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Arch Dis Child Fetal Neonatal Ed. Nov 2007; 92(6): F484–F488.
Published online Jun 19, 2007. doi:  10.1136/adc.2006.108506
PMCID: PMC2675401
Effect of parental smoking on cotinine levels in newborns
D V Joseph, J A Jackson, J Westaway, N A Taub, S A Petersen, and M P Wailoo
D V Joseph, J Westaway, M P Wailoo, Department of Child Health, University of Leicester, Leicester, UK
J A Jackson, Department of Medical Education, University of Warwick, Warwick, UK
N A Taub, Department of Health Sciences, University of Leicester, Leicester, UK
S A Petersen, Department of Medical Education, University of Leicester, Leicester, UK
Correspondence to: Dr Mike Wailoo
Room 520, RKCSB, University of Leicester, Leicester Royal Infirmary, Leicester LE2 7LX, UK;
Accepted April 3, 2007.
Smoking is a major risk factor for cot death. Many infants smoke passively as a result of parental smoking. This paper reports on infants exposed to a smoking environment and how they accumulate metabolites of cigarette smoke, such as cotinine, which may be physiologically harmful.
To assess cotinine levels in infants of smoking parents.
Cotinine excretion in urine was assessed in 104 infants, of whom 71 had smoking parents and 33 had non‐smoking parents. All cotinine levels were measured at approximately 12 weeks of age. The subjects were selected from a database of infants in developmental physiological studies which assessed the impact of various factors on early postnatal development.
On average babies with at least one parent who was a current cigarette smoker excreted 5.58 (95% CI 3.4 to 9.5) times as much cotinine in the urine as did the babies of non‐smoking parents. Maternal smoking was the largest contributing factor. Co‐sleeping (p = 0.037) and the minimum room temperature (p = 0.028) were significant contributory factors.
Infants from smoking households accumulate cotinine, a metabolite of nicotine, which may have a detrimental effect on the cardiorespiratory system.
Keywords: passive smoking, infant, cotinine, nicotine, SIDS
Articles from Archives of Disease in Childhood. Fetal and Neonatal Edition are provided here courtesy of
BMJ Group