Provider Counseling About Secondhand Smoke Exposure for Urban Children With Persistent or Poorly Controlled Asthma

Abstract

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.

Linkage of Maternal Caregiver Smoking Behaviors on Environmental and Clinical Outcomes of Children with Asthma: A Post-Hoc Analysis of a Financial Incentive Trial Targeting Reduction in Pediatric Tobacco Smoke Exposures

“…Children with asthma in lower-income families are exposed to higher tobacco smoke exposures (TSE) that have been linked with worsened asthma severity [ 1 , 2 , 3 ]. An estimated one-third of these exposures occur in the home setting of which the primary caregiver is suspected to be a predominant source [ 4 , 5 ]. The primary caregiver who smokes is classically viewed as a primary target of TSE reduction, as evidenced by public health media campaigns detailing the harms of tobacco smoke and by pediatricians who use in-office visits to directly inform caregivers of the link between TSE and asthma [ 6 , 7 ].…”