CHILDREN TEST POSITIVE FOR TOBACCO CARCINOGENS

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DATE: January 23, 2002, Volume 15, Number 07

THIS WEEK'S STORIES

- MANY YOUNG CHILDREN TEST POSITIVE FOR TOBACCO CARCINOGENS

- HIGH COTININE IN PREGNANT WOMEN POSES RISK FOR PRETERM BIRTH

- SMOKING AND WOMEN'S HEALTH

QUOTE OF THE WEEK

" Ultimately, the only power to which man should aspire is that which

he exercises over himself. "

-Elie Wiesel (1928 - ). The writer, teacher, and Nobel Peace Prize

laureate is profiled at

http://www.eliewieselfoundation.org/ElieWiesel/ElieWieselBio.htm

- MANY YOUNG CHILDREN TEST POSITIVE FOR TOBACCO CARCINOGENS

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- FULL IMPACT ON FUTURE HEALTH NOT YET KNOWN

A pioneering study finds that a disturbing number of young children

may already be harboring potent, cancer-causing by-products of

tobacco smoke in their still-developing bodies.

To assess the potential impact of second-hand smoke on children's

health, researchers from the University of Minnesota measured levels

of cotinine, a nicotine metabolite, in the urine of 204 children in

grades two through twelve. The children were part of a larger study

(the SHIELD study) examining environmental health in children living

in poorer neighborhoods in Minneapolis. In addition to cotinine,

investigators also measured urinary levels of two powerful

carcinogens in tobacco smoke strongly linked to lung cancer, called

NNAL and NNAL-Gluc.

Researchers used cotinine testing to identify the children with

possible high exposure to environmental tobacco smoke. They

discovered that one out of four children in the group had levels of

cotinine above 5ng/ml. What's more, nearly every one of these

children with raised cotinine levels tested positive for the lung

carcinogens NNAL and NNAL-Gluc (50 out of 52).

In fact, levels of cotinine were found to correlate strongly with

NNAL and NNAL-Gluc levels, indicating that both were valid markers of

second-hand smoke uptake. Yet the researchers also discovered that

even some of the children whose personal history or cotinine test

results did not indicate excessive exposure to environmental tobacco

smoke also sometimes showed traces of these carcinogens. In either

case, the health consequences could be serious.

" It is biologically plausible that children exposed to carcinogens in

environmental tobacco smoke could be at risk for cancer later in

life, " the investigators observed.

Non-smoking adults exposed to environmental tobacco smoke have a 20%

increased risk of developing lung cancer. The risks in children,

whose growing bodies could be even more vulnerable, has not yet been

determined.

" Although it is difficult to quantify the public health risk this

uptake represents, it is potentially larger than acceptable, " the

researchers warned.

NOTE: The urinary Cotinine Assay provides practitioners with a

convenient, noninvasive method for evaluating the potential health

impact of environmental tobacco smoke in children. This test can

uncover an often unsuspected trigger of recurrent infections and

general poor health. Urine cotinine measurement is routinely used in

some hospital pediatric respiratory units because of its proven value

in preventive healthcare. Learn about the test at

http://www.gsdl.com/assessments/cotinine/

RELATED ARTICLES AND RESOURCES

Children Remain At Risk From Parental Smoking

http://www.gsdl.com/news/connections/vol10/conn20001004-p.html#story2

Children's Exposure To Tobacco Smoke: Still A Health Threat

http://www.gsdl.com/news/connections/vol13/conn20010620.html#story1

Source: Hecht SS, Ye M, Carmella SG, Fredrickson A, Adgate JL,

Greaves IA, Church TR, AD, Mongin SJ, Sexton K. Metabolites of a

tobacco-specific lung carcinogen in the urine of elementary

school-aged children. Cancer Epidemiol Biomarkers Prev

2001;10:1109-1116.

© 2002 Great Smokies Diagnostic Laboratory

Call 800-522-4762 for more information or send your request for test

kits and educational materials to cs@...

==============

- HIGH COTININE IN PREGNANT WOMEN POSES RISK FOR PRETERM BIRTH

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- RELATIONSHIP STRONGER THAN SELF-REPORTED SMOKING HABITS

The impact of smoking on pregnancy may be difficult to determine

based solely on asking an expectant mother how much she smokes. Poor

memory, social pressure, and different types of usage could all cloud

the true risks posed to the unborn child.

The Pregnancy, Infection, and Nutrition Study evaluated the impact of

tobacco smoking on fetal birth and development in over 2400 pregnant

women attending prenatal clinics in central North Carolina. The women

were all between 6 and 7 months pregnant at the time they were

enrolled in the study.

The study found 28% of the women continued to smoke during pregnancy.

Smoking was strongly associated with slowed fetal growth, resulting

in a smaller baby at delivery. Yet smoking was only weakly associated

with a higher risk of premature birth. This may be because many women

who smoked throughout their term smoked only lightly, especially the

African-American smokers.

But another important reason could be that smoking habits were

self-reported. Investigators did find a strong relationship between

levels of an objective biomarker of tobacco exposure (urinary

cotinine) and preterm birth. In fact, even cotinine levels measured

after delivery were more strongly associated with adverse [pregnancy]

outcome than the women's smoking status reported during the prenatal

period.

Higher levels of cotinine in urine were also associated with the

premature rupture of amniotic membranes - what's known in the popular

vernacular as " breaking water. "

This evidence calls into question the accuracy of self-reports of

smoking. " [There is] modest incentive to misrepresent smoking

habits, " the study noted, " because of social pressure or errors in

recall. "

For this reason, clinical indicators may play an important role in

accurately determining health risks associated with exposure to

tobacco smoke. " The incremental value of biomarkers of [tobacco]

exposure was demonstrated, despite the short time period that they

reflect, " the study observed.

NOTE: Measuring levels of this nicotine metabolite using the Cotinine

Assay provides an added objective clinical indicator for evaluating

possible adverse health risks of exposure to tobacco smoke. Cotinine

assessment has been used in several recent studies of the

effectiveness of smoking cessation programs and as a motivational

tool to help smokers overcome this difficult addiction. Find out more

at http://www.gsdl.com/assessments/cotinine/

RELATED ARTICLES AND RESOURCES:

Fetal Exposure to Tobacco Smoke Linked to Stillbirth

http://www.gsdl.com/news/connections/vol14/conn20011017.html#story1

High Healthcare Costs Related To Passive Smoking

http://www.gsdl.com/news/connections/vol10/conn20001004-p.html#story1

Source: Savitz DA, Dole N, Terry Jr, JW, Zhou H, Thorp Jr, JM.

Smoking and pregnancy outcome among African-American and White women

in central North Carolina. Epidemiology 2001;12:636-642.

© 2002 Great Smokies Diagnostic Laboratory

Call 800-522-4762 for more information or send your request for test

kits and educational materials to cs@...

==============

- SMOKING AND WOMEN'S HEALTH

This Week's Lab Tidbit

- TOBACCO: THE EQUAL OPPORTUNITY KILLER

Women are right to fear breast cancer. It's deadly, treatment is

uncertain, and " cures " come at a high price. However, the greatest

cancer threat to the lives of women today is actually not to their

breasts, but to their lungs.

As Surgeon General Satcher, M.D., observed in his 2001 Women

and Smoking report: " Lung cancer, once rare among women, has

surpassed breast cancer as the leading cause of female cancer death

in the United States, now accounting for 25 percent of all cancer

deaths among women. "

Studies continue into the gender-specific effects of smoking. Women's

bodies may metabolize analytes of nicotine less effectively than

men's. There may be links between smoking and increased risk for

diseases unique to women or for the several diseases which afflict

women in greater proportion than men. It may also be that there are

gender differences in the modifying effects of genetic polymorphisms

on disease risks associated with smoking.

Several things are painfully clear, however. Nearly as many women

(22.0 %) as men (26.4%) now smoke, and, among young people the rates

have increased in recent years. After the significant declines

experienced in the 1970s and the leveling off in the 1980s, the 1990s

may emerge as the decade the epidemic gained a second wind.

" The rise in smoking among women around the world has coincided with

aggressive Western-style tobacco advertising, " observed Centers for

Disease Control (CDC) Director P. Koplan, M.D. According to a

2001 Federal Trade Commission report, tobacco advertising and

promotion expenditures grew 22.3% from $6.7 billion in 1998 to $8.24

billion in 1999.

CDC Resources:

A full copy of Women and Smoking: A Report of the Surgeon General and

other related information is available on the CDC's Web site:

http://www.cdc.gov/tobacco/sgr/sgr_forwomen/Executive_Summary.htm

Copies of the Executive Summary and the report's " At A Glance " can

also be ordered via fax by calling 1-800-CDC-1311 or by writing the

CDC's Office on Smoking and Health, Mail Stop K-50, 4770 Buford

Highway, Atlanta, Ga. 30341. A special consumer-focused section on

quitting smoking is now available on the National Women's Health

Information Center Web site, <A HREF= " http://www.4woman.gov " >

http://www.4woman.gov</A>.

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