哮喘联盟

   摘要
   简介:二手烟暴露（SHS）仍然是一个公共卫生问题。很少有关于健康儿童和哮喘儿童的照顾者在吸烟行为、风险感知和SHS方面差异的研究。
   方法：共纳入738例每日吸烟的美国受试者，443例哮喘儿童的照顾者（CG-AC）和295例健康儿童的照顾者（CG-HC）；50.9% 白种人，25%黑人, 15% 拉丁美洲人。收集横断面数据。使用自报和被动剂量测定法检测SHS。
   结果：与CG-HC相比，CG-AC很少有儿童暴露于SHS的风险因素（更低的尼古丁依赖，更高的戒烟动力，更好的认识到戒烟给儿童带来的好处和更低的乐观偏差，P<0.05）。虽然两组中超过95%的家庭SHS均可检测，但有60.6% 的CG-AC组实行家庭禁烟，而CG-HC组只有40.1%（P < 0.05）。CG-AC组比CG-AC组自报的SHS更低，但两组客观测得的SHS几乎相等。当使用被动测量法测得家庭SHS达到可检测浓度时，CG-AC组实行家庭禁烟的比例几乎是CG-HC组的两倍。
   结论：有慢性疾病状态（如哮喘）儿童的照顾者可能会自报较低的SHS水平。儿童健康状态（如哮喘）可能会提示医生询问SHS情况，但鉴于两组低的家庭禁烟率和实际SHS暴露的高水平，应该建议所有儿童进行SHS暴露评估和减少/消除SHS。
 

（苏楠 审校）
Nicotine Tob Res. 2013 Dec 4. [Epub ahead of print]

Children With Asthma Versus Healthy Children: Differences in Secondhand Smoke Exposure and Caregiver Perceived Risