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Children With Asthma

Children With AsthmaEnvironmental tobacco smoke (ETS) exposure has adverse consequences for respiratory health, and there is a well-documented association between long-term ETS exposure and the exacerbation of asthma in children. The meta-analysis by Cook and Strachan concluded that parental smoking was associated with the increased prevalence of asthma and respiratory symptoms and that, among children who had already developed asthma, parental smoking was associated with more severe disease that increased the incidence of emergency department (ED) visits, life-threatening attacks, and asthma symptoms. Other expert reviews have drawn similar conclusions, most recently that maternal smoking during pregnancy is associated with an increased likelihood of wheezing with respiratory illness and contributes to the development of asthma in very young children.
The fact that adverse health consequences of ETS exposure for children with asthma have been documented in virtually all the relevant studies suggests that the current prevalence and intensity of exposure are clinically important, despite overall decreases in the rate of smoking in the US population. The California Tobacco Survey, for example, found that in 1996, 87% of all California children and adolescents were “protected” from ETS exposure in the home by restrictions on smoking or by a complete ban. However, only 65% of families with a child 0 to 5 years of age in which there was a smoker reported that they restricted or prohibited smoking in the home. In those families in which all adults smoked, only 40% claimed they restricted or prohibited smoking inside the home. California smoking rates are lower than those in many other states and countries, suggesting that exposure is even greater elsewhere. In addition, the rates of both smoking and asthma morbidity and mortality tend to be elevated in urban areas with high levels of poverty and/or minority populations. Daily passive smoke exposure was reported in one third of children from families of low socioeconomic status who had asthma in a Baltimore sample.