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Does passive smoking increase the frequency of health service contacts in children with asthma?

I K Crombie1, A Wright, L Irvine

  • 1Department of Epidemiology and Public Health, University of Dundee, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK. i.k.crombie@dundee.ac.uk

Thorax
|December 20, 2000
PubMed

Insights

Passive smoking in children with asthma is linked to fewer doctor visits when parents smoke heavily, possibly due to underestimation of symptoms. This suggests children with asthma may not receive adequate care.

Area of Science:

  • Pediatric Respiratory Medicine
  • Environmental Health
  • Public Health

Background:

  • Passive smoking is a significant cause of respiratory illness in children.
  • Accurate assessment of passive smoking's impact on childhood asthma is limited, especially using objective exposure measures.
  • This study investigated the health effects of passive smoking on children with asthma, using salivary cotinine levels to quantify exposure.

Purpose of the Study:

  • To investigate the relationship between passive smoking exposure, measured by salivary cotinine levels and parental smoking reports, and health service utilization for asthma in children.
  • To explore the association between objective and subjective measures of passive smoking and asthma-related healthcare contacts.
  • To identify factors influencing healthcare-seeking behavior for childhood asthma in households with smokers.

Main Methods:

  • Recruited 438 children aged 2-12 years with asthma and at least one smoking parent in Tayside and Fife, Scotland.
  • Assessed asthma morbidity using health service contacts documented in GP records.
  • Measured passive smoking exposure via salivary cotinine levels and parental self-reported smoking frequency in the child's presence.

Main Results:

  • A weak U-shaped association was observed between salivary cotinine levels and asthma-related healthcare contacts.
  • Higher reported parental smoking in front of the child correlated with fewer asthma visits (RR=0.66), an effect not seen for non-respiratory visits.
  • Demographic factors, child's age, number of children, and parental perception of asthma severity significantly influenced visit frequency.

Conclusions:

  • High levels of parental smoking at home are paradoxically associated with reduced asthma-related healthcare contacts.
  • This reduction may stem from heavy smokers' underestimation of asthma severity or reluctance to seek medical care.
  • Children with asthma exposed to heavy parental smoking might be at risk of inadequate asthma management.
Abstract

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