The Philadelphia School District (PSD) recently sub-contracted 45 of its lowest performing schools to 7 private organizations, with Edison Inc. receiving responsibility for 21/45 schools. To better understand issues that might have contributed to the poor academic performance of these youngsters, we surveyed the use of tobacco and correlated it with prevalence of asthma symptoms, both diagnosed and undiagnosed. We compared data between PSD and Edison schools.
We screened for asthma by using the ISAAC video questionnaire, supplemented by questions on experimentation with tobacco and passive exposure at home. Our target population comprised 6,727 middle-schoolers from 65 Philadelphia public schools: 6006 managed by PSD and 721 by Edison.
Overall, 23.7% of PSD children and 24.5% of Edison reported having asthma. Among asthmatics, home exposure to environmental smoke was reported by 73.2% for Edison and 64.5% for PSD, P = .03. Experimentation with smoking was reported by 31% of Edison and 24.1% of PSD, P = .05. When comparing children with self-reported asthma to those without it, we found a significantly higher percentage of tobacco experimentation among asthmatics (24.1% vs. 20.5% at PSD and 31% vs. 23.2% at Edison, P’s = .004 and .04 respectively). Children with asthma were also more exposed to secondhand smoke than non-asthmatics, although this difference approached statistical significance only for the PSD (64.5% vs. 61.8.1%, P=.06). When analyzed by ethnicity, smoking experimentation was overall present in 22.5% of African-Americans, 21% of Whites, 18.4% of Hispanics, and 14.2% of Asians.CONCLUSIONS: These data indicate a significantly higher prevalence of tobacco exposure and experimentation among students from school with worse academic performance. Children with asthma were significantly more likely to be experimenting with tobacco.
Tobacco prevention and control should be incorporated in the educational activities of outreach asthma programs for school children.
S. Mangione, GlaxoSmithKline, grant monies.