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Heather Wipfli, PhD, Erika Avila-Tang, PhD, MHS, Ana Navas-Acien, MD, PhD, MPH, Sungroul Kim, PhD, Georgiana Onicescu, ScM, Jie Yuan, BS, Patrick Breysse, PhD, MHS, Jonathan M Samet, MD for the Famri Homes Study Investigators

Heather Wipfli, Erika Avila-Tang, Georgiana Onicescu, and Jonathan M. Samet are with the Department of Epidemiology, Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Ana Navas-Acien, Sungroul Kim, and Patrick Breysse are with the Department of Epidemiology and the Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore. Jie Yuan is with the Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore.

Correspondence: Requests for reprints should be sent to: Heather Wipfli, Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, W6027, Baltimore, MD 21205 (e-mail: hwipfli{at}jhsph.edu; adineva{at}jhsph.edu)

ABSTRACT

Objectives. We sought to describe the range of exposure to secondhand smoke (SHS) among women and children living with smokers around the world and generate locally relevant data to motivate the development of tobacco control policies and interventions in developing countries.

Methods. In 2006, we conducted a cross-sectional exposure survey to measure air nicotine concentrations in households and hair nicotine concentrations among nonsmoking women and children in convenience samples of 40 households in 31 countries.

Results. Median air nicotine concentration was 17 times higher in households with smokers (0.18 µg/m³) compared with households without smokers (0.01 µg/m³). Air nicotine and hair nicotine concentrations in women and children increased with the number of smokers in the household. The dose–response relationship was steeper among children. Air nicotine concentrations increased an estimated 12.9 times (95% confidence interval=9.4, 17.6) in households allowing smoking inside compared with those prohibiting smoking inside.

Conclusions. Our results indicate that women and children living with smokers are at increased risk of premature death and disease from exposure to SHS. Interventions to protect women and children from household SHS need to be strengthened.