Abstract
Risk factors, such as parental smoking, are commonly associated with increased asthma symptoms and hospitalizations of children. Deseret Mutual Benefits Administrators (DMBA) is the health insurer for employees of The Church of Jesus Christ of Latter-day Saints and their families. Due to religious proscription, employees abstain from alcohol and tobacco use, creating a cohort of children not exposed to parental smoking. Calculation of hospitalization rates for DMBA, Utah, and the US were made in children to compare rates between a nonsmoking population and general populations. Compared to DMBA, rate ratios for asthma hospitalization and emergency department asthma visits were higher for the US and Utah. The incidence of hospital outpatient department and physician office visits was significantly greater for the US population compared to the DMBA. This study demonstrates a decreased need for health services used by children not exposed to second-hand smoke.
Highlights
Asthma is a chronic respiratory condition that affects over 7 million United States (US) children [1]
Age- and sex-specific hospital discharge rates for asthma are presented in Table 2 for the Deseret Mutual Benefits Administrators (DMBA) and comparison populations
Hospitalizations among US children were 5 times higher than among DMBA children
Summary
Asthma is a chronic respiratory condition that affects over 7 million United States (US) children [1]. Parental cigarette smoking influences children’s asthmarelated symptoms. Children are more vulnerable to tobacco smoke than adults because their respiratory and immune systems are not completely developed [2]. As early as 1992, the Environmental Protection Agency reported that environmental tobacco smoke (ETS) is causally associated with 1 million episodes and increased severity of symptoms among asthmatic children [3]. ETS is a risk factor for new asthma cases in children [4]. In the US in 1997, figures for childhood illness and death attributed parental smoking with an estimated excess of 1.8 million outpatient visits for asthma and an excess of 14 asthma deaths [5]. A worldwide study conducted in 2004 found that 603,000 deaths were attributable to ETS exposure, 28% of which were in children [6]
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