No-smoking rules not common enough for asthmatic children

Urban children with persistent asthma living in homes with smokers are 10 times less likely to be protected by a smoking ban in the home and car than asthmatic children living with no smokers, according to a new study by researchers at the University of Rochester Medical Center.

The study, published in the March-April issue of Ambulatory Pediatrics, shows that the message has not reached every parent that any secondhand smoke exposure for children - especially those suffering from asthma - is detrimental to their health. Parents and caregivers may be trying to limit smoke exposure by smoking in a different room or by opening a window in the car, but these strategies aren't very effective.

"Of course, the best case scenario is if the parents or guardians can quit smoking," said lead author Jill Halterman, M.D., M.P.H., assistant professor at Golisano Children's Hospital at Strong. "But that's not always immediately possible. Another option is for parents to institute a "no-smoking" rule in the home and the car, and allow no exceptions to this rule. It is best if smokers always go outside to smoke, and this strategy may also help the parents to eventually quit."

The study surveyed 231 parents of children with persistent and severe asthma at three Rochester pediatric practices. Almost half of the children lived with a smoker. Among all the families surveyed, only 64 percent had complete "no-smoking rules" for the home and car with no exceptions, and among the homes with smokers only 40 percent had such a rule. Children with severe asthma symptoms were no more likely to be protected by a no smoking rule than those with less severe symptoms.

Most caregivers surveyed said their health care providers asked them about smoke exposure in the home, but only 40 percent said they had been asked about exposure in the car - where concentration is higher than in the home - and few said they were offered resources to help them quit smoking.

"We, as health care providers, can do more to help parents understand better how to limit their children's exposure to secondhand smoke. If parents are having trouble quitting, we can find them help. If caregivers want to limit their child's exposure, we can talk about strategies to reducing exposure in the home and the car," Halterman said.