Abstract
Objective: Childhood exposure to secondhand tobacco smoke (SHS) increases a child’s burden of respiratory conditions, but parental smoking bans may reduce such morbidity. This study evaluated household smoking bans and their relationship to respiratory illness in an outpatient otolaryngology clinic. Methods: The study was performed at the Heim Pal National Children’s Hospital, Ear, Nose and Throat (ENT) Department (Budapest, Hungary) from July to November, 2010. A consecutive series of children’s caregivers were approached to participate in a survey measuring household smoking bans, upper and lower respiratory tract symptoms and illnesses, and socioeconomic factors. Bivariate and multivariate logistic regression analyses were performed. Results: Of the 215 caregivers recruited for the study, 208 agreed to participate (response rate of 96.7%). More than half of the children were male (54%), and 39% lived in a household with at least one member who smoked. Smoking was frequently banned inside the car (91.3%) and home (85.1%). Respondents felt it easiest to ask friends (97.1%) and family members not living in the household (98.1%) to refrain from smoking inside the home. Respondents also found it easier to ask a stranger (81.7%) or a family member (61.1%) not to smoke around the child. Logistic regression showed that respondents for children with a history of pneumonia found it less difficult to ask visitors in the home not to smoke compared to children without pneumonia (OR = 0.23, 95% CI = 0.06–0.98). Conversely, respondents for children who had had adenoidectomy found it over three times more difficult to ask strangers not to smoke near the child compared to those of children without adenoidectomy (OR = 3.20, 95% CI = 1.43–6.38). Conclusions: In a population of children visiting an outpatient ENT clinic in Budapest, Hungary, we found a high degree of exposure to SHS. The ease with which caregivers felt towards asking others not to smoke predicted specific respiratory conditions. Since the ENT clinic offers a wonderful opportunity for clinicians to counsel parents on tobacco cessation, increased tobacco education of these providers is needed.
Highlights
Exposure to second hand tobacco smoke (SHS) is hazardous and associated with striking morbidity and mortality from cancer, heart disease, adverse infant and perinatal outcomes, and respiratory illnesses [1]
In a population of children visiting an outpatient ENT clinic in Budapest, Hungary, we found a high degree of exposure to SHS
Since the ENT clinic offers a wonderful opportunity for clinicians to counsel parents on tobacco cessation, increased tobacco education of these providers is needed
Summary
Exposure to second hand tobacco smoke (SHS) is hazardous and associated with striking morbidity and mortality from cancer, heart disease, adverse infant and perinatal outcomes, and respiratory illnesses [1]. The dangers of SHS are serious for children, increasing their vulnerability to sudden infant death syndrome, otolaryngologic conditions such as otitis media, and lower respiratory diseases, and other illnesses [1,2]. Children’s ventilation rates are higher than those of adults. Because of their smaller size, they are exposed to proportionally more toxins. Unlike adults, children cannot choose to live with non-smokers. They cannot enforce smoke-free bans in private spaces such as the home or the car, nor can they readily leave areas where smokers are currently smoking [2]. Over the past decade, measured cotinine (a nicotine metabolite) levels in children have not declined as rapidly as cotinine levels in adults [1]
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