Background: Clinicians of many types have opportunities to address with parents children’s exposure to secondhand smoke. Since children with atopic conditions have worse outcomes when exposed to environmental tobacco smoke, pediatric otolaryngologists have tremendous access to smoking parents of children with these conditions. No research has yet evaluated in this setting environmental tobacco smoke and the occurrence of atopic diseases.
Methods: Caregivers or parents of 201 consecutive
patients in a Hungarian pediatric otolaryngology clinic were queried on
otolaryngologic conditions; self-reported diagnoses of atopic diseases; and
tobacco smoke exposure.
Results: A history of asthma was reported in 20 out of
194 total patients (10.3%). Seventy five children out of the 194 patients had
at least one parent who smoked (38.7%). Additionally, 15 out of the 20 children
with asthma (75.0%) had at least one parent who smoked. In bivariate analysis
(Table 1), parental smoking, smaller flat size, and having ENT operations
planned for the future correlated with a diagnosis of asthma. Having a
diagnosis of hay fever or eczema approached statistical significance (p=0.07
and p=0.057, respectively) in correlating with having a diagnosis of asthma.
Multivariable logistic regression (Table 2) showed that
males were 64% less likely than females to have a diagnosis of asthma (Odds
Ratio [OR] = 0.34, 95% confidence interval [CI] = 0.12-0.96). Having a diagnosis
of hay fever (OR = 6.68, 95% CI = 1.30-34.2) and having a parent who smoked (OR
= 7.82, 95% CI = 2.50-24.4) greatly increased the odds of having a diagnosis of
asthma.
Conclusions: Second hand smoke exposure among children in
an otolaryngology clinic was common, and was associated with co-existing atopic
conditions. Discussion of secondhand smoke exposure of children is not simply
for primary care physicians to address with parents. Specialty physicians such
as pediatric otolaryngologists also have an important opportunity to advocate
for parental smoking cessation as part their care of children.
No comments:
Post a Comment