United States: Children exposed to passive smoking more often admitted to hospital

According to research conducted by the University of Cincinnati[1], children exposed to tobacco smoke are more often admitted to emergency rooms and hospitalized than unexposed children, contributing to a heavy toll on the country's health care system.

Exposure to tobacco smoke is a significant contributor to rising health care costs in the United States. Despite major progress in tobacco control and historically low smoking prevalence, approximately 40% of children remain exposed to tobacco smoke in the country. Children exposed to tobacco smoke are at increased risk for respiratory infections, ear infections, asthma, and sudden infant death syndrome. As such, reducing childhood exposure to secondhand smoke has been identified by the World Health Organization[2] as a global public health priority.

The study analyzed electronic medical records of 380 children exposed to tobacco smoke and 1,140 children who were not exposed. Ages covered in both groups ranged from birth to 17 years of age. Exposure to secondhand smoke was defined as the child inhaling smoke from a lit tobacco product that the child did not consume, and the child inhaling particles of tobacco smoke embedded in the room (thirdhand smoking).

Exposure to passive smoking represents an additional cost for the health system

According to the study results, the percentage of children having at least one emergency care visit in the past 12 months was higher in the group of children exposed to tobacco smoke (52.4%) than in the group of children not exposed (45.1%). Overall, children in the "exposed to tobacco smoke" group had almost twice the risk of hospital admissions compared to those in the "unexposed" group. The average cost of a pediatric emergency department visit was significantly higher: $$1,137 on average for a child exposed to tobacco smoke, compared to $$1,1019 on average for a child not exposed, a difference of $118$.

Studies generally suggest that smoking accounts for 6 to 14%—with most estimates between 6 and 8%—of total annual health care expenditures in the United States.[3]. The productivity loss attributed specifically to premature deaths related to exposure to tobacco smoke is estimated at approximately $1.4 trillion.[4], but this amount is largely underestimated because it does not take into account the value of lost productivity and quality of life related to exposure to tobacco smoke. The available literature has not specifically studied children's exposure to tobacco smoke and the overall costs of emergency department and pediatric care. Previous research evaluated only patients with asthma and did not consider other conditions. However, a 2008 study estimated that in children up to age 4, exposure to tobacco smoke was associated with $117 million in health care costs for respiratory conditions[5].

Better informing parents about the risks associated with exposure to tobacco smoke

The study recommends that health professionals develop targeted prevention for parents and address the risks of children's exposure to tobacco smoke during any pediatric consultation. The main source of exposure to tobacco smoke in children is parental smoking. Therefore, interventions to reduce children's exposure to tobacco smoke focus on practical modalities to eliminate the child's exposure to tobacco smoke (e.g. by ensuring that parents do not smoke in the car), and by supporting parents' smoking cessation with relapse prevention.

Pediatric emergency departments are not currently used to support smoking cessation among parents who smoke. According to one study, in the United States, more than 50% of parents who smoke who present to pediatric emergency departments report being motivated to quit, receptive to cessation interventions, and aware that exposure to tobacco smoke is harmful to their child's health[6]Parents are more receptive to prevention messages when visits are directed at their children rather than them.

Keywords: United States, Secondhand smoke, Thirdhand smoke, Children, Health, Cost©Tobacco Free Generation

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[1] Ashley L. Merianos,Roman A. Jandarov,Judith S. Gordon,Michael S. Lyons,E. Melinda Mahabee-Gittens, Healthcare resources attributable to child tobacco smoke exposure, February 23, 2021 doi.org/10.1371/journal.pone.0247179[2] World Health Organization. WHO Report on the Global Tobacco Epidemic 2013: Enforcing Bans on Tobacco Advertising, Promotion and Sponsorship. Geneva, Switzerland: World Health Organization Tobacco Free Initiative; 2013.[3] Congressional Budget Office, Raising the Excise Tax on Cigarettes: Effects on Health and the Federal Budget, June 2012[4] Mason J, Wheeler W, Brown MJ. The economic burden of exposure to secondhand smoke for child and adult never smokers residing in US public housing. Public Health Rep. 2015;130:230–244. pmid:25931627[5] Hill SC, Liang L Smoking in the home and children's health Tobacco Control 2008;17:32-37.[6] Mahabee-Gittens, EM; Khoury, JC; Ho, M.; Stone, L.; Gordon, JS A smoking cessation intervention for low-income smokers in the ED. Am. J. Emerg. Med. 2015, 33, 1056–1061National Committee Against Smoking |