Associations of household environmental tobacco smoke exposure with respiratory symptoms and utilisation of medical services in healthy young children in Hong Kong

Prevalence of electronic smoking exposure and tonsillectomy surgery in children

OBJECTIVE

The hypothesis tested was the negative impact of electronic smoke exposure on the developing of respiratory infection, specifically in the upper tract. In this study, we aimed to investigate if smoke exposure increased the number of tonsillectomy surgery in children compared to the hernia repair control group.

METHODS

The design of our study was retrospective case-control. We retrospectively reviewed medical records or children of up to 12 years of age that were admitted for tonsillectomy at King Abdullah University Hospital (KAUH) from January 2019 to December 2023 to determine exposure to both electronic and tobacco smoking. Records of hernia repair surgery children aged 12 and less at this facility were also retrospectively reviewed for both electronic and tobacco smoke exposure during the same period. Data was collected from medical records and phone call interviews with the patients and their families.

RESULTS

A total of 743 children were included, 64 % were males. The participants were divided into two groups: 439 had recurrent tonsillitis and needed tonsillectomy, the other 304 underwent hernia repair surgery (control group). Overall, 28 % of children were exposed to electronic smoking, 29 % to tobacco smoking, and 5.9 % to both. Electronic and tobacco smoke exposure was significantly evident among the tonsillectomy group compared to the hernia group. Logistic regression analysis showed that exposure to electronic smoking (OR: 2.74) and tobacco smoking (OR: 2.47) were significantly associated with an increased likelihood of undergoing tonsillectomy. However, patients with exposure to both smoking types did not show a significant link, while the absence of any smoking exposure was significantly associated to lower odds of tonsillectomy.

CONCLUSION

Children who underwent tonsillectomy had a higher likelihood of being exposed to tobacco or electronic smoking compared to children in the hernia repair surgery group.

Secondhand Smoke Exposure and Its Impact on Pediatric Lung Function, Aerobic Fitness, and Body Mass: Evidence from a Cross-Sectional Study

BACKGROUND

Several studies have documented the detrimental impacts of secondhand smoke (SHS) exposure to a range of pediatric respiratory conditions, including asthma, bronchitis, and reduced lung function. The aim of the study was to investigate the influence of SHS exposure on lung function, physical fitness, and body mass index (BMI) in children aged 10 to 14 years.

METHODS

This cross-sectional study included children aged 10 to 14 years at the Elementary School "Trilj" in Trilj, Croatia. Data on SHS exposure were collected using a questionnaire. Antropometric and spirometry measurements were performed. Physical fitness was assessed using the shuttle run (BEEP) test.

RESULTS

This study included 157 children, 89 (56.69%) boys and 68 (43.31%) girls. Children exposed to every day SHS in households had significantly lower values of forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC, peak expiratory flow (PEF) (p < 0.001) and higher z-score BMI levels (p = 0.018) in comparison to unexposed children. Logistic regression showed that children unexposed to SHS had higher odds for better results in the BEEP test (OR 62.45, 95% CI 21.26-179.24, p < 0.001). Children with poorer physical fitness, expressed by lower BEEP score levels, had significantly lower FVC, FEV1, FEV1/FVC, and PEF (p < 0.001).

CONCLUSIONS

Every day SHS exposure in children was associated with poorer lung function, higher BMI, and poorer physical fitness.

The association between indoor air quality and respiratory health symptoms among preschool children in Penang, Malaysia

A cross-sectional study was conducted among 126 preschool children aged 4-6 years in traffic, industrial, and suburban areas of Penang, Malaysia, to determine their exposure to indoor air pollutants and their associations with respiratory symptoms. A standardised and validated questionnaire was used to collect data on respiratory health symptoms among respondents. An indoor air quality assessment was conducted in selected preschools that included temperature, relative humidity, air velocity, volatile organic compounds (VOCs), and particulate matter (PM2.5, and PM10). There were significant differences in median concentrations of PM2.5, PM10 and relative humidity among study groups. Statistical analysis showed significant associations between air pollutants in preschool with respiratory symptoms. Factors that influenced the increased likelihood of cough and phlegm were linked to the increase in PM2.5 exposure. This study suggests regular classroom cleaning and routine maintenance of air conditioners to be done inside the preschools.

