Commentary highlights limits of maternal recall in assessing infant tobacco smoke exposure

A commentary in Pediatric Research highlights the limitations of relying on maternal recall to assess children’s environmental tobacco smoke (ETS) exposure. It discusses research by Micalizzi and colleagues using longitudinal data spanning 17 years, with 109 mother–child dyads followed from the perinatal period into adolescence. Maternal reports of smoking and infant ETS exposure at six months were compared with cotinine measurements; mothers later recalled infant exposure when their children were adolescents.

At six months postpartum, maternal reports of their own smoking showed strong concordance with maternal salivary cotinine, but not with infant cotinine levels. Retrospective reports were also inconsistent with infant cotinine measurements. Reports acknowledging infant exposure were largely reliable, whereas reports denying exposure showed discrepancies suggesting underreporting or exposure misclassification. The supplied commentary does not provide numerical agreement estimates for this analysis.

The authors advocate prospective assessment combining interviews or surveys with biomarkers, with attention to exposure timing, frequency and amount. They note that biomarker detection windows, feasibility and sensitivity vary, and that polysubstance use and environmental and socioeconomic factors complicate interpretation. Participants’ prior involvement in a smoking intervention may also have improved reporting reliability, limiting generalizability. This is a methodological commentary rather than a new trial or clinical guideline; its central implication is that maternal reports and biomarkers provide complementary information.