PURPOSE: The relationship between secondhand smoke exposure and childhood asthma morbidity among children enrolled in a clinical trial was examined. The purpose of the trial was to examine the effectiveness of an adherence intervention in children with persistent asthma.
METHODS: Children were randomized to intervention (daily supervision of inhaled steroid at school) or usual care. Data regarding the child's asthma morbidity over the past 12 months and secondhand smoke exposure were collected from family caregivers through interviews done at baseline and one year later.
RESULTS: 261 family caregivers completed both interviews. The mean age of children was 10.99 years (SD=2.08). 57.47% percent of children (n=150) were male and 90.04% (n=235) were black. At the first interview, 52.11% of caregivers (n=136) reported no smoke exposure for their child. 26.44% (n=69) reported smoke exposure outside the home and 21.46% (n=56) reported household smoke exposure. At the second interview, 59.39% of caregivers (n=155) reported no smoke exposure for their child. 19.54% (n=51) reported smoke exposure outside the home and 21.07% (n=55) reported household smoke exposure. One hundred eighty-four caregivers reported the same smoke exposure at the second interview. Forty-six caregivers reported less smoke exposure and 31 reported increased smoke exposure. No significant differences were found in these changes (Chi-Square = 1.56, p = 0.46). Changes in health care utilization were examined between the first and second interview. Statistically significant decreases in ER visits were seen among those who reported the same (p=0.03) or decreased smoke exposure (p=.003). Statistically significant decreases in hospitalizations were seen only among those with decreased smoke exposure (p=.02). Statistically significant decreases in urgent care visits were seen only among those who reported the same level of smoke exposure (p<.0001). These relationships did not differ between the intervention and control groups.
CONCLUSION: Secondhand smoke exposure is high among this urban population of children with asthma and appears to be related to health care utilization.
CLINICAL IMPLICATIONS: Clinicians should work with caregivers of children with asthma to limit exposure to secondhand smoke.
DISCLOSURE: Lynn Gerald, No Financial Disclosure Information; No Product/Research Disclosure Information