Prevalence of Wheezing and Its Association with Environmental Tobacco Smoke Exposure among Rural and Urban Preschool Children in Mpumalanga Province, South Africa

BACKGROUND

This study aimed to investigate the prevalence of wheezing and its association with environmental tobacco smoke exposure among rural and urban preschool children in Mpumalanga province, South Africa, an area associated with poor air quality.

METHODS

In this study, parents/caregivers of preschool children (n = 3145) completed a modified International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Data were analysed using multiple logistic regression models.

RESULTS

The overall prevalence of Wheeze Ever was 15.14%, with a higher prevalence in urban preschoolers than rural preschoolers (20.71% vs. 13.30%, p < 0.000). Moreover, the total prevalence of Asthma Ever was 2.34%. The prevalence was greater in urban preschoolers than in rural preschoolers (3.92% vs. 1.81%, p < 0.001). In the final adjusted model, both urban- and rural-area children who lived with one or more people who smoked in the same household (WE: OR 1.44, 95% CI 1.11-1.86) (CW: OR 2.09, 95% CI 1.38-3.16) and (AE: OR 2.49, 95% CI 1.12-5.54) were found to have an increased likelihood of having Wheeze Ever, Current Wheeze, and Asthma Ever as compared to those who lived with non-smokers.

CONCLUSIONS

The implementation of smoking limits and prohibition is crucial in areas that are frequented or utilized by children. Hence, it is imperative for healthcare providers to actively champion the rights of those who do not smoke within the society, while also endorsing legislative measures aimed at curtailing the extent of tobacco smoke exposure.

Monthly Motivational Interview Counseling and Nicotine Replacement Therapy for Smoking Parents of Pediatric Patients: A Randomized Controlled Trial

Background

Parental smoking is the dominant source of passive smoke exposure in the pediatric population. The current randomized controlled trial (RCT) study aimed to evaluate the effectiveness of a multi-component smoking reduction intervention in parental smoking reduction and children's environmental tobacco smoke exposure reduction in clinical settings.

Methods

A single-blinded, 6-month randomized controlled trial recruited smoking parents (N = 210) of children who attended the pediatric wards or clinics at the Prince of Wales Hospital. Participants allocated to the intervention group (n = 105) received monthly motivational interviews on smoking reduction with emphasis on health hazards related to children's passive smoke exposure, 8-week nicotine replacement therapy, and referral to smoking cessation service if the parents preferred. The control group (n = 105) received simple verbal advice on smoking cessation. Primary outcomes were parental urine cotinine validated and self-reported ≥50% smoking reduction rates at 6 months.

Results

Smoking parents in the intervention group had significantly more biochemically validated ≥50% smoking reduction than the control: 27.1 vs. 10.0% (OR = 3.34, 95% CI: 1.16-9.62, P = 0.02). The rate of self-reported ≥50% smoking reduction was also significantly higher in the intervention group than the control: 51.9 vs. 20.2% (OR = 4.40, 95% CI: 2.38-8.12, P < 0.001). For secondary outcomes, the rate of parental self-reported smoking cessation was higher in the intervention arm: 10.5 vs. 1.0% (OR = 12.17, 95% CI: 1.54-96.07, P < 0.001), however, no differences were detected in biochemically validated cessation and changes in children's passive smoke exposure between the groups.

Conclusion

Monthly smoking reduction counseling together with nicotine replacement therapy is more effective than simple verbal cessation advice in the smoking reduction for parents of pediatric patients. However, this study did not demonstrate differences in smoking cessation or reduction in children's passive smoke exposure with a 6-month follow-up. Achievement of a smoke-free environment remains challenging.

Trial Registration

Clinicaltrials.gov, identifier: NCT03879889.