Background: Marijuana smoking is becoming increasingly legal in the United States. Most places with legal recreational use do not restrict use in the presence of children, but the prevalence and effects of exposure on children are not well known. Parents who smoke tobacco are also more likely to also use marijuana, increasing the risk for children's exposure to multiple types of smoke. Objectives: To determine the prevalence of marijuana smoke exposure among children with a parent who smokes tobacco. Methods: As part of a randomized controlled trial of an inpatient parent smoking cessation intervention, we have recruited 123 children with at least one parent who smokes tobacco. Parents completed a survey about tobacco and marijuana use in the home, as well as collecting the child's health information and demographic characteristics. 101 children provided a urine sample, and there was sufficient remaining for this study from 58; samples were tested for cotinine (LC/MS) and NNAL (LC/MS) at the laboratory at UCSF. Samples from children whose parents consented for future research (N=43) will be anonymized and shipped on dry ice to the laboratory at the Centers for Disease Control and Prevention, and will be analyzed for A9-tetrahydrocannabinol (THC) and 11-nor-9-carboxy-THC (COOH-THC) using UHPLC-MS/MS, with limits of detection (LOD) of 0.005 and 0.015 ng/mL, respectively. Chi-square tests will be done in SAS to assess bivariable differences in exposure by demographics, cotinine level, and clinical status. Results: We expect to find a high prevalence of marijuana smoke exposure in this cohort, and that marijuana levels will correlate strongly with cotinine and NNAL. This information will help us to understand the relationship between tobacco smoke and marijuana smoke exposure in children.
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