REFERENCE: Hovell, M. F., Zakarian, J. M., Wahlgren, D. R., Matt, G. E., & Emmons, K. M. (2000). Measurement of environmental tobacco smoke exposure: Trials and tribulations. Tobacco Control.

Objective. This report summarizes ETS exposure measures, reviews the empirical evidence of the validity of reported measures of children's exposure and discusses future measures of ETS exposure.

Data Sources. Studies were identified by computer search and from the authors' research.

Study selection. Studies were selected for inclusion of nicotine and/or cotinine and reported measures of ETS exposure.

Data synthesis. Five studies reported significant associations between children's reported ETS exposure and either environmental nicotine or urine cotinine assays. Relationships between parent reports and nicotine ranged from .22 to .75. Coefficients for cotinine ranged from .28 to .71. Correlations increased over time and were stronger for parents' reports of their own smoking as a source of children's exposure than for proxy reports of exposure from others. Correlations varied between studies more than expected due to sampling error.

Conclusions. Empirical studies show general concordance of reported and either environmental or biological measures of ETS exposure. Relationships were moderate, and suggest sufficient validity to be employed in research and service programs. Future studies need to identify the differences in types of reported or objective measures, population characteristics, etc. contributing to observed variability in order to better understand the conditions under which more valid ETS reports and other measures can be obtained. It is recommended that reported and objective measures be employed together, and that existing measures be directed to interventions that may reduce ETS exposure among children.



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