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Effect of parental smoking on cotinine levels in newborns
  1. D V Joseph1,
  2. J A Jackson2,
  3. J Westaway1,
  4. N A Taub3,
  5. S A Petersen4,
  6. M P Wailoo1
  1. 1
    Department of Child Health, University of Leicester, Leicester, UK
  2. 2
    Department of Medical Education, University of Warwick, Warwick, UK
  3. 3
    Department of Health Sciences, University of Leicester, Leicester, UK
  4. 4
    Department of Medical Education, University of Leicester, Leicester, UK
  1. Dr Mike Wailoo, Room 520, RKCSB, University of Leicester, Leicester Royal Infirmary, Leicester LE2 7LX, UK; mw33{at}


Background: 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.

Aim: To assess cotinine levels in infants of smoking parents.

Method: 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.

Results: 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.

Conclusion: Infants from smoking households accumulate cotinine, a metabolite of nicotine, which may have a detrimental effect on the cardiorespiratory system.

  • passive smoking
  • infant
  • cotinine
  • nicotine
  • SIDS

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  • Competing interests: None.