Overweight/obesity enhances associations between secondhand smoke exposure and asthma morbidity in children.
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ABSTRACT:
SUBMITTER: Wu TD
PROVIDER: S-EPMC6215532 | biostudies-literature | 2018 Nov - Dec
REPOSITORIES: biostudies-literature
Publications
Overweight/obesity enhances associations between secondhand smoke exposure and asthma morbidity in children.
Wu Tianshi David TD Brigham Emily P EP Peng Roger R Koehler Kirsten K Rand Cynthia C Matsui Elizabeth C EC Diette Gregory B GB Hansel Nadia N NN McCormack Meredith C MC
The journal of allergy and clinical immunology. In practice 20180503 6
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Project description:ObjectiveTo determine whether secondhand smoke (SHS) exposure is associated with greater asthma severity in children with physician-diagnosed asthma living in CT, and to examine whether area of residence, race/ethnicity or poverty moderate the association.MethodsA large childhood asthma database in CT (Easy Breathing) was linked by participant zip code to census data to classify participants by area of residence. Multinomial logistic regression models, adjusted for enrollment date, sex, age, race/ethnicity, area of residence, insurance type, family history of asthma, eczema, and exposure to dogs, cats, gas stove, rodents and cockroaches were used to examine the association between self-reported exposure to SHS and clinician-determined asthma severity (mild, moderate, and severe persistent vs. intermittent asthma).ResultsOf the 30,163 children with asthma enrolled in Easy Breathing, between 6 months and 18 years old, living in 161 different towns in CT, exposure to SHS was associated with greater asthma severity (adjusted relative risk ratio (aRRR): 1.07 [1.00, 1.15] and aRRR: 1.11 [1.02, 1.22] for mild and moderate persistent asthma, respectively). The odds of Black and Puerto Rican/Hispanic children with asthma being exposed to SHS were twice that of Caucasian children. Though the odds of SHS exposure for publicly insured children with asthma were three times greater than the odds for privately insured children (OR: 3.02 [2.84,3,21]), SHS exposure was associated with persistent asthma only among privately insured children (adjusted odds ratio (aOR): 1.23 [1.11,1.37]).ConclusionThis is the first large-scale pragmatic study to demonstrate that children exposed to SHS in Connecticut have greater asthma severity, clinically determined using a systematic approach, and varies by insurance status.
| S-EPMC5375151 | biostudies-literature
Project description:BackgroundSecondhand smoke (SHS) exposures have been linked to asthma-related outcomes but quantitative dose-responses using biomarkers of exposure have not been widely reported.ObjectivesAssess dose-response relationships between plasma cotinine-determined SHS exposure and asthma outcomes in minority children, a vulnerable population exposed to higher levels of SHS and under-represented in the literature.MethodsWe performed analyses in 1172 Latino and African-American children with asthma from the mainland USA and Puerto Rico. We used logistic regression to assess relationships of cotinine levels ≥0.05 ng/mL with asthma exacerbations (defined as asthma-related hospitalisations, emergency room visits or oral steroid prescription) in the previous year and asthma control. The shape of dose-response relationships was assessed using a continuous exposure variable in generalised additive logistic models with penalised splines.ResultsThe OR for experiencing asthma exacerbations in the previous year for cotinine levels ≥0.05 ng/mL, compared with <0.05 ng/mL, was 1.40 (95% CI 1.03 to 1.89), while the OR for poor asthma control was 1.53 (95% CI 1.12 to 2.13). Analyses for dose-response relationships indicated increasing odds of asthma outcomes related with increasing exposure, even at cotinine levels associated with light SHS exposures.ConclusionsExposure to SHS was associated with higher odds of asthma exacerbations and having poorly controlled asthma with an increasing dose-response even at low levels of exposure. Our results support the conclusion that there are no safe levels of SHS exposures.
