Passive smoking exposure of sick children in Hong Kong

Abstract

1 This study aims to investigate the extent of passive smoking exposure of sick children in Hong Kong; their father' smoking behaviors and their mother' action to protect the child from environmental tobacco smoke (ETS).

2 This cross-sectional survey was the first phase of a randomized controlled trial on a health education intervention provided by nurses in the general paediatric wards of four major hospitals in Hong Kong. The subjects are non-smoking mothers of sick children admitted to hospital and with a smoking husband living together in the same household with the child. Eligible subjects completed a self-administered baseline questionnaire before entering into the trial.

3 All the 848 children whose mothers completed the questionnaire during December 1997 to April 1998 had a smoking father. They constituted about 24% (95% CI: 22.6-24.9%) of all the sick children during the same period. More than half of the children' fathers (55%; 51.6-58.3%) smoked 1-14 cigarettes per day and about 68% (64.7-71.0%) of them were daily smokers for over 10 years. Over half (53%; 49.4-56.2%) of the fathers smoked 1-14 cigarettes at home every day. About 21% of the fathers smoked near the child occasionally and 31% (27.4-33.6%) smoked 1-14 cigarettes near the child per day. About 16% of the children lived with more than one smoker (2-3). About 86% (83.3-88.0%) of the children had 1-3 smokers who smoked at home and 61% (58.1-64.7%) of them had 1-3 smokers who smoked near them every day. However, 70% ofthe children were reported by their mothers as exposed to ETS at home. This percentage (70%) was less than the percentage (86%) of smokers who smoked at home daily. About 31.1% of the mothers reported symptoms of coughing and running nose (20.6%) in their children when they were exposed to ETS. To protect the child from ETS exposure, 43% of the mothers requested the father not to smoke near the child, 33.1% requested the father to smoke less cigarettes and 31.5% advised the father to quit smoking.

4 In conclusion, sick children in Hong Kong are at risk of exposure to ETS, but not all mothers are aware of the health risks and their actions were inadequate. There is a critical need to promote awareness of ETS exposure and the health risks in the family in Hong Kong so as to reduce illness and hospital admission in children.

Keywords

passive smoking environmental tobacco smoke smoking children Hong Kong

References

1 United States Environmental Protection Agency . Office of Health and Environmental Assessment. Respiratory health effects of passive smoking: lung cancer and other disorders. Office of Research and Development, US Environmental Protection Agency. Washington DC: US Environmental Protection Agency , 1992.

2 US Department of Health and Human Services . The health consequences of involuntary smoking. A Report of the Surgeon General. U.S. Public Health Service, Washington DC , 1986.

3 Charlton A . Children and passive smoking: A review . I Family Practice 1994; 38: 267-273 .

4 Lam TH . Passive Smoking in Perspective . Med Toxicol Adv Drug Exper 1989; 4: 153-162 .

5 Greenberg RA et al. Passive smoking during the first year of life . American I Public Health 1991; 81: 850-853 .

6 Chilmonczyk BA et al. Association between exposure to environmental tobacco smoke and exacerbation of asthma in children . New Engl I Med 1993; 28: 1665-1669 .

7 Charlton A . Passive smoking and health risks to children: A review of the recent evidence. In: Aoki M. et al (eds.) Smoking and Health 1988; pp 271-274.

8 Action on Smoking and Health . Passive smoking: summary of new findings. Retrieved 25 June, 1998 from the World Wide Web. http://www.ash.org.uk/papers/passive.html

9 Report of the Scientific Committee on Tobacco and Health. Department of Health, UK , 1998.

10.

10 Lam TH et al. Respiratory symptoms due to active and passive smoking in junior secondary school students in Hong Kong . International I Epidemiology 1998; 27: 41-48 .

11.

11 Chung SF et al. A case control study on passive smoking and childhood hospitalization due to respiratory illnesses . Proc Hosp Authority Convent 1995, Hong Kong, 1995.

12.

12 Lam TH et al. Respiratory symptoms due to active and passive smoking in junior secondary school students in Hong Kong . International I Epidemiology 1998; 27: 41-48 .

13.

13 Neuspiel DR et al. Parental smoking and postinfancy wheezing in children: a prospective cohort study . Am J Public Health 1989; 79: 168-171 .

14.

14 Woodward A , Douglas RM , Graham NMH , Miles H . Acute respiratory illness in Adelaide children: breast feeding modifies the effect of passive smoking . J Epidemiol Community Health 1990; 44: 224-230 .

15.

15 Schmidt F . Passive smoking and lung function in asthmatic children . Clin Investigator 1993; 71: 67-68 .

16.

16 Hollis JF et al. Nurse-assisted counselling for smokers in primary care . Annu Internal Med 1993; 118: 521-525 .

17.

17 Macleod Clark J . Helping people to stop smoking: a study of the nurse' role . J Adv Nursing 1990; 16: 357-363 .

18.

18 Couriel J . Passive smoking and the health of children . Paediatric Respir Med 1993; 1: 12-15 .

19.

19 Meltzer S et al. Reduction of secondary smoke exposure in asthmatic children: parent counselling . J Asthma 1993; 30: 391-400 .