Please use this identifier to cite or link to this item: https://doi.org/10.1136/tobaccocontrol-2015-052383
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dc.titleTobacco smoke exposure and respiratory morbidity in young children
dc.contributor.authorSnodgrass, A. M.
dc.contributor.authorP. T. Tan
dc.contributor.authorS. E. Soh
dc.contributor.authorA. Goh
dc.contributor.authorL. P. Shek
dc.contributor.authorH. P. van Bever
dc.contributor.authorP. D. Gluckman
dc.contributor.authorK. M. Godfrey
dc.contributor.authorY. S. Chong
dc.contributor.authorS. M. Saw
dc.contributor.authorK. Kwek
dc.contributor.authorO. H. Teoh
dc.date.accessioned2017-04-19T08:59:31Z
dc.date.available2017-04-19T08:59:31Z
dc.date.issued2015
dc.identifier.citationSnodgrass, A. M., P. T. Tan, S. E. Soh, A. Goh, L. P. Shek, H. P. van Bever, P. D. Gluckman, K. M. Godfrey, Y. S. Chong, S. M. Saw, K. Kwek, O. H. Teoh (2015). Tobacco smoke exposure and respiratory morbidity in young children. Tobacco control 25 (e2) : e75-e82. ScholarBank@NUS Repository. https://doi.org/10.1136/tobaccocontrol-2015-052383
dc.identifier.issn09644563
dc.identifier.issn14683318
dc.identifier.urihttp://scholarbank.nus.edu.sg/handle/10635/135329
dc.description.abstractObjective Secondhand smoke exposure is a potentially preventable cause of significant respiratory morbidity in young children. Our study aimed to quantify respiratory morbidity in young children exposed to secondhand smoke to identify potentially modifiable factors. Materials and methods This study was embedded in a prospective birth cohort study of pregnant women and their children from fetal life onwards in Singapore (Growing Up in Singapore Towards healthy Outcomes, or GUSTO). Data on prenatal, antenatal and postnatal active and secondhand tobacco smoke exposure were obtained by an investigator-administered questionnaire for the periods before pregnancy, at 26–28 weeks’ gestation and 24 months after delivery. Data on respiratory morbidity (wheezing episodes, croupy cough, nebuliser use, snoring) and other morbidity (fever, hospitalisation, ear infection) of the child was collected at week 3 and at months 3, 6, 9, 12, 15, 18 and 24 after delivery. Information on parental atopy and potential confounders such as socioeconomic status and maternal educational level were also obtained. Statistical analysis of the data was performed to quantify any significant differences in incidence of respiratory morbidity in children exposed to tobacco smoke in utero and postdelivery, compared with those in smoke-free environments. Results Women who smoked regularly prior to pregnancy comprised 12.5% (n=155) of the study population; this number fell to 2.3% (n=29) during pregnancy. Mothers exposed to secondhand smoke in the household before pregnancy comprised 35.7% of the study population (n=441) and 31.5% (n=389) were exposed during pregnancy. Postnatally, the prevalence of secondhand tobacco smoke exposure from birth to 2 years of age was 29% (n=359). Participants of Malay ethnicity (p<0.001), mothers with no or primary level education (p<0.001) and mothers with low socioeconomic status (p<0.001) had the highest exposure to tobacco smoke. Offspring secondhand smoke exposure at home by 12 months and by 24 months of age was associated with an increase in hospital admissions due to respiratory disease (RR 1.89, 95% CI 1.02 to 3.50, p=0.04 by 12 months and RR 1.64, 95% CI 1.05 to 2.55, p=0.03 by 24 months) as well as all-cause hospitalisation (RR 1.57, 95% CI 1.14 to 2.17, p=0.01 by 12 months and RR 1.49, 95% CI 1.17 to 1.90, p=0.001 by 24 months), adjusting for parental atopy and child atopic dermatitis. Participants exposed to secondhand smoke by 12 months postdelivery had a significantly increased risk of having at least one wheezing episode (RR 1.71, 95% CI 1.38 to 2.11, p<0.001). Conclusions Secondhand smoke exposure during the prenatal and postnatal periods is associated with increased respiratory morbidity in children. Opportunistic screening and targeted smoking cessation counselling for parents at child hospital admissions and well-child outpatient visits, as well as preconception smoking cessation counselling for future pregnancies, may be beneficial to protect the child from negative health impacts. © 2016, BMJ Publishing Group. All rights reserved.
dc.description.urihttp://libproxy1.nus.edu.sg/login?url=http://dx.doi.org/10.1136/tobaccocontrol-2015-052383
dc.publisherBMJ Publishing Group
dc.typeArticle
dc.contributor.departmentDUKE-NUS GRADUATE MEDICAL SCHOOL S'PORE
dc.contributor.departmentOBSTETRICS & GYNAECOLOGY
dc.contributor.departmentPAEDIATRICS
dc.contributor.departmentSAW SWEE HOCK SCHOOL OF PUBLIC HEALTH
dc.description.doi10.1136/tobaccocontrol-2015-052383
dc.description.sourcetitleTobacco control
dc.description.volume25
dc.description.issuee2
dc.description.pagee75-e82
dc.identifier.isiut000391438200003
dc.description.seriesGUSTO (Growing up towards Healthy Outcomes)
dc.published.stateUnpublished
dc.grant.idNMRC/TCR/004-NUS/2008
dc.grant.idNMRC/TCR/012-NUHS/2014
dc.grant.fundingagencyNMRC, National Medical Research Council
dc.grant.fundingagencyNRF, National Research Foundation Singapore
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