Secondhand Smoke Exposure in Children Hospitalized in Colorado: Tobacco is Not the Only Substance Being Found :

Before, during, and after the legalization of recreation marijuana in Colorado, concerns were raised in the pediatric community regarding the exposure of children to this substance as from second-hand smoke. But is that really happening?   Wilson et al. (10.1542/peds.2018-0820) share with us a small but important study of 83 hospitalized children whose parents agreed during the hospitalization to enroll in a smoking cessation study.  Once enrolled, the hospitalized child then had urine samples sent for evidence of tobacco and marijuana metabolites (regardless of whether the parents admitted to smoking marijuana or tobacco).  Nearly half (46%) of the 83 children showed evidence of exposure to marijuana in the urine samples obtained (via assay for 11-hydroxy tetrahydrocannabinol (COOH-THC) a metabolic product whose half-life is 3-4 days) and 11% had detectable levels of tetrahydrocannabinol (THC), the primary psychoactive ingredient in marijuana, and if found in urine suggests a recent and active exposure.  Of note, 84% of parents said they do not ever smoke marijuana in the home, although clearly by the data obtained, exposures to children were occurring. Of the 6 children under the age of 8 who had detectable THC levels, parents did however self-report household marijuana use on “some or every day.” While we still do not know if secondhand exposure is harmful to a child’s development or medical well-being, the fact that exposure is so high in this small group of hospitalized children in a region where recreational marijuana has been legalized is concerning.  If you are practicing in an area where marijuana is legalized for medical purposes or for recreation, hopefully you are counseling about the need to avoid secondhand exposure and perhaps your patients who are being exposed can become part of learning more as to the harmful effects of such an exposure which as of today remain largely unknown.  There is a lot of useful information about the parental smoking habits of the parents of children described in this study—so link to it and learn more.