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Tobacco Smoke Increases
Asthma Incidence in Children

Am J Respir Crit Care Med 2001; 163:429-436.

Having a mother who smoked during pregnancy and being exposed to environmental tobacco smoke (ETS) are among the factors that increase physician-diagnosed asthma and wheezing in children.

"Smoking has a wide range of adverse health effects for smokers," Dr. Frank D. Gilliland, of the University of Southern California, Los Angeles, told Reuters Health. "Unfortunately," he added, "smokers' children also pay a high price for their parents' addiction to nicotine."

Dr Gilliland and colleagues, whose findings are published in the February issue of the American Journal of Respiratory and Critical Care Medicine, examined surveys completed by the parents of 5762 school-aged children to determine the effects of various types of smoke exposure.

Children with in utero exposure to maternal smoking, but no subsequent ETS exposure, were at almost twice the risk of having physician-diagnosed asthma. A number of other markers of wheeze and asthma were at least doubled in these children and they were 3.4 times more likely than others to have made an emergency room visit in the previous year.

In contrast, ETS exposure did not increase the risk of physician-diagnosed asthma, but did increase the risk of various types of wheeze. For example, current ETS exposure was associated with an odds ratio for "lifetime wheezing" of 1.3. The corresponding figure for wheezing causing shortness of breath was 1.6. The odds ratio for having made an emergency room visit in the previous year was 1.9. These effects were more pronounced in children exposed to two or more smokers and were significant even after adjustment for maternal smoking during pregnancy.

Commenting on the findings, Dr Gilliland noted that "our study shows that smoking by women during childbearing years increases the risk for asthma diagnosis and the symptomatic wheezing and medical care needs in their children."

The increase in the proportion of women who smoke, he added "may account for some of the rise in childhood asthma observed over the last 30 years. There is a clear need for a greater focus on reducing smoking initiation and promoting and enabling smoking cessation at younger ages."

WESTPORT, CT (Reuters Health) Mar 14

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