Clark CM, et al. – The specialists attempted this study to figure out whether salivary cotinine was elevated more often or to a higher degree in children meeting criteria for tonsillectomy or tympanostomy tube insertion. They found evidence of environmental tobacco smoke (ETS) exposure in approximately 50% of children who undergo tonsillectomy and tympanostomy tube insertion. However, parental history underestimates passive smoke exposure, which could impact perioperative care.

Methods

• From 3 groups of children, saliva samples were obtained for salivary cotinine measurement.
• Group 1 served as healthy controls.
• Group 2 consisted of subjects meeting tympanostomy tube criteria.
• Group 3 consisted of patients meeting tonsillectomy criteria.
• Environmental tobacco smoke (ETS) exposure was defined as a salivary cotinine concentration ≥1.0 ng/mL.
• Demographic data, smoke exposure history, and co–morbidities were also evaluated.

Results

• In total 331 patients were enrolled, with 112 in Group 1, 111 in Group 2, and 108 in Group 3.
• In investigations, no differences were reported for smoke exposure by history or smoker's identity, salivary cotinine level, or frequency of positive cotinine results.
• 42.6% of Group 1 had positive salivary cotinine compared to 51.8% of Group 2 and 47.7% of Group 3.
• Group 1 had a mean salivary cotinine level of 2.42 ng/mL compared to 2.54 ng/mL in Group 2 and 2.60 ng/mL in Group 3.
• The frequency of positive cotinine levels was higher than expected based on parental history.
• Among subjects with positive cotinine levels, 93 had no ETS exposure, and 64 had ETS exposure by history.