Cotinine Levels Correlate with Asthma Readmissions in Children

Louis M. Bell, MD

Serum and saliva cotinine levels, but not reported tobacco smoke exposure, were significantly associated with readmissions.

Exposure to tobacco smoke has been linked to poor asthma control. To help identify children at risk for secondhand tobacco smoke exposure, researchers examined reported exposure, serum and saliva levels of cotinine (a metabolite of nicotine), and readmission in 619 children (age range, 1–16 years; 57% black) admitted to a large urban children's hospital for asthma.

Interestingly, a history of tobacco exposure as reported by the primary caregiver did not correlate with children's cotinine levels. Overall, 35% of caregivers reported tobacco exposure, yet cotinine was detected in 56% of serum samples and 80% of saliva samples. Among caregivers who reported no exposure, serum and saliva cotinine levels were detected in 39% and 70% of children, respectively.

During 1 year of follow-up, 17% of children were readmitted. Readmission rates did not significantly differ between children with and without reported exposure (19% and 15%). However, the readmission rate in children with detectable serum or saliva cotinine levels was significantly higher than the rate in children without detectable levels (serum, 20% vs. 13%; saliva, 18% vs. 9%).

Citation(s):

Howrylak JA et al. Cotinine in children admitted for asthma and readmission. Pediatrics 2014 Feb; 133:e355.