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Secondhand smoke exposure increases pneumonia severity in children

Children hospitalized with community-acquired pneumonia from households with two or more smokers appeared to have a longer length of stay than children from households with no smokers, according to study results.

These children “were more likely to require intensive care compared with children not exposed to any household smoke,” Anna Ahn, MD, a resident at Children’s Hospital of Pittsburgh of UPMC, told Healio.com/Pulmonology. “This suggests that heavier exposure to secondhand smoke is associated with greater severity of pneumonia.”

Anna Ahn

Ahn and colleagues used data from children aged younger than 18 years in the CDC’s Etiology of Pneumonia in the Community study to analyze the link between secondhand smoke (SHS) exposure and disease severity among children hospitalized with community-acquired pneumonia (CAP). Patients from three children’s hospitals in Tennessee and Utah (n = 2,219) were included during the study from 2010 to June 2012. Almost 65% of patients reported no exposure to household SHS exposure, 20.7% reported exposure to at least one household smoker, and 14.7% reported exposure to two or more household smokers.

Children with any reported household SHS exposure had a minimally longer median length of stay compared with those unexposed to SHS (67.4 hours vs. 64.4 hours; adjusted HR = 0.94; 95% CI, 0.86-1.03).

Children exposed to two or more household smokers, however, appeared to have a significantly longer median length of stay (70.4 hours) than unexposed children (aHR = 0.85; 95% CI, 0.75-0.97).

Exposure to more than two household smokers also increased a child’s likelihood of admittance to the ICU vs. children not exposed to SHS (aOR = 1.44; 95% CI, 1.05-1.96). Mechanical ventilation also was more likely to occur in children exposed to two or more household smokers (aOR = 1.28; 95% CI, 0.81-2.02).

Ahn told Healio.com/Pulmonology the results should influence discussions about promoting smoke-free environments.

“Hospitalization for any reason, and particularly for pneumonia and other respiratory illnesses, serves as an excellent teachable moment to reinforce the importance of a smoke-free environment through caregiver counseling and active intervention,” she said. – by Ryan McDonald

Disclosure: The researchers report no relevant financial disclosures.