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NEW YORK (Reuters Health) - Secondhand exposure to cigarette smoke is an asthma trigger in children and a new study shows that smoking by the primary caregiver and daycare provider are important sources of smoke exposure in children with asthma.
In the study, children with asthma who were exposed to secondhand smoke "had as much smoke exposure as if their mother smoked," Dr. Harold J. Farber told Reuters Health.
Children with a double hit of smoke exposure - from both their daycare provider and primary caregiver - had the highest levels of nicotine metabolites in their urine, said Farber, of Texas Children's Hospital in Houston.
Farber and colleagues tested urine samples of 519, 3- to 12-year-old children with asthma for nicotine metabolites indicative of exposure to secondhand smoke. They also asked the children's parents to recount their child's exposures to secondhand smoking in their home and in other areas where the children spend significant time.
More than three-quarters of the children studied had poorly controlled asthma, the researchers note in the medical journal Chest. Sixty-three percent of the children had a non-smoking primary caregiver.
Tests showed the lowest nicotine metabolite levels among the children with no reported exposures to secondhand smoke -- about half the study population.
Caregiver reports for the remaining youngsters showed that those passively exposed to tobacco smoke either at home or at daycare had similar levels of nicotine metabolites, and these levels were markedly higher than those of unexposed kids.
Children passively exposed to tobacco smoke at home and daycare had the highest overall levels of nicotine metabolites.
"Parents who smoke frequently underestimate the exposure of their children," Farber told Reuters Health. But most primary caregivers are receptive to the idea of limiting exposures, research shows. This could be achieved by making sections of the home smoke-free or keeping kids away from smoke-exposed locations.
Farber suggests that health care providers caring for children with asthma offer parents smoking cessation help.
SOURCE: Chest, June 2008.
