ROLE OF PARENTAL SMOKING AND ENVIRONMENTAL TOBACCO SMOKE EXPOSURE IN
CHILDHOOD CANCER: A STUDY USING HAIR COTININE ANALYSIS AND
QUESTIONNAIRES
Abstract
OBJECTIVES In the etiology of childhood cancers, many genetic
and environmental factors play a role. One of these factors is cigarette
smoking and the main source of tobacco smoke exposure of children is
parental smoking. However, establishing a causal relationship between
parental smoking and childhood cancers has proven challenging due to
difficulties in accurately detecting tobacco smoke exposure
METHODS To address this issue, we used hair cotinine analysis
and a questionnaire to get information about tobacco smoke exposures of
pediatric cancer patients and healthy children. 104 pediatric cancer
patients and 99 healthy children participated in our study. Parental
smoking behaviours (pre-conceptional, during pregnancy and current
smoking) and environmental tobacco smoke (ETS) exposures of children are
compared. RESULTS We have found no differences between two
groups by means of maternal smoking behaviours. However, the rates of
paternal pre-conceptional smoking and smoking during pregnancy were
significantly low in cancer patients (p<0,05). These data
suggests that social desirability bias among fathers of cancer patients
may have contributed to this discrepancy. According to questionnaire
cancer patients had significantly lower ETS exposures than healthy
children (p<0,05). However, ETS exposure assessment through
cotinine analysis demonstrated that cancer patients had higher exposure
to ETS compared to healthy children (p<0.001).
CONCLUSION Our findings provide evidence supporting the
potential role of smoking as a risk factor for childhood cancers. This
study also revealed that questionnaires could cause biases. We suggest
that cotinine analysis along with validated questionnaires can be used
to prevent biases in studies of tobacco smoke in the etiology of
childhood cancers.