PT  - JOURNAL ARTICLE
AU  - Andreas M Neophytou
AU  - Sam S Oh
AU  - Marquitta J White
AU  - Angel C Y Mak
AU  - Donglei Hu
AU  - Scott Huntsman
AU  - Celeste Eng
AU  - Denise Serebrisky
AU  - Luisa N Borrell
AU  - Harold J Farber
AU  - Kelley Meade
AU  - Adam Davis
AU  - Pedro C Avila
AU  - Shannon M Thyne
AU  - William Rodríguez-Cintrón
AU  - José R Rodríguez-Santana
AU  - Rajesh Kumar
AU  - Emerita Brigino-Buenaventura
AU  - Saunak Sen
AU  - Michael A Lenoir
AU  - L Keoki Williams
AU  - Neal L Benowitz
AU  - John R Balmes
AU  - Ellen A Eisen
AU  - Esteban G Burchard
TI  - Secondhand smoke exposure and asthma outcomes among African-American and Latino children with asthma
AID  - 10.1136/thoraxjnl-2017-211383
DP  - 2018 Nov 01
TA  - Thorax
PG  - 1041--1048
VI  - 73
IP  - 11
4099  - http://thorax.bmj.com/content/73/11/1041.short
4100  - http://thorax.bmj.com/content/73/11/1041.full
SO  - Thorax2018 Nov 01; 73
AB  - Background Secondhand smoke (SHS) exposures have been linked to asthma-related outcomes but quantitative dose–responses using biomarkers of exposure have not been widely reported.Objectives Assess dose–response relationships between plasma cotinine-determined SHS exposure and asthma outcomes in minority children, a vulnerable population exposed to higher levels of SHS and under-represented in the literature.Methods We performed analyses in 1172 Latino and African-American children with asthma from the mainland USA and Puerto Rico. We used logistic regression to assess relationships of cotinine levels ≥0.05 ng/mL with asthma exacerbations (defined as asthma-related hospitalisations, emergency room visits or oral steroid prescription) in the previous year and asthma control. The shape of dose–response relationships was assessed using a continuous exposure variable in generalised additive logistic models with penalised splines.Results The OR for experiencing asthma exacerbations in the previous year for cotinine levels ≥0.05 ng/mL, compared with <0.05 ng/mL, was 1.40 (95% CI 1.03 to 1.89), while the OR for poor asthma control was 1.53 (95% CI 1.12 to 2.13). Analyses for dose–response relationships indicated increasing odds of asthma outcomes related with increasing exposure, even at cotinine levels associated with light SHS exposures.Conclusions Exposure to SHS was associated with higher odds of asthma exacerbations and having poorly controlled asthma with an increasing dose–response even at low levels of exposure. Our results support the conclusion that there are no safe levels of SHS exposures.