Chest
Volume 122, Issue 3, September 2002, Pages 826-828
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Clinical Investigations
Asthma
Environmental Tobacco Smoke Exposure During Travel Among Adults With Asthma

https://doi.org/10.1378/chest.122.3.826Get rights and content

Objectives

In California, state law now prohibits smoking in most public places. We examined the prevalence and short-term health impact of environmental tobacco smoke (ETS) exposure during travel among adults with asthma.

Design, setting, and participants

A cohort of 374 nonsmoking adults with asthma recruited from a random sample of allergy, pulmonary, and family practice physicians in northern California underwent structured telephone interviews.

Measurements and results

The prevalence of self-reported ETS exposure during travel in the past 12 months was substantial (30%; 95% confidence interval, 25 to 35%). Of the exposed subjects, approximately one third (34%) indicated no other regular source of ETS exposure. ETS-related cough, wheezing, or chest tightness during travel was the most common complaint (66%), followed by eye irritation (46%) and nose irritation (43%). After ETS exposure, many subjects indicated extra inhaled asthma medication use (55%). Subjects with no other regular ETS exposure reported a greater likelihood of eye irritation (58% vs 40%; p = 0.068) and nose irritation (58% vs 36%; p = 0.025) than persons with regular exposure. In contrast, there were no differences in respiratory symptoms, asthma medication use, or asthma exacerbation by regular ETS exposure status.

Conclusions

In adults with asthma, ETS exposure is common during travel. For many subjects, travel is their principal source of exposure.

Section snippets

Materials and Methods

We used data collected during an ongoing prospective, longitudinal cohort study of adults with asthma recruited from physician practices in Northern California. Details of recruitment have been reported previously.678 In brief, we recruited subjects from a random sample of certified American Board of Medical Specialty internal medicine and pulmonary specialists, internal medicine and allergy/immunology specialists, and family practice specialists. The present study eligibility is based on

Results

The average age (mean ± SD) of the 374 nonsmoking adults with asthma was 44 ± 7.7 years. Subjects included 264 women (71%) and 105 people of nonwhite race/ethnicity (28%). Fewer than one half of subjects indicated past cigarette smoking (n = 120; 32%).

The prevalence of self-reported ETS exposure during travel in the 12 months before interview was substantial (n = 111; 30%; 95% confidence interval, 25 to 35%). Of the people reporting travel-related ETS exposure, 38 subjects (34%) did not live

Discussion

As public smoking becomes more restricted in California, ETS exposure during travel may be a relatively more important source of exposure. Nearly one third of subject reported ETS exposure during travel in the past year. Of these subjects, a substantial proportion indicated no other regular source of ETS exposure (34%).

The health impact of intermittent ETS exposure during travel has not been examined previously. In people with asthma, who may comprise a vulnerable group, travel-related ETS

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Supported by National Institutes of Health grants K23 HL04201 (Dr. Eisner) and RO1 HL56438 (Dr. Blanc).

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