Head Start Children's Increased Risk of Asthma from Parent Smoking, a Cross Sectional Study

Objectives: Secondhand and third hand smoking increase the risk of serious respiratory problems in children, such as a greater number and severity of asthma. In 2009, 15% of adults in Massachusetts classified themselves as smokers. Furthermore, families living at or below the poverty line are at increased risk of exposure to environmental tobacco smoke (ETS). This study aimed to (1) establish the prevalence of smoking among Action for Boston Community Development (ABCD) Head Start parents/guardians, all living at or below federal poverty guidelines, and (2) determine the percentage of childhood asthma associated with parent smoking.

Methods: A cross-sectional survey was collected at four ABCD Head Start programs in Boston from December 2010 to January 2011. A total of 160 parents completed the questionnaire. The risk difference, population attributable risk (PAR), and relative risk Z-test for children with asthma was calculated among parents who smoke versus parents that do not. Results: Eighteen percent (95% CI: 11.6% to 23.4%) of Head Start parents classified themselves as smokers. Among parents that smoke, 32.1% (95% CI: 14.7% to 49.3%) also indicated that they have a child with asthma. There is an 18% risk difference for a family to have at least one child with asthma if a parent smokes. Twenty-two percent of the risk of a family having a child with asthma is attributed to parent smoking. Lastly, children are 2.3 times more likely to have a diagnosis of asthma if a parent smokes (p<0.001).

Conclusions: Prevalence of smoking in Boston Head Start parents is higher than the prevalence of smoking in the adult population in Massachusetts. Exposure to tobacco smoke at home significantly increases the risk of asthma in Head Start children.