Institutes of Health – Grant

ID number: 1R21ES032161-01

Award Date: 9/1/2020

Institution: University of Cincinnati 


Currently, tobacco smoke exposure biomarkers that differentiate exposure to thirdhand smoke (THS) from exposure to secondhand smoke (SHS) or e-cigarette aerosol exposure are lacking. The goal of this project is to examine existing tobacco-specific and nonspecific biomarkers to assess children’s exposure to diverse tobacco/nicotine products. Researchers will analyze National Health and Nutrition Examination Survey (NHANES) 2013-2016 data to examine the prevalence and health risks of exposure to SHS and THS among children presumed to be unexposed to any tobacco smoke and among children exposed to e-cigarette aerosol only. This project has three study aims. Aim 1 is to compare tobacco-specific biomarkers of exposure (e.g., cotinine, total nicotine equivalents, tobacco-specific nitrosamines) with self-reported smoking and tobacco smoke exposure to categorize children into one of four groups: (a) mixed SHS and THS group (MEG): lives with nonsmokers or smokers of combustible products only, reported SHS; (b) THS group (TEG): lives with nonsmokers or smokers, no reported SHS; (c) e-cigarette group (ECG): lives with e-cigarette only users, reported e-cigarette aerosol exposure; and (d) no/minimal exposure group (NEG): lives with nonsmokers, no reported SHS. Aim 2 is to examine multiple tobacco-nonspecific (i.e., polyaromatic hydrocarbons, volatile organic compounds) and tobacco-specific biomarkers and biomarker ratios (e.g., NNAL/cotinine, 2-hydroxyfluorene/cotinine) to assess which combination of biomarker profiles further differentiates children by exposure type. Aim 3 is to examine the associations between exposure type and demographics, exposure-related symptoms, diagnoses, and healthcare utilization patterns in the MEG, TEG, and ECG compared with the NEG. Study findings will provide insight into the different health effects children experience depending on type of tobacco product exposure. 

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