| S-EPMC6225993 | biostudies-literature
Project description:ObjectiveWe previously reported that children exposed to secondhand smoke (SHS) that carried variants in the NAT1 gene had over two-fold higher hair cotinine levels. Our objective was to determine if NAT1 polymorphisms confer increased risk for developing asthma in children exposed to SHS.MethodsWhite participants in the Cincinnati Childhood Allergy and Air Pollution Study (n = 359) were genotyped for 10 NAT1 variants. Smoke exposure was defined by hair cotinine and parental report. Asthma was objectively assessed by spirometry and methacholine challenge. Findings were replicated in the Genomic Control Cohort (n = 638).ResultsSignificant associations between 5 NAT1 variants and asthma were observed in the CCAAPS exposed group compared to none in the unexposed group. There was a significant interaction between NAT1 rs13253389 and rs4921581 with smoke exposure (p = 0.02, p = 0.01) and hair cotinine level (p = 0.048, p = 0.042). Children wildtype for rs4921581 had increasing asthma risk with increasing hair cotinine level, whereas those carrying the NAT1 minor allele had an increased risk of asthma regardless of cotinine level. In the GCC, 13 NAT1 variants were associated with asthma in the smoke-exposed group, compared to 0 in the unexposed group, demonstrating gene-level replication.ConclusionsVariation in the NAT1 gene modifies asthma risk in children exposed to secondhand-smoke. To our knowledge, this is the first report of a gene-environment interaction between NAT1 variants, smoke exposure, cotinine levels, and pediatric asthma. NAT1 genotype may have clinical utility as a biomarker of increased asthma risk in children exposed to smoke.
| S-EPMC7274907 | biostudies-literature
Project description:ImportanceThe degree that in-home cannabis smoking can be detected in the urine of resident children is unclear.ObjectiveTest association of in-home cannabis smoking with urinary cannabinoids in children living at home.Design, setting, and participantsThis cross-sectional study used baseline data from Project Fresh Air, a 2012-2016 randomized clinical trial to reduce fine particulate matter levels. Eligible participants were recruited from households in San Diego County, California, with children under age 14 years and an adult tobacco smoker in residence. Children's urine samples were analyzed in 2022.ExposuresIn-home cannabis smoking, measured by: parent or guardian report of in-home cannabis smoking; number of daily nonspecific smoking events computed via an air particle count algorithm; and number of daily cannabis smoking events ascertained by residualization, adjusting for air nicotine, tobacco smoking, and other air particle generating or ventilating activities.Main outcomes and measuresLevels of the cannabis biomarker Δ9-tetrahydrocannabinol (THC) and its major metabolites, 11-hydroxy-Δ9-tetrahydrocannabinol and 11-nor-9-carboxy-Δ9-tetrahydrocannabinol. Biomarker molar equivalents were summed to represent total THC equivalents (TTE) in urine. Logistic regression assessed whether in-home smoking was associated with cannabis biomarker detection. For children with detectable urinary cannabinoids, linear regression assessed in-home smoking association with quantity of urinary TTE.ResultsA total of 275 children were included in analysis (mean [SD] age, 3.6 [3.6] years; 144 male [52.4%]; 38 Black [13.8%], 132 Hispanic [48.0%], and 52 White [18.9%]). Twenty-nine households (10.6%) reported in-home cannabis smoking in the past 7 days; 75 children [27.3%] had detectable urinary cannabinoids. Odds of detectable TTE in children's urine were significantly higher in households with reported in-home cannabis smoking than households without (odds ratio [OR], 5.0; 95% CI, 2.4-10.4) and with each additional ascertained daily cannabis smoking event (OR, 2.5; 95% CI, 1.6-3.9). Although the point estimate for TTE levels was higher among children with detectable urinary cannabinoids and exposure to more daily cannabis smoking events (increase per event, 35.68%; 95% CI, -7.12% to 98.21%), the difference was not statistically significant.Conclusions and relevanceIn this cross-sectional study, in-home cannabis smoking was associated with significantly increased odds of child exposure to cannabis smoke, as assessed by urinary cannabinoid biomarkers. As young children spend most of their time at home, reducing in-home cannabis smoking could substantially reduce their exposure to the toxic and carcinogenic chemicals found in cannabis smoke.
