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Provider Counseling About Secondhand Smoke Exposure for Urban Children With Persistent or Poorly Controlled Asthma
Insights
Secondhand smoke (SHS) exposure is common in urban children with asthma. Caregiver smoking significantly impacts home smoking bans, and SHS counseling needs improvement for better child asthma management.
Area of Science:
- Environmental Health
- Pediatric Pulmonology
- Public Health
Background:
- Secondhand smoke (SHS) exposure poses significant risks to children, especially those with asthma.
- Urban children with asthma remain vulnerable to SHS exposure in their homes.
Purpose of the Study:
- To characterize SHS exposure levels among urban children diagnosed with persistent asthma.
- To evaluate the extent and nature of SHS counseling provided during primary care visits for these children.
Main Methods:
- Caregiver interviews and medical record reviews were conducted for 318 children (aged 2-12 years) with persistent asthma.
- Data collected included household smoking status and the presence of home smoking bans.
Main Results:
- 32% of children lived with a smoking caregiver, and 15% lived with other smokers.
- Homes with smoking caregivers had lower smoking ban prevalence (65%) compared to homes with other smokers (72%) or no smokers (95%).
- 67% of caregivers received SHS counseling, primarily when they were smokers, with less frequent counseling for others.
Conclusions:
- SHS exposure is a persistent issue for urban children with asthma.
- Current SHS counseling practices in primary care are insufficient and require enhancement for all families with asthmatic children.
- Targeted interventions are needed to improve home smoking bans and comprehensive SHS counseling.
Abstract:
Urban children continue to be exposed to secondhand smoke (SHS), and this is particularly concerning for children with asthma. The objective of this study is to describe SHS exposure among urban children with asthma and assess SHS counseling delivered at primary care visits. We interviewed caregivers of 318 children (2-12 years) with persistent asthma at the time of a health care visit and reviewed medical records. We found that one third (32%) of children lived with a caregiver who smoked and that 15% lived with other smokers. Children whose caregivers smoked had the lowest prevalence of home smoking bans compared with homes with other smokers and no smokers (65% vs. 72% vs. 95%, respectively). Overall, 67% of caregivers received some SHS counseling. Providers most often counseled caregiver smokers; counseling occurred less frequently for caregivers in homes with other or no smokers. Further efforts to improve provider SHS counseling for all children with asthma are needed.
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