Chest
Clinical InvestigationsSMOKINGInvoluntary Smoking and Asthma Severity in Children: Data From the Third National Health and Nutrition Examination Survey
Section snippets
Study Population
The National Center for Health Statistics of the Centers for Disease Control and Prevention (Atlanta, GA) conducted NHANES III.13 NHANES III was approved by the Institutional Review Board of the National Center for Health Statistics, and the appropriate informed consent was obtained from survey participants. In this survey, a stratified, multistage, clustered probability design was used to select a representative sample of the civilian, noninstitutionalized US population. Survey participants
Results
Of the 13,944 children aged 2 months through 16 years who participated in NHANES III, 1,025 had physician-diagnosed asthma. Of this group, we excluded 308 who were < 4 years old, 36 who had not had a physical examination, 145 who had not had cotinine levels determined (typically because the blood sample was not enough for the cotinine analysis), and 13 who had cotinine levels of > 20 ng/mL, suggesting current smoking or spit tobacco use, resulting in 523 children in our analytic sample. Of
Discussion
Our primary findings are that children in whom asthma has been diagnosed by a physician have increased severity associated with tobacco smoke exposure. These children were significantly more likely to have more severe asthma, as indicated by increased symptoms of cough and wheeze, by an increased number of respiratory illnesses, and by lower levels of lung function. They were also more likely to have visited a physician more than once in the previous year, although this increase was not
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Cited by (167)
Tobacco Smoke Exposure, Respiratory Health, and Health-care Utilization Among US Adolescents
2020, ChestCitation Excerpt :Aligning with our findings, prior studies that used parental smoking as a tobacco smoke exposure measure indicate that children of smokers have lower FEV1% compared with children of nonsmokers.13,14 We expand on findings delimited to children with asthma that found those with biochemically validated tobacco smoke exposure have decreased pulmonary function as measured by FEV19 and FVC.10 Similarly, a Swedish birth cohort study found no difference between self-reported tobacco smoke exposure and the FEV1/FVC ratio among 16-year-olds.8
Secondhand Smoke Exposure and Subsequent Academic Performance Among U.S. Youth
2020, American Journal of Preventive MedicineCitation Excerpt :Previous research demonstrated the detrimental health impact of secondhand smoke exposure among adolescents, for example, respiratory symptoms and infections, ear problems and infections, and asthma.3–5 These secondhand smoke exposure–related conditions can lead to school absenteeism,22–25 which may explain how exposure to secondhand smoke impacts adolescents’ academic performance. An alternative explanation could be that exposure to secondhand smoke may be a marker of deviant behaviors or association with deviant peers.
Management of Respiratory Disorders and the Pharmacist's Role: Asthma
2019, Encyclopedia of Pharmacy Practice and Clinical Pharmacy: Volumes 1-3Management of respiratory disorders and the pharmacist’s role: Asthma
2019, Encyclopedia of Pharmacy Practice and Clinical PharmacySecondhand Smoke Exposure and Pediatric Healthcare Visits and Hospitalizations
2017, American Journal of Preventive MedicineCitation Excerpt :Similarly, mixed evidence for healthcare utilization among asthmatic children has been documented. In addition to studies that have shown a positive relationship between SHSe and healthcare visits and associated costs in children with asthma,8,9,18,19 an inconsistent association using salivary cotinine to measure SHSe was found, such that children with high cotinine levels had an elevated general practitioner contact rate, whereas children with moderate cotinine levels had a reduced rate of consultations for asthma.20 Although there are clear evidence-based guidelines that exhort pediatric practitioners to routinely screen for and provide SHSe counseling at every healthcare visit, rates of assistance for helping caregivers reduce their child’s SHSe remain low.21
This study was funded by the Centers for Disease Control and Prevention.