Asthmatic children who are exposed to cigarette smoke are more likely to make repeat trips to the hospital for breathing problems. But researchers say asking parents about kids’ smoke exposure may not yield the most reliable information.
In a recent study, saliva revealed exposure to tobacco smoke in roughly 80% of children brought to the hospital for asthma or breathing problems. But only about a third of parents said their children came in contact with smoke.
What’s more, finding evidence of nicotine, a chemical in tobacco, in children’s saliva was a better predictor of whether they would need to come back to the hospital, compared to the information parents gave to doctors. “We think saliva is a good and potentially useful test for assessing an important trigger for asthma,” Dr Robert Kahn, the study’s senior author, told Reuters Health.
Wheezing children younger than 2 years of age had a high rate of viral infection and a low rate of IgE antibody to inhalant allergens. When these children were exposed to passive smoke, salivary cotinine levels were elevated suggesting heavy exposure. After 2 years of age, sensitization to inhaled allergens became increasingly important and viruses remained a significant risk factor for wheezing. These data support recommendations to reduce tobacco smoke exposure at home, especially for young patients, and to consider sensitization to inhaled allergens and allergen avoidance in wheezing children at an early age, particularly after age 2 years.
Smoking cessation tools
Previous research has found that being exposed to tobacco can lead to airway problems and poor asthma control among children, Kahn and his colleagues write in the journal Paediatrics.
By figuring out which children are being exposed to tobacco, doctors may be able to step in and identify and possibly eliminate the exposure, said Kahn, a paediatrician at Cincinnati Children’s Hospital Medical Centre in Ohio.
For example, if a parent is still smoking cigarettes and exposing the child to smoke, doctors can offer the parent smoking cessation tools while the child is hospitalised.
The take-home message should always be that exposure to second-hand smoke for both adults and children is a significant health risk factor – particularly for children with asthma and respiratory disorders,” Kreindler said. “They should not be exposed to second-hand smoke under any circumstance.”