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Pediatric Academic Societies Annual Meeting
May 01, 2012
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Exposure to secondhand smoke results in poor asthma control, other symptoms

BOSTON – Children with asthma continue to suffer adverse effects from secondhand smoke, according to a presentation here during the 2012 Pediatric Academic Societies Meeting.

Despite longstanding recommendations for children with asthma to avoid tobacco smoke, many children continue to be still exposed to secondhand smoke and is associated with poor asthma control, disturbed sleep, activity limitation and wheeze with exercise (multivariate analysis), according to a study to presented here.

“National asthma guidelines have advised avoidance of environmental tobacco smoke (ETS) for patients with asthma for decades, but it is unclear to what degree these recommendations are being followed and what the impact of exposure has been in an era of increased awareness of the effects of ETS exposure,” lead author Lara J. Akinbami, MD, medical officer at CDC’s National Center for Health Statistics, said in a press release from the Pediatric Academic Societies.

Akinbami and colleagues analyzed data from the 2003-2010 National Health and Nutrition Examination Survey (NHANES) for 972 children ages 6 to 19 years who were diagnosed by a doctor with asthma and who reported having asthma at the time of the survey. They looked at the association between exposure to ETS and the following effects of wheezing in the past year:

  • number of days of school or work missed;
  • number of health care visits to a doctor’s office or emergency department (ED);
  • number of days with sleep disturbed;
  • amount of activity limitation; and
  • any wheezing with exercise or physical activity.

During the health interviews for NHANES, respondents were asked about demographic characteristics, smoking in the household, personal smoking habits (ages 12 and older) and asthma history. Blood samples were taken to assess serum cotinine to measure exposure to ETS or personal use of tobacco products.

The study findings indicated that 53% of the children were exposed to ETS. After adjusting for differences in age, sex, race and poverty status, exposure to ETS was associated with higher odds of having three or more visits (compared with no visits) to a physician’s office or ED due to wheezing in the past year; sleep disturbed by wheezing one or more nights per week (compared with none); and activity limitations (fair amount, moderate amount or significant amount compared with none) due to wheezing.

There was no significant association between ETS exposure and missing school or work due to wheezing or wheezing during exercise, according to Akinbami.

“Although this advice is certainly not new, discussing avoidance of environmental tobacco smoke with asthma patients remains critical,” Akinbami said. “New tools are needed to help families achieve the goal of reducing exposure, both inside the home and in other environments.”

For more information:

Disclosure: Dr. Akinbami reports no relevant disclosures.