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Kids, asthma and secondhand smoke at home = twice as many hospitalizations

Parents who allow their children with asthma to be exposed to second hand smoke (SHS) at home need to know the risk is high their child will be hospitalized. In fact, the risk is nearly double that for kids with asthma who are not exposed to SHS.

An article in the Annals of Allergy, Asthma and Immunology, the scientific publication of the American College of Allergy, Asthma and Immunology (ACAAI), reviewed 25 studies investigating smoking exposure at home. More than 430,000 children were included, with a mean age of 7.6 years of age. The majority - 96 percent - of the studies investigated smoking exposure at home.

"Previous studies have linked SHS exposure with increased asthma prevalence, poorer asthma control and increased symptoms," said Zhen Wang, PhD, lead author of the study. "We wanted to quantify the strength of the association, and to show just how much greater the risk is of hospitalization for kids with asthma who are exposed to SHS in the home."

The article says children are perhaps more likely to be negatively affected by cigarette exposure than adults due to the immaturity of their lungs and immune systems. In addition, toxins such as SHS reduce lung growth rates, even though details of how this occurs aren't entirely known.

"The results of this review serve as a reminder to parents of just how dangerous it is to expose their children to SHS," said allergist Avni Joshi, MD, ACAAI member and senior author of the article. "Allergists are trained to work with both children and adults to get their asthma under control. Controlled asthma means fewer emergency room visits, hospitalizations and proper use of long-term controller medications. An allergist can also help avoid over-reliance on quick-relief medications and work on modifiable risk factors for poor asthma outcomes like assessing and addressing tobacco exposures. Some allergists have developed family-centered tobacco control programs which address parents' tobacco use during a clinic visit for a child with asthma."

Only a small percentage of patients who could benefit from specialty care are referred to an allergist and the majority of patients - including a disproportionate number of children - do not receive adequate care to control asthma, its debilitating symptoms and the increased costs of uncontrolled asthma.

According to the ACAAI Asthma Management and the Allergist: Better Outcomes at Lower Cost, asthma care provided by allergists is associated with better patient outcomes across a range of important markers. Compared to care provided by generalists, patients getting care from an allergist have fewer hospitalizations and emergency room visits, higher ratings for the quality of care, fewer restrictions in activities and improved physical functioning. The ACAAI Scope and Impact of the Asthma Epidemic infographic contains valuable asthma management information.

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