Related Experiment Video
Updated: Apr 6, 2026
Studying Effects of Cigarette Smoke on Pseudomonas Infection in Lung Epithelial Cells
Published on: May 11, 2020
Secondhand Smoke Exposure and Illness Severity among Children Hospitalized with Pneumonia
Anna Ahn1, Kathryn M Edwards1, Carlos G Grijalva2
1Monroe Carell Jr Children's Hospital at Vanderbilt, Nashville, TN; Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN.
Insights
Secondhand smoke (SHS) exposure in children hospitalized with community-acquired pneumonia (CAP) is linked to increased disease severity. Children with two or more smokers at home experienced longer hospital stays and higher intensive care unit admission rates.
Area of Science:
- Pediatric Respiratory Medicine
- Environmental Health
- Public Health
Background:
- Community-acquired pneumonia (CAP) is a leading cause of childhood hospitalization.
- Secondhand smoke (SHS) exposure is a known risk factor for respiratory illnesses in children.
- The impact of SHS on CAP severity in hospitalized children requires further elucidation.
Purpose of the Study:
- To investigate the association between household secondhand smoke (SHS) exposure and the severity of community-acquired pneumonia (CAP) in hospitalized children.
- To determine if SHS exposure influences key clinical outcomes such as length of hospital stay, intensive care unit (ICU) admission, and need for mechanical ventilation.
Main Methods:
- A cohort of 2219 children hospitalized with CAP was studied across three hospitals.
- Household SHS exposure was categorized by the number of smokers in the home.
- Statistical models, including proportional hazards and logistic regression, were employed to analyze outcomes, adjusting for various demographic and clinical factors.
Main Results:
- 35.4% of children experienced SHS exposure, with 14.8% exposed to two or more smokers.
- Exposure to two or more smokers was associated with a longer hospital length of stay (aHR, 0.85; 95% CI, 0.75-0.97) and increased likelihood of ICU admission (aOR, 1.44; 95% CI, 1.05-1.96).
- No significant association was found between SHS exposure and mechanical ventilation, and children with one smoker showed similar outcomes to non-exposed children.
Conclusions:
- Children hospitalized with CAP from homes with two or more smokers exhibit increased disease severity.
- Higher SHS exposure correlates with prolonged hospitalization and greater need for intensive care.
- These findings underscore the importance of reducing SHS exposure to mitigate CAP severity in pediatric patients.
Objective:
To assess the relationship between secondhand smoke (SHS) exposure and disease severity among children hospitalized with community-acquired pneumonia (CAP).
Study Design:
Children hospitalized with clinical and radiographic CAP were enrolled between January 1, 2010, and June 30, 2012 at 3 hospitals in Tennessee and Utah as part of the Centers for Disease Control and Prevention's Etiology of Pneumonia in the Community study. Household SHS exposure was defined based on the number of smokers in the child's home. Outcomes included hospital length of stay, intensive care unit admission, and mechanical ventilation. Proportional hazards and logistic regression models were used to assess associations between SHS exposure and outcomes. All models were adjusted for age, sex, race/ethnicity, household education level, government insurance, comorbidities, enrollment site, year, and season.
Results:
Of the 2219 children included in the study, SHS exposure was reported in 785 (35.4%), including 325 (14.8%) with ≥2 smokers in the home. Compared with nonexposed children, the children exposed to ≥2 smokers had longer length of stay (median, 70.4 hours vs 64.4 hours; adjusted hazard ratio, 0.85; 95% CI, 0.75-0.97) and were more likely to receive intensive care (25.2% vs 20.9%; aOR, 1.44; 95% CI, 1.05-1.96), but not mechanical ventilation. Outcomes in children exposed to only 1 household smoker were similar to those in nonexposed children.
Conclusion:
Children hospitalized with CAP from households with ≥2 smokers had a longer length of stay and were more likely to require intensive care compared with children from households with no smokers, suggesting that they experienced greater pneumonia severity.
Related Concept Videos
01:30Pneumonia I: Introduction
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
01:30Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
01:30Pneumonia III: Complications and Assessment
01:29Pneumonia II: Pathophysiology
01:28Pneumonia IV: Management
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
01:17Pulmonary Cycle: Exhalation