Secondhand smoke exposure increases odds of hospital asthma readmission for children

A new study shows that exposure to secondhand smoke at home or in the car dramatically increases the odds of children being readmitted to the hospital within a year of being admitted for asthma.

The study, published in the journal Pediatrics, raises the possibility that measurement of tobacco exposure could be used in clinical practice to target smoking cessation efforts and reduce the likelihood of future hospitalizations.

To determine tobacco exposure, the researchers at Cincinnati Children's Hospital Medical Center and Penn State Milton S. Hershey Children's Hospital measured cotinine in the blood and in saliva of more than 600 children. Cotinine is a substance produced when the body breaks down nicotine and provides a scientific assessment of tobacco exposure.

"The ability to measure serum and salivary cotinine levels presents the possibility of an objective measure that can be obtained when a child is seen in the emergency department or in the hospital and may be used to predict future hospitalizations," says Robert Kahn, MD, MPH, associate director of general and community pediatrics at Cincinnati Children's and senior author of the study.

"Such a measure for exposure to could be used to target specific interventions at caregivers of those children before discharge from the hospital. Several interventions, including parental counseling and contact with the , could be adopted in ."

The study is part of the Greater Cincinnati Asthma Risks Study, which seeks to understand the causes of hospital readmission, particularly for low income and . The researchers studied children between the ages of 1 and 16 admitted to Cincinnati Children's between August 2010 and October 2011. Serum and salivary cotinine levels were taken during their hospital stay, and their primary caregivers were asked about tobacco exposure. All children were followed for at least 12 months to see if they were readmitted to the hospital.

The researchers found that there was no correlation between caregiver report of and readmission. But a more scientific analysis of actual secondhand exposure via measurement of cotinine in the blood and saliva demonstrated a readmission risk in children exposed to more than twice that of children not exposed.

"Of the 619 in the study, 76 percent were covered by Medicaid," says Judie Howrylak, MD, PhD, a physician at Hershey Children's and lead author of the study. "Certainly there could be a financial incentive for insurance companies to help caregivers quit smoking, rather than pay the downstream costs of a future asthma readmission."

Related Stories

Living with a smoker may raise blood pressure in boys

May 01, 2011

Exposure to secondhand smoke, even at extremely low levels, is associated with increased blood pressure in boys, according to new research being presented Sunday, May 1, at the Pediatric Academic Societies (PAS) annual meeting ...

Children as young as seven affected by parents smoking

Jul 24, 2013

A new study out today (24 July) shows that children as young as seven had elevated levels of cotinine (a by-product of nicotine) in their blood if their mother smoked, particularly children whose mothers smoked ten cigarettes ...

Recommended for you

PCV13 recommended for 6- to 18-year-olds at high risk

14 hours ago

(HealthDay)—Pneumococcal conjugate vaccine 13 (PCV13) should be administered to certain children aged 6 through 18 years who are at high risk of invasive pneumococcal disease (IPD), according to a policy ...

Brain abnormality found in group of SIDS cases

Nov 25, 2014

More than 40 percent of infants in a group who died of sudden infant death syndrome (SIDS) were found to have an abnormality in a key part of the brain, researchers report. The abnormality affects the hippocampus, ...

Eczema cases rising among US children

Nov 24, 2014

(HealthDay)—A growing number of children are being diagnosed with the allergic skin condition eczema—but it can usually be eased with topical treatments, according to a new report.

Adult-sized ATVs deadly for kids, report shows

Nov 24, 2014

(HealthDay)—Santa might think twice about giving kids an all-terrain vehicle this year. Riding ATVs poses high risks of injury or death for children and teens, with dangers differing by age, a new U.S. ...

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.