Asthma: Saving Children from Smoke

Asthma, or inflamed airways, is the most common cause of childhood hospitalizations. The disease increased by 75 percent in the U.S. between 1980 and 1994 and is highest among preschool boys and low-income minority youth.

Asthma is caused by environmental triggers including cat dander, cockroaches, dust mites and tobacco smoke. The World Health Organization estimates that 50 percent of the world's children are threatened by environmental tobacco smoke. Almost one-half of American children live with a smoker, and one-fifth of asthmatic children experience more severe symptoms due to tobacco smoke. It is therefore imperative that families reduce their asthmatic children's exposure to environmental irritants. When researchers at the University of British Columbia advised parents to reduce their newborn's exposure to asthma triggers, the number of infants with asthma decreased by 44 percent. Unfortunately, these improvements are not often sustained.

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Parents can take measures to avoid smoking around their children, even if they are unable to quit smoking altogether. These include smoking outside or away from their child. Researchers at the University of North Carolina found that nurses can be especially instrumental in modifying the behavior of those parents whose children suffer pulmonary illnesses. My colleagues and I found that health education for parents reduced asthmatic children's exposure to environmental tobacco smoke. These decreases were sustained for two years.

Researchers at the Harvard School of Public Health recorded similar benefits after educating the parents of healthy children. We also found that counseling as well as asthma-management education reduced reported exposure to environmental tobacco smoke in Latino children.

Finally, researchers at the Palo Alto Medical Foundation Research Institute in California found that asthmatic children were less likely to need medical care after nurses provided parents with counseling.

These studies provide convincing evidence that behavioral changes or "shaping procedures" directed at parents can protect asthmatic and healthy children alike.

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