Association of secondhand smoke exposure with asthma symptoms, medication use, and healthcare utilization among asthmatic adolescents

ABSTRACT

Objective: To investigate the association between secondhand smoke exposure (SHSe) and asthma symptoms, medication use, and emergency department (ED)/urgent care (UC) utilization among adolescents. Methods: We performed a secondary cross-sectional analysis of Population Assessment of Tobacco and Health Study Wave 2 (2014–2015) including asthmatic adolescents (N = 2198). Logistic regression models and Poisson regression models were built. Results: Participants with SHSe ≥1 hour in the past 7 days were at increased risk of reporting shortness of breath and harder to exercise aOR, 1.22; 95% CI, 1.04–1.43), wheezing (aOR, 1.26; 95% CI, 1.01–1.56), wheezing disturbing sleep (aOR, 1.88; 95% CI, 1.35–2.63), wheezing during/after exercise (aOR, 1.41; 95% CI, 1.19–1.66), wheezing limiting speech (aOR, 2.11; 95% CI, 1.55–2.86), dry cough at night (aOR, 1.86; 95% CI, 1.54–2.24), and asthma symptoms disturbing sleep (aOR, 2.25; 95% CI, 1.81–2.79). Participants with SHSe ≥1 hour were more likely to take asthma medications (aOR, 1.25; 95% CI, 1.03–1.52), including steroids (aOR, 1.86; 95% CI, 1.19–2.91), oxygen therapy (aOR, 2.88; 95% CI, 1.82–4.54), and controlling medications (aOR, 1.50; 95% CI, 1.24–1.82). Symptoms and medications varied by living with a smoker and home SHSe. Participants with SHSe were at increased risk of having a higher number of asthma attacks that required steroid use. Participants who lived with a smoker and had home SHSe were at increased risk of having higher ED/UC visits for asthma. Conclusions: SHSe reduction efforts are needed for asthmatic adolescents, and EDs/UCs are promising venues.

KEYWORDS:

• Adolescence
• asthma symptoms
• environmental tobacco smoke exposure
• epidemiology
• secondhand smoke
• tobacco abuse
• urgent care

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Additional information

Funding

This study was funded by the National Institute on Drug Abuse (NIH Grant Number 1K01DA044313) and Eunice Kennedy Shriver National Institute of Child Health and Human Development (NIH Grant Number 1R01HD083354).