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309798
Secondhand smoke exposure is still associated with emergency department use among children and adolescents with asthma
Sunday, November 16, 2014
Catrina Chambers, PhD
,
Cardiovascular Research Institute, Center for Tobacco Control Research and Education, University of California, San Francisco, San Francisco, CA
Ryan Lindsay, PhD
,
Cardiovascular Research Institute, Center for Tobacco Control Research and Education, University of California, San Francisco, San Francisco, CA
Hai-Yen Sung, Ph.D.
,
Institute for Health & Aging, University of California, San Francisco, San Francisco, CA
Wendy Max, PhD
,
Institute for Health & Aging, University of California, San Francisco, San Francisco, CA
Background: Secondhand smoke (SHS) is a known trigger of asthma symptoms among children and adolescents, which prompt use of emergency department (ED) services. Yet, this population remains at risk of continued SHS exposure. Methods: Usining data from the 1999-2012 National Health and Nutrition Examination Surveys, we analyzed the association of SHS exposure with asthma ED use among 642 children aged 3-11 and 576 non-smoking adolescents aged 12-19 with asthma. SHS exposure was defined by serum cotinine levles (>=0.05 ng/mL). Multivariate logistic regression models adjusted for several covariates. All significant results are reported at p<=0.1. Results:30% of children and 21% of non-smoking adolescents with asthma reported asthma ED use in the past 12 months. The geometric mean cotinine levels were significanly higher for those reporting asthma ED use compared to those who did not (0.13 ng/mL vs. 0.09 ng/mL, p=0.05, for children and 0.11 ng/mL vs. 0.07 ng/mL, p=0.02, for adolescents). The adjusted odds ratio (AOR) of reporting asthma ED use was higher among those exposed to SHS conpared to those unexposed (AOR=1.14,90% CI=0.99-1.31, for children and AOR=1.16,90% CI=1.10-1.29, for adolescents). Conclusion: Increased SHS exposure was associated with higher odds of reporting asthma ED use among children and non-smoking adolescents with asthma. Our results indicate further reduction in SHS exposure, especially among children and non-smoking adolescents with asthma, is needed. Promoting smoke-free housing policy and other risk reduction interventions may be helpful for reducing SHS exposure among this vlunerable population.
Learning Areas:
Chronic disease management and prevention
Planning of health education strategies, interventions, and programs
Public health or related education
Public health or related public policy
Social and behavioral sciences
Learning Objectives:
Compare asthma-specific emergency department (ED) visits among children and non-smoking adolescents who have asthma by SHS exposure as measured by serum cotinine levels (>= 0.05 ng/mL).
Explain the association between asthma-specific ED use and exposure to SHS among children and non-smoking adolescents while controlling for socio-demographic factors.
Discuss recommendations aimed towards reducing SHS exposure among youth diagnosed with SHS-related conditions such as asthma and promoting smoke-free housing policies.
Keyword(s): Tobacco Control, Child Health Promotion
Presenting author's disclosure statement:Qualified on the content I am responsible for because: I am qualified to be a reviewer because I have a doctorate in public policy with a concentration in health policy, my dissertation focused on the health implication of statewide smoking ordinances among individual with asthma, I have been the project director and senior research associate on two asthma disparities grants, and I have acted in the capacity of expert on the development of asthma-related health and health policy related interventions.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines,
and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed
in my presentation.
