Secondhand Smoke Exposure and Asthma Outcomes Among African-American and Latino Children With Asthma

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To assess dose-response relationships between plasma cotinine–determined secondhand smoke (SHS) exposure and asthma outcomes in minority children.The study included 1172 Latino and African American children with asthma from the mainland and Puerto Rico.The investigators used subsamples of participants from the Gene-environments and Admixture in Latino Americans Study and the Study of African Americans, Asthma, Genes, and Environments. Both are case-control studies of asthma in which researchers recruited children who were 8 to 21 years old. Logistic regression was used to assess relationships of cotinine levels ≥0.05 ng/mL with asthma exacerbations (defined as asthma-related hospitalizations, emergency department visits, or oral steroid prescription) in the previous year and asthma control.The odds ratio for experiencing asthma exacerbations in the previous year for cotinine levels ≥0.05 ng/mL, compared with <0.05 ng/mL, was 1.40 (95% confidence interval: 1.03–1.89). There was an increase in dose response for asthma control when comparing “very poorly controlled” with “controlled” asthma. When examining the level of asthma control each participant maintained over the past year, the odds ratio for poor asthma control was 1.53 (95% confidence interval: 1.12–2.13). Analyses for dose-response relationships indicated increasing odds of asthma outcomes related with increasing exposure, even at cotinine levels associated with light SHS exposure.Among African American and Latino children, exposure to SHS is associated with higher odds of asthma exacerbations and having poorly controlled asthma. A dose-response relationship exists even at low levels of exposure. There are no safe levels of SHS exposure.Researchers in this study focused on an understudied population that is disproportionately affected by asthma morbidity and SHS exposure. This study furthers our knowledge regarding SHS exposure by demonstrating that any SHS exposure is harmful for minority children with asthma. We should continue to educate families that SHS negatively impacts lung health.