***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE : To determine if the belief that thirdh and smoke is harmful to children is associated with smoking parents ’ attitudes , home or car smoking policies , and quitting behaviors . METHODS : Data from a national r and omized controlled trial , Clinical Effort Against Secondh and Smoke Exposure , assessed  thirdh and smoke beliefs  of 1947 smoking parents in an exit survey after a pediatric office visit in 10 intervention and 10 control practice s. Twelve-month follow-up data were collected from 1355 parents . Multivariable logistic regression determined whether belief that thirdh and smoke harms the health of children is independently associated with parental behaviors and attitudes 12 months later . A χ2 test assessed whether parents who disagreed that thirdh and smoke is harmful were more likely to make a quit attempt if they later believed that thirdh and smoke is harmful . RESULTS : Belief at the exit survey that thirdh and smoke is harmful was independently associated with having a strictly enforced smoke-free home policy ( adjusted odds ratio : 2.05 ; 95 % CI : 1.37–3.05 ) and car policy ( adjusted odds ratio : 1.69 ; 95 % CI : 1.04–2.74 ) at the 12-month follow-up . A significantly higher percentage ( 71 % vs 50 % ) of parents who did not hold the thirdh and smoke harm belief at baseline made at least 1 quit attempt if they agreed that thirdh and smoke is harmful at the 12-month follow-up ( P = .02 ) . CONCLUSIONS : Thirdh and smoke harm belief was associated with a strictly enforced smoke-free home and car and attempts to quit smoking . Sensitizing parents to thirdh and smoke risk could facilitate beneficial tobacco control outcomes Background Dust and surfaces are important sources of lead and pesticide exposure in young children . The purpose of this pilot study was to investigate if third-h and smoke ( THS ) pollutants accumulate on the h and s of children who live in environments where tobacco is used and if h and nicotine levels are associated with second-h and smoke ( SHS ) , as measured by salivary cotinine . Methods Participants were parents and children ( n=25 ; age mean (SD)=5.4 ( 5.3 ) years ) presenting to the emergency department with a potentially SHS-related illness . A convenience sample of participants were recruited at baseline from an ongoing two-group , r and omised controlled trial of a SHS reduction and tobacco cessation intervention .  Parents were current smokers ; thus , all children were at risk of SHS and THS exposure to varying extents . Primary outcome measures , which were assessed in child participants only , were h and nicotine and salivary cotinine . Parents reported sociodemographics and smoking patterns ; children ’s medical records were abstract ed for chief complaint , medical history and discharge diagnosis . Results All children had detectable h and nicotine ( range=18.3–690.9 ng/wipe ) . All but one had detectable cotinine ( range=1.2–28.8 ng/mL ) . Multiple linear regression results showed a significant positive association between h and nicotine and cotinine ( p=0.009 ; semipartial r2=0.24 ) , independent of child age . Discussion The higher-than-expected nicotine levels and significant association with cotinine indicate that THS may play a role in the overall exposure of young children to tobacco smoke toxicants and that h and wipes could be a useful marker of overall tobacco smoke pollution and a proxy for exposure . Trial registration number Clinical Trials.gov Identifier : Introduction Some car rental companies in California and other states in the USA have established non-smoking policies for their vehicles . This study examined the effectiveness of these policies in maintaining smoke-free rental cars . Methods A stratified r and om sample of 250 cars ( non-smoker , smoker and unknown design ation ) was examined in San Diego County , California , USA . Dust , surfaces and the air of each vehicle cabin were sample d and analysed for residual tobacco smoke pollutants ( also known as thirdh and smoke ( THS ) ) , and each car was inspected for visual and olfactory signs of tobacco use . Customer service representatives were informally interviewed about smoking policies . Findings A majority of putative non-smoker cars had nicotine in dust , on surfaces , in air and other signs of tobacco use . Independent of a car 's smoking status , older and higher mileage cars had higher levels of THS pollution in dust and on surfaces ( p<0.05 ) , indicating that pollutants accumulated over time . Compared with smoker cars , non-smoker cars had lower levels of nicotine on surfaces ( p<0.01 ) and in dust ( p<0.05 ) and lower levels of nicotine ( p<0.05 ) and 3-ethynylpyridine ( p<0.05 ) in the air . Non-smoking signage in cars was associated with lower levels of THS pollutants in dust and air ( p<0.05 ) . Conclusions Existing policies and practice s were successful in lowering THS pollution levels in non-smoker cars compared with smoker cars . However , policies failed in providing smoke-free rental cars ; THS levels were not as low as those found in private cars of non-smokers with in-car smoking bans . Major obstacles include inconsistent communication with customers and the lack of routine monitoring and enforcement strategies . Strengthening policies and their implementation would allow car rental companies to reduce costs , better serve their customers and make a constructive contribution to tobacco control efforts OBJECTIVE . There is no safe level of exposure to tobacco smoke . Thirdh and smoke is residual tobacco smoke contamination that remains after the cigarette is extinguished . Children are uniquely susceptible to thirdh and smoke exposure . The objective of this study was to assess health beliefs of adults regarding  thirdh and smoke exposure of children and whether smokers and nonsmokers differ in those beliefs . We hypothesized that beliefs about thirdh and smoke would be associated with household smoking bans . METHODS . Data were collected by a national r and om-digit-dial  telephone  survey from September to November 2005 . The sample was weighted by race and gender within Census region on the basis of US Census data . The study questions assessed the level of agreement with statements that breathing air in a room today where people smoked yesterday can harm the health of children . RESULTS . Of 2000 eligible respondents contacted , 1510 ( 