Secondhand Smoking Tied to Increased Risk of Hospital Readmissions of Kids for Asthma

Exposure to secondhand smoking doubles the chances of children with asthma being readmitted to hospital within a year, according to a study reported in journal Pediatrics.

A new study found that a child's exposure to secondhand smoking either in a car or at home increases the odds of being readmitted to hospital within a year for recurrence of asthma.

The study, conducted by researchers at the Cincinnati Children's Hospital Medical Center and Penn State Milton S. Hershey Children's Hospital, says that clinicians should measure exposure to tobacco in asthma patients and use it to persuade people to stop smoking and not expose vulnerable people to harm,. This would also bring down chances of future hospitalization.

To measure tobacco exposure, the researchers calculated the levels of cotinine in the blood as well as saliva of more than 600 kids of ages 1 to16 years. Since cotinine is a substance that is produced when the body breaks down nicotine, it is a strong scientific assessment for exposure to tobacco. The kids were admitted to the Medical Center between August 2010 and October 2011 and were followed for 12 months. Also the primary caregivers were enquired on exposure to tobacco.

"The ability to measure serum and salivary cotinine levels presents the possibility of an objective measure that can be obtained when a child is seen in the emergency department or in the hospital and may be used to predict future hospitalizations," says Robert Kahn, MD, MPH, associate director of general and community pediatrics at Cincinnati Children's. "Such a measure for exposure to tobacco smoke could be used to target specific interventions at caregivers of those children before discharge from the hospital. Several interventions, including parental counseling and contact with the primary care physician, could be adopted in clinical practice."

The study found no association between the reported use of tobacco by caregivers and hospital readmissions. This led them to look into other reasons behind hospital readmission, mostly in low income and minority children. A more detailed scientific analysis of secondhand exposure through cotinine measurement of blood and saliva samples revealed that children exposed to secondhand smoke were twice likely to be readmitted than those not exposed to tobacco. 

Among the 619 subjects studied, nearly 76 percent were covered by Medicaid. The researchers are further studying the effect of traffic pollution on readmission rates and racial and economic diversity in asthma-related readmissions of children.