Background: The association between environmental tobacco smoking (ETS) and childhood pneumonia has not been established in developed or developing countries. We conducted this study to assess the effect and impact of ETS exposure on pneumonia among children in central Vietnam.
Methods: A population-based, large scale of cross-sectional survey was conducted covering all residents of 33 communes in Khanh Hoa Province, the central part of Vietnam. Information on demography, socio-economic status and house environment, including smoking status of each household member, was collected from householders. The episodes of hospitalized pneumonia in each household in the last 12 months among children under 5 years old was recorded based on caregiver's report.
Results: In total 353,512 individuals living in 75,828 households were enumerated in the study areas. Of these, 24,768 (7.0%) were under 5 years old. The prevalence of ETS was 70.4% and the period prevalence of hospitalized pneumonia was 2.6%. In multiple logistic regression analysis, ETS exposure was independently associated with hospitalized pneumonia (adjusted odds ratio 1.55, 95% confidence interval 1.25 to 1.93). The prevalence of tobacco smoking was high among male adults compared with females (51.5% vs 1.5%, respectively). We estimate that 28.8% of childhood pneumonia in this community is attributable to environmental smoke.
Conclusions: Children in Vietnam are exposed to substantial levels of tobacco smoke, which results in 44,000 excess hospitalizations due to pneumonia among children under 5 years of age every year.