Secondhand smoke and asthma: What are the effects on healthcare utilization among children?

- In-home smoke exposure doubled the odds of hospitalization among kids with asthma.
- In-home smoke exposure was not related to hospitalization among non-asthmatics.
- In-home smoke exposure was related to emergency department visits.
- Asthma was associated with increased utilization of all healthcare services.

ObjectiveThis study aims to examine the associations between asthma, secondhand smoke exposure and healthcare utilization in a nationally representative sample of children.MethodsData from 5686 children aged 0-11 years were analyzed. Healthcare utilization, asthma diagnosis and demographic information came from the 2001 and 2006 Medical Expenditure Panel Surveys. Secondhand smoke exposure was measured during the 2000 and 2005 National Health Interview Surveys. Multivariable regression models were used to determine the association between secondhand smoke exposure, asthma diagnosis and healthcare utilization (hospitalizations, emergency department visits, outpatient visits and prescription medication use).ResultsAsthma modified the relationship between secondhand smoke exposure and hospitalizations, as exposure more than doubled the odds of hospitalization among children with asthma but had no effect on children without asthma. Secondhand smoke exposure increased the odds by 37% of emergency room visits (P < 0.001), but was not associated with outpatient visits or medication use. Children with asthma had a higher odds of utilizing all healthcare services (P < 0.001).ConclusionsSecondhand smoke exposure was associated with a greater utilization of hospitals and emergency departments, and the effect on hospitalizations was most pronounced among children with asthma. Reducing secondhand smoke exposure would help to reduce the burden on the healthcare system, especially among children with asthma.