Ashley Merianos, PhD, a health services researcher at University of Cincinnati, talks about how exposure to adults’ tobacco smoke is taking a high toll on kids’ health and the healthcare system.
Can you give me a quick overview of what you and your colleagues have been looking at?
MERIANOS: Despite substantial progress in tobacco control efforts in recent years leading to an adult cigarette smoking rate at an all-time low of 14 percent, about thirty five percent of children remain exposed to tobacco smoke nationwide. We find higher rates of up to 48 percent among children seeking care at the pediatric emergency department and urgent care visit. So, our study assessed the health and economic burden that child tobacco smoke exposure places on the pediatric emergency department and urgent care setting.
What kind of health impacts are you seeing kids in the emergency room? Is it lung related or cold flu related instances or is it across the board?
MERIANOS: We find that children exposed to tobacco smoke have higher rates of respiratory symptoms, for example, cough, as well as illnesses such as asthma. We also see a lot of prematurity histories in children exposed to tobacco smoke. So, they do have a higher respiratory as well as other health issue burden. Our study looked at visits related to just overall respiratory illness.
Were there any dollar figures put to that? How much is that costing the system?
MERIANOS: We found that children exposed to tobacco smoke had an average of almost $120 more per each pediatric emergency department visit compared to unexposed children who do not live with a smoker.
I know it sounds like a simple question, but is this information that’s been tough to get out? You said all the information is out there. The rate of adult smokers is going down but there’s still that secondhand exposure. Is that information, is there a disconnect? It’s not getting out there.
MERIANOS: Yes. I think that there needs to be an increase in awareness as well as education of freely available resources for adults who want to quit smoking. We know that one in two adults who smoke try to make a quit attempt every year. And the success rate is about seven and a half percent. We really need to make sure that those who are interested in quitting are getting the resources that they need.
Can you tell me a little bit about how you went about getting the information for that and over what period of time?
MERIANOS: We compared children exposed to tobacco smoke who live with a smoker compared to children who did not live with a smoker and were unexposed. We got that information from a randomized controlled trial intervention. So, we assessed children before they got any, before their parents got any smoking cessation materials. We assessed their health care visit utilization from that visit forward for 12 months. We looked at the baseline visit compared to 12 months later. What we found was children who were exposed to tobacco smoke had increased urgent care utilization as well as hospital admissions over that 12-month period.
Ashley, I kind of asked this question, but I’ll ask it in a different way. What are the implications from this finding – from these findings?
MERIANOS: We need to encourage not only voluntary home and car smoking bans, but we also need to make sure that parents as well as other household members are getting the resources that they need if they’re interested in quitting smoking to not only protect their own health but also their child’s health.
You’d mentioned something interesting. Kids are a captive audience. You know they’re around this all the time. Where are they being exposed the most? Is it in the car? Did you get any other additional details from the survey?
MERIANOS: Yes. Children are mostly exposed in their own homes as well as cars, especially due to the tobacco control efforts that have led to, for example, no smoking rules in public places from restaurants to schools. We are finding that children are more likely to be exposed in their homes. We’re also finding that children who live with a smoker who does not smoke inside the home are still at risk for thirdhand tobacco smoke. We’re also finding that there are issues associated with thirdhand smoke only in children as well.
Can you describe for our viewers who have heard of secondhand and not thirdhand, what is that exposure?
MERIANOS: So secondhand smoke is when you’re inhaling cigarette smoke from a lit tobacco product. Thirdhand smoke is the residue that remains in the environment well after the cigarette smoking has ceased. Where secondhand smoke is inhaled, thirdhand smoke is inhaled and it can also be dermally absorbed as well as ingested. What we’re finding is that in children’s homes of smokers that when they have a ban, there’s still a lot of nicotine found in their homes as well as on their hands when they come into the emergency department when no one around them is smoking.
So, they’re still touching it. They’re still absorbing it through their skin. Does this pave the way for better intervention or better education, and can you speak to that a little bit?
MERIANOS: Yes. We really need to also focus on tobacco smoke exposure reduction as well as remediation intervention, so really helping those who, for example, want to quit but also want to make sure that they’re getting rid of thirdhand smoke, that they have the resources to do so and know where to turn.
Interview conducted by Ivanhoe Broadcast News.
END OF INTERVIEW
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