| S-EPMC11758598 | biostudies-literature
Project description:Urban children continue to be exposed to secondhand smoke (SHS), and this is particularly concerning for children with asthma. The objective of this study is to describe SHS exposure among urban children with asthma and assess SHS counseling delivered at primary care visits. We interviewed caregivers of 318 children (2-12 years) with persistent asthma at the time of a health care visit and reviewed medical records. We found that one third (32%) of children lived with a caregiver who smoked and that 15% lived with other smokers. Children whose caregivers smoked had the lowest prevalence of home smoking bans compared with homes with other smokers and no smokers (65% vs. 72% vs. 95%, respectively). Overall, 67% of caregivers received some SHS counseling. Providers most often counseled caregiver smokers; counseling occurred less frequently for caregivers in homes with other or no smokers. Further efforts to improve provider SHS counseling for all children with asthma are needed.
| S-EPMC6341479 | biostudies-literature
Project description:BackgroundEnvironmental tobacco smoke (ETS) exposure is associated with poor asthma outcomes in children. However, little is known about natural changes in ETS exposure over time in children with asthma and how these changes may affect health-care utilization. This article documents the relationship between changes in ETS exposure and childhood asthma morbidity among children enrolled in a clinical trial of supervised asthma therapy.MethodsData for this analysis come from a large randomized clinical trial of supervised asthma therapy in which 290 children with persistent asthma were randomized to receive either usual care or supervised asthma therapy. No smoking cessation counseling or ETS exposure education was provided to caregivers; however, children were given 20 min of asthma education, which incorporated discussion of the avoidance of asthma triggers, including ETS. Asthma morbidity and ETS exposure data were collected from caregivers via telephone interviews at baseline and at the 1-year follow-up.ResultsAt baseline, 28% of caregivers reported ETS exposure in the home and 19% reported exposure outside of the primary household only. Among children whose ETS exposure decreased from baseline, fewer hospitalizations (p = 0.034) and emergency department (ED) visits (p < or = 0.001) were reported in the 12 months prior to the second interview compared to the 12 months prior to the first interview. Additionally, these children were 48% less likely (p = 0.042) to experience an episode of poor asthma control (EPAC).ConclusionsThis is the first study to demonstrate an association between ETS exposure reduction and fewer EPACs, respiratory-related ED visits, and hospitalizations. These findings emphasize the importance of ETS exposure reduction as a mechanism to improve asthma control and morbidity. Potential policy implications include supporting ETS reductions and smoking cessation interventions for parents and caregivers of children with asthma. Research to identify the most cost-effective strategy is warranted.
| S-EPMC2763557 | biostudies-literature
Project description:IntroductionSecondhand smoke (SHS) exposure poses significant risks to children's health, yet global research on this issue requires further analysis to facilitate a comprehensive exploration of knowledge production and topic trends. This study aims to analyze the research outputs, cooperation and evolution on children's exposure to secondhand smoke.MethodsA scientometric approach was employed to analyze global research on adolescent secondhand smoke exposure. Data were gathered from scholarly databases and analyzed using CiteSpace software, which was used to assess publication trends, citation patterns, and research collaborations. The study examined publications, citations, interdisciplinary collaboration across countries, institutions, authors, and disciplines, as well as identifying research hotspots and emerging trends using burst detection and co-citation network analysis.ResultsThe analysis revealed significant growth in research on adolescent SHS exposure over recent decades, with the United States, United Kingdom, and China being the most productive countries in this field. Key journals in the substance abuse field serve as the primary venues for publishing relevant studies. Interdisciplinary collaborations have increased, particularly between health, policy, and social science disciplines. Research hotspots include the impact of SHS on children's physical and mental health, with a particular focus on behavioral and developmental issues. Additionally, e-cigarette and heated tobacco products have emerged as new concerns in recent research.ConclusionsThe study highlights the rapid expansion of research on SHS exposure among children, underscoring the growing recognition of its widespread health impacts. Interdisciplinary research collaborations are becoming more prevalent, and significant efforts are needed to address emerging issues such as e-cigarette exposure. These results underscore the need for further research to explore and address these evolving issues.
