摘要：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. Extensive research shows that secondhand smoke (SHS) exposure places adults and children at increased risk for premature death, diverse illnesses, and other adverse effects, such as reduced lung-function growth in children. 1 Worldwide, over 40% of men smoke tobacco, compared with only about 12% of women. 2 This global profile implies that women and children constitute the bulk of the population exposed to SHS. The World Health Organization (WHO) conducted the Global Youth Tobacco Survey between 1999 and 2005 and found that approximately 44% of youths were exposed to tobacco smoke at home and that 47% had at least 1 parent who smoked. 3 There is insufficient information, however, regarding levels of SHS in households and the range of exposures among women and children throughout the world. Questionnaires have been the most commonly used tool to assess the prevalence and intensity of SHS exposure at home. 3 – 5 Although questionnaires can confirm that SHS exposure is taking place, they are not highly informative as to the specific level of exposure because of inherent limitations of the data collected. 1 For our study, we sought to quantify the levels of SHS exposure among women and children living with smokers in diverse climates and cultures. Measuring air nicotine and hair nicotine concentrations are validated methods of quantifying airborne levels of SHS and the uptake of SHS in the body, respectively. 6 , 7 We carried out a multicountry study measuring nicotine concentrations in the air of households with and without smokers and in the hair of women and children living in these households. Survey data were also collected to evaluate smoking behaviors and smoking policies in the households and around the children, as well as perceptions and attitudes about SHS.
