Smoke exposure puts infants with family history of asthma/allergies at higher risk for severe infection

More evidence has surfaced that supports the war on smoking, especially if smokers have an infant in their household. A study published today in the June issue of Annals of Allergy, Asthma & Immunology, the scientific journal of the American College of Allergy, Asthma and Immunology (ACAAI), found that infants with a family history of allergic disease with lower respiratory tract infections, who are exposed to secondhand smoke are at risk for longer hospital stays.

An estimated 20 to 30 percent of otherwise healthy infants develop lower respiratory infections, such as bronchiolitis, annually. Of these, three percent are hospitalized.

"Respiratory infections in infants are common, but if the infant has a family history of respiratory issues such as asthma, they are at higher risk for infection and hospitalization," said allergist Meghan Lemke, MD, ACAAI member and lead study author. "Our research found that infants with a family history of allergic disease who are also exposed to secondhand smoke had a 23 percent longer hospital stay than those without secondhand smoke exposure."

Researchers examined 451 mothers and infants enrolled in a study focusing on childhood asthma and atopic disease outcomes associated with viral respiratory infections. In this group, 57 percent of infants were exposed to secondhand smoke. While 36 percent had a mother with atopic disease and an allergy, and 68 percent had an immediate relative with an allergic disease.

"Infants that are hospitalized for bronchiolitis have up to a 30 percent chance of developing persistent wheezing or asthma within the first decade of life," said allergist James Sublett, MD, chair of the ACAAI Indoor Environment Committee. "Secondhand smoke is extremely harmful to children with asthma and other respiratory illnesses, and has been shown to contribute to uncontrolled asthma."

According to the Centers for Disease Control and Prevention (CDC), secondhand smoke contains more than 7,000 chemicals, hundreds of which are toxic and 70 that can cause cancer.

"Secondhand smoke can trigger asthma attacks in small children, which can be life-threatening," said Dr. Sublett. "It is critical that parents and other family members never smoke around children, young or old, especially inside of the home and car where smoke can linger."

Seven million American children have asthma, a disease that is a leading cause of missed school days and 456,000 hospitalizations in the United States annually. Asthmatics under the care of a board-certified allergist have a 60 to 89 percent reduction in hospitalizations.

Smoke-free laws linked to a rapid decrease in hospitalizations and heart attack deaths

Smoke-free legislation was associated with substantially fewer hospitalizations and deaths from heart and respiratory diseases, according to research in the American Heart Association journal Circulation.

Researchers reviewed 45 studies covering 33 smoke-free laws at the local and state levels around the United States and from countries as varied as Uruguay, New Zealand and Germany and found:

• Comprehensive smoke-free laws were associated with a rapid 15 percent decrease in heart attack hospitalizations and 16 percent decrease in stroke hospitalizations. 
• Smoke-free laws were also rapidly followed by a 24 percent decrease in hospitalizations for respiratory diseases, including asthma and chronic obstructive pulmonary disease.
• The most comprehensive laws — those covering workplaces, restaurants and bars — resulted in the highest health benefits.

"The public, health professionals and policy makers need to understand that including exemptions and loopholes in legislation – such as exempting casinos – condemns more people to end up in emergency rooms," said Stanton Glantz, Ph.D., senior study author and director of the Center for Tobacco Control Research and Education at the University of California, San Francisco. "These unnecessary hospitalizations are the real cost of failing to enact comprehensive smoke-free legislation."

The findings support the American Heart Association's position that smoke-free laws should be comprehensive and apply to all workplaces and public environments, including restaurants, bars and casinos. The analysis also is consistent with other studies that have found smoke-free laws were followed by significant decreases in acute heart attack and other cardiac-related hospital admissions.

"Stronger legislation means immediate reductions in secondhand smoke-related health problems as a byproduct of reductions in secondhand smoke exposure and increases in smoking cessation that accompany these laws," Glantz said. "Passage of these laws formalize and accelerate social change and the associated immediate health benefits."