| S-EPMC11924373 | biostudies-literature
Project description:BackgroundSmokefree legislation may protect children from secondhand smoke (SHS) in the home from smoking parent(s). We examined the effect of the 2007 smokefree legislation on children's exposure to SHS in the home and maternal action to protect children from SHS exposure in Hong Kong.MethodsFamilies with a smoking father and a non-smoking mother were recruited from public clinics before (2005-2006, n = 333) and after the legislation (2007-2008, n = 742) which led to a major extension of smokefree places in Hong Kong. Main outcomes included children's SHS exposure in the home, nicotine level in mothers' and children's hair and home environment, mothers' action to protect children from SHS, and their support to the fathers to quit.ResultsFewer mothers post-legislation reported children's SHS exposure in the home (87.2% versus 29.3%, p<0.01), which was consistent with their hair nicotine levels (0.36 ng/mg versus 0.04 ng/mg, p<0.01). More mothers post-legislation in the last month took their children away from cigarette smoke (6.3% versus 92.2%; p<0.01) and advised fathers to quit over 3 times (8.3% versus 33.8%; p<0.01). No significant change was found in the content of smoking cessation advice and the proportion of mothers who took specific action to support the fathers to quit.ConclusionsSHS exposure in the home decreased and maternal action to protect children from SHS increased after the 2007 smokefree legislation. Maternal support to fathers to quit showed moderate improvement. Cessation services for smokers and specific interventions for smoking families should be expanded together with smokefree legislation.
| S-EPMC4148325 | biostudies-literature
Project description:IntroductionA significant proportion of children in the United States remain exposed to secondhand smoke (SHS). We are reporting on relationships observed between parental report of their child's SHS exposure in two groups of children (ages 2-5 years and 9-14 years) with a biological marker of long-term SHS exposure, hair nicotine.MethodsParticipants were healthy children recruited via convenience sampling for two age groups: 2-5 years and 9-14 years. The presence and amount of SHS exposure were assessed by both questionnaire and hair sampling for nicotine determination.ResultsA total of 115 participants were recruited (54 toddlers and 61 youth). The groups were similar in terms of demographics and reported SHS exposure. Hair nicotine levels were significantly different by age group, with toddlers having higher levels than youth. The most important independent determinants of hair nicotine were toddler age group, receiving Medicaid for health insurance, and number of smokers the subject was exposed to in 24 hr.ConclusionsOur findings suggest that young children who are insured by Medicaid have higher levels of hair nicotine, a biomarker of SHS exposure, when compared with an older age group. Further efforts to protect this vulnerable population and mitigate their lifetime risks of SHS exposure-related morbidities are warranted.
| S-EPMC3432275 | biostudies-literature
Project description:IntroductionExposure to secondhand smoke (SHS) is associated with morbidity and mortality from coronary heart disease, lung cancer, respiratory infections, asthma, sudden infant death syndrome, and other illnesses. Although substantial numbers of college students smoke, little is known about their exposure to SHS. This paper provides data on self-reported exposure of college students to SHS.MethodsA Web-based survey of a random sample of undergraduate students at 10 universities (eight public and two private) in North Carolina was conducted (N = 4,223).ResultsA total of 83% of students reported any exposure in the 7 days preceding the survey. Exposure in a restaurant or bar was the most common (reported by 65% of students), followed by exposure at home or in the same room as a smoker (55%) and in a car (38%). Being a daily or nondaily smoker, binge drinking, being a fraternity or sorority member or pledge, female gender, White race, and higher parental education levels were associated with exposure in one or more contexts. Students younger than 21 years were less likely to report exposure in a bar or restaurant and more likely to report exposure in cars or at home. The overall campus smoking rate was positively associated with reported exposure in cars, at home or in someone's room, and in any location.DiscussionCollege administrators, other policy makers, and tobacco control advocates should take steps to reduce smoking and concomitant exposure to SHS among college students.
| S-EPMC2711986 | biostudies-literature