Kids with asthma still exposed to secondhand smoke

Kathryn Doyle

By Kathryn Doyle

NEW YORK (Reuters Health) - Despite public health campaigns, too many people are still smoking around little kids with asthma, say U.S. researchers.

According to national data from 2003 to 2010, half of all children ages 6 to 19, even those with asthma, have been exposed to secondhand smoke.

For kids ages 6 to 11, even low levels of second hand smoke were linked to more missed school days, trouble sleeping, less physical activity and more wheezing, the authors write in Academic Pediatrics.

The fact that kids with asthma are still inhaling others' smoke is a real problem, said Dr. Karen M. Wilson, who studies children's' exposure to secondhand smoke at Children's Hospital Colorado in Aurora.

"Secondhand smoke consists of particulate matter, and chemicals, both of which induce an inflammatory response in the airways, which can cause an asthma attack," said Wilson, who was not involved in the study.

Limiting physical activity is also dangerous because it increases the chances a child will become obese, which worsens asthma, she told Reuters Health.

For older children, secondhand smoke was not linked to those negative symptoms.

"We speculated that this may be because similar levels of exposure may mean different things at different ages," Dr. Lara Akinbami said.

"Adolescents may have more sporadic exposure (hanging with friends) compared to younger children who may be more chronically exposed at home," Akinbami, who led the study at the National Center for Health Statistics in Hyattsville, Maryland, told Reuters Health by email.

Other research has indicated that only smoking in one room of the house is not enough to protect kids, Akinbami said.

Secondhand smoke did not seem to worsen asthma symptoms for black children, but they tend to be exposed to more smoke and to have worse symptoms to start with, Akinbami said.

The study included a very small number of black children who were not exposed to secondhand smoke, which could have made it difficult to compare smoking and nonsmoking homes, she added.

"I think the most important factor is that even low level exposure - the kind of exposure that might happen with a parent who smokes outside - can have negative consequences," Wilson said.

"Not smoking at all, and limiting exposure from other sources, such as neighboring apartments, is the best way to protect children with asthma," she said.

The report notes that over the past several years secondhand smoke exposure has dropped for adults more than for kids.

"This is because the clean indoor air laws are designed to protect individuals in workplaces, which includes bars and restaurants," Amy Ferketich, a tobacco control researcher at The Ohio State University in Columbus, said.

"Children tend to be exposed to (secondhand smoke) in homes and cars, and these places are not included in most clean indoor air laws and policies," Ferketich, who was not involved in the study, said.

Though most adults already know that smoking around kids is not a good idea, more can be done, according to Wilson and the other experts.

All recommended that clean indoor air policies be extended to cover multi-unit housing.

"Resources, such as state quitlines, need to be well promoted, and provide comprehensive cessation services," Wilson said. "Parents should work with their health care providers, and their children's providers, to reduce exposure and quit themselves, in order to protect their children."

SOURCE: Academic Pediatrics, online September 10, 2013.