Elsevier

Ambulatory Pediatrics

Volume 6, Issue 2, 1 March 2006, Pages 115-119
Ambulatory Pediatrics

Do Parents of Urban Children With Persistent Asthma Ban Smoking in Their Homes and Cars?

https://doi.org/10.1016/j.ambp.2005.10.004Get rights and content

Objective

Environmental tobacco smoke (ETS) increases morbidity for children with asthma. One method to reduce children’s ETS exposure is to completely ban smoking in the home and car. We sought to evaluate the degree to which urban children with persistent asthma are protected by household and car smoking bans, and to determine whether health care professionals are counseling parents to implement smoking bans.

Methods

We asked parents of children with asthma to complete an in-person interview including questions about asthma symptoms, smokers in the home, smoking bans (home and car), and the receipt of ETS counseling by health care professionals.

Results

We included 231 children with persistent asthma symptoms (response rate 94%). Nearly half of the children lived with a smoker. Overall, only 64% of households had complete restrictions on smoking in the home and car. Even among the children with severe persistent symptoms, less than two-thirds were protected by a complete smoking ban. Among households with smokers, only 51% had a ban on smoking in the home and 49% in the car. The majority of caregivers had been questioned by health care professionals about home smoke exposure; less were asked about exposure in the car (40%) or given suggestions to decrease the child’s exposure (58%).

Conclusions

To our knowledge this is the first study to establish the prevalence of smoking bans among children with persistent asthma. Many children with asthma, even those with the most severe symptoms, remain exposed to ETS in the home and in cars. Identifying and reducing smoke exposure among these children should be a health care priority.

Section snippets

Setting and Participants

We conducted this study by using interview data from an office-based asthma intervention based in 3 urban pediatric clinics in Rochester, NY. We included children ages 2–12 years with physician diagnosed asthma who had asthma symptoms noted in their medical record within the previous 2 years. Children were eligible for enrollment if they arrived at the office for any scheduled visit with a physician or nurse practitioner. We included asthmatic children presenting to the office for any reason,

Results

Of the 301 asthmatic subjects enrolled, 231 had persistent asthma symptoms and were included in this analysis (mean age 6.3 years). Table 1 shows the demographic characteristics of these children. The majority of the subjects were boys (60%), and 71% were enrolled in Medicaid. Fifty-five percent of the children were described as African American, and 31% described Hispanic ethnicity. The children were selected if they had persistent asthma symptoms, and more than one-third had severe persistent

Discussion

These data demonstrate that many urban children with asthma are not living in smoke-free environments and likely are experiencing preventable morbidity. Overall, less than two-thirds of the children were protected by complete smoking bans. Exposure to smoke in the car was relatively common (26%), and is of particular concern because ETS in the car is significantly more concentrated than in a house. Although approximately 10% of children living with nonsmokers were exposed to ETS, the majority

Acknowledgments

The research for this article was funded by grants from the Halcyon Hill Foundation, and the Robert Wood Johnson Foundation’s Generalist Physician Faculty Scholars Program. We thank George B. Segel, MD, for his insightful review of the manuscript, and Kathy Lynch, BA, for her help with manuscript preparation.

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