Too many asthmatic kids breathe smoke: report

NEW YORK (Reuters Health) - A "distressingly high" proportion of inner-city children with asthma are exposed to cigarette smoke at levels that could be harming their health, a study conducted in Chicago demonstrates.

More than two-thirds of the 8- to 14-year-olds in the study had levels of the nicotine byproduct cotinine in their saliva demonstrating that they were breathing enough second-hand smoke to affect their asthma, Dr. Rajesh Kumar of Children's Memorial Hospital in Chicago and colleagues found.

Kids with asthma living in inner cities are known to be at risk of complications due to tobacco exposure, and of becoming smokers themselves, the researchers note in the Journal of Allergy and Clinical Immunology. But information on how many asthmatic children are actually breathing second-hand smoke at home has been scarce.

To investigate, the researchers surveyed caregivers of 482 8- to 14-year-old children with asthma about tobacco use, and also tested the children's saliva for cotinine, an indicator of tobacco smoke exposure.

Nearly half of the caregivers said that there were smokers living in the household, while 31 percent admitted to smoking themselves. But the saliva tests revealed that roughly 68 percent of the children were exposed to tobacco smoke.

Among the children with caregivers who reported smoking, cotinine levels were nearly double those of the children whose caregivers didn't smoke. Having a smoker in the household also increased cotinine levels, but to a lesser degree.

Some of the second-hand smoke exposure may have been occurring outside the home, the researchers speculate, while some of the children may have been smokers themselves. "Regardless of the source," they say, "exposure in these children is much more prevalent than previously appreciated."

Identifying caregivers of asthmatic children who are smokers and providing "intense intervention" to help them quit could help reduce harm from asthma in poor inner city children, the researchers conclude.

SOURCE: Journal of Allergy and Clinical Immunology, October 2008.