Secondhand Smoke Sends Kids to the ER

Children who live with smokers are far more likely to require healthcare for respiratory problems than children who are not exposed to tobacco smoke at home, a new study finds.

When researchers from the University of Arizona and the University of Cincinnati compared the use of healthcare resources among children exposed to tobacco smoke at home to kids who were not exposed to smoke, they found children exposed to secondhand smoke at home spent more time in emergency rooms and urgent care facilities than those who did not live with smokers.

“We need to tell parents that any level of tobacco smoke exposure is dangerous, and smoking outside, for example, does not protect their children.”

Each of the children in the study had been brought to a large hospital’s pediatric emergency department or urgent care for treatment, and researchers compared the health records of 380 children who were exposed to tobacco smoke at home and 1,140 children who were not exposed. The average age of the children was slightly under five years old.

Children who were exposed to tobacco smoke at home were more than 24 times more likely to be admitted to the hospital. They were more than seven times likelier to be given steroids during their hospital visit. Kids three years old or younger who were exposed to tobacco smoke were almost eight times more likely to need nasal suctioning.

Among children in both groups who had asthma, those exposed to tobacco smoke were more than 27 times more likely than those who were not to receive steroids. And they were almost 16 times more likely to receive albuterol.

Children who were exposed to tobacco smoke were almost six times more likely to have laboratory testing done and almost five times more likely to have x-rays taken.

Socioeconomic status was also associated with the likelihood of tobacco smoke exposure. Almost 75 percent of the children in the study had public insurance, an indicator of low income.

The team was surprised at how frequently children who were exposed to tobacco smoke were admitted to the hospital compared to those who were not exposed, and at how many healthcare resources such as testing and medication these children needed.

Emergency departments and urgent care facilities may offer smoking cessation interventions, but most don’t routinely screen families for tobacco smoke exposure or provide information about smoking cessation. This is a missed opportunity: a caregiver confronted with the effect smoking in the home has on their children’s health during a hospital visit might be more motivated to try to quit.

“Emergency care providers need to offer families the resources they need to reduce or eliminate tobacco smoke exposure they may not be receiving in other healthcare settings,” Ashley Merianos, lead author on the study, told TheDoctor.

Children who were exposed to tobacco smoke were more than 24 times more likely to be admitted to the hospital.

“We need to tell parents that any level of tobacco smoke exposure is dangerous, and smoking outside, for example, does not protect their children,” said Merianos, an associate professor at the University of Cincinnati School of Human Services.

The team is looking into developing an intervention that would be offered to pediatric emergency departments and urgent care providers. Patients and their families would be asked about tobacco smoke exposure regardless of the reasons why they came to the emergency department in the first place. Then, if the parents or caregivers are interested in quitting, tools to support smoking cessation could be made readily available.

The study is published in Pediatric Research.