87 % ) completed surveys , 1478 ( 97.9 % ) answered all questions pertinent to this analysis , and 273 ( 18.9 % ) were smokers . Overall , 95.4 % of nonsmokers versus 84.1 % of smokers agreed that secondh and smoke harms the health of children , and 65.2 % of nonsmokers versus 43.3 % of smokers agreed that thirdh and smoke harms children . Strict rules prohibiting smoking in the home were more prevalent among nonsmokers : 88.4 % vs 26.7 % . In multivariate logistic regression , after controlling for certain variables , belief that thirdh and smoke harms the health of children remained independently associated with rules prohibiting smoking in the home . Belief that secondh and smoke harms the health of children was not independently associated with rules prohibiting smoking in the home and car . CONCLUSIONS . This study demonstrates that beliefs about the health effects of thirdh and smoke are independently associated with home smoking bans . Emphasizing that thirdh and smoke harms the health of children may be an important element in encouraging home smoking bans Secondh and and third h and smoke ( SHS , THS ) exposure is prevalent in multi-unit housing ( MUH ) . Minorities and low-income MUH residents are disproportionally exposed to SHS and THS compared to other population s. This study describes the characteristics , attitudes , knowledge , and behaviors related to SHS , THS and marijuana smoke exposure  ( MSHS ) of a sample of Hispanic tenants in r and omly selected MUH units in eastern metro Los Angeles ( n = 402 ) . Although most participants ( 97 % ) banned smoking inside their homes , 80 % reported infiltration of SHS inside their apartments within the last year . Most ( 85 % ) favored a complete ban on smoking in apartment buildings . Twenty-eight percent did not know that marijuana ( MSHS ) smoke exposure is also harmful to their health . Knowledge scores were higher among Spanish-speakers ( p < 0.05 ) . Given the interpersonal barriers to advocating for change , widespread policy and communication interventions are also necessary to protect Hispanic MUH residents ’ rights to clean air in their living space Background Most states in the U.S. permit hotels to allow smoking in some guest rooms , and only five ( Indiana , Michigan , North Dakota , Vermont , and Wisconsin ) require that all hotel and motel rooms be 100 % smoke-free ( State and local 100 % smokefree hotel and motel guest room laws enacted as of July 3 , 2017 ) . Little is known , however , about how hotels ’ smoking policies have been implemented . This study examined hotels ’ smoking policies and their implementation . Methods A telephone survey of a r and om sample of 383 California hotel managers was conducted . Results Overall , 60.6 % of hotels reported that smoking was prohibited in all guest rooms , and 4.7 % reported that smoking was prohibited everywhere on their property . While California law permitted smoking in up to 65 % of guest rooms , only 6.9 % of rooms were reported as smoking-permitted . Over 90 % of hotels had smoking rooms scattered among nonsmoking rooms , and about half of the smoking hotels reported that guests requesting either smoking or nonsmoking rooms were sometimes assigned to the other room type . When guests smoked in nonsmoking rooms fees could be substantial , but were often uncollected . Conclusions Hotel smoking policies and their implementation fall short of protecting nonsmoking guests and workers from exposure to secondh and and thirdh and smoke . Complete indoor smoking bans for all hotels are needed to close existing loopholes . Nonsmokers who wish to protect themselves from exposure to tobacco smoke should avoid hotels that permit smoking and instead stay in completely smoke-free hotels Introduction This study examined tobacco smoke pollution ( also known as thirdh and smoke , THS ) in hotels with and without complete smoking bans and investigated whether non-smoking guests staying overnight in these hotels were exposed to tobacco smoke pollutants . Methods A stratified r and om sample of hotels with ( n=10 ) and without ( n=30 ) complete smoking bans was examined . Surfaces and air were analysed for tobacco smoke pollutants ( ie , nicotine and 3-ethynylpyridine , 3EP ) . Non-smoking confederates who stayed overnight in guestrooms provided urine and finger wipe sample s to determine exposure to nicotine and the tobacco-specific carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone as measured by their metabolites cotinine and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol ( NNAL ) , respectively . Findings Compared with hotels with complete smoking bans , surface nicotine and air 3EP were elevated in non-smoking and smoking rooms of hotels that allowed smoking . Air nicotine levels in smoking rooms were significantly higher than those in non-smoking rooms of hotels with and without complete smoking bans . Hallway surfaces outside of smoking rooms also showed higher levels of nicotine than those outside of non-smoking rooms . Non-smoking confederates staying in hotels without complete smoking bans showed higher levels of finger nicotine and urine cotinine than those staying in hotels with complete smoking bans . Confederates showed significant elevations in urinary NNAL after staying in the 10 most polluted rooms . Conclusions Partial smoking bans in hotels do not protect non-smoking guests from exposure to tobacco smoke and tobacco-specific carcinogens . Non-smokers are advised to stay in hotels with complete smoking bans . Existing policies exempting hotels from complete smoking bans are ineffective 
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The findings from most of these studies suggest a potential health impact of THS exposure ( i.e. : cytotoxicity , metabolic alterations in metabolism , in glycemia ; or cell structure ; alterations in liver , lung , skin and behaviour in mice ) , and low awareness about the risks of THS among the general population .
Conclusions : Numerous specific biomarkers of THS were evaluated , with the most common being nicotine , nitrosamines , and cotinine .
The most common method of preparing THS dust sample s were cotton wipes , while chromatography , used alone or coupled with mass spectrometry , was the most common analytical technique .
The studies in this review demonstrate the harmful effects of THS on health in cells , in animal models , and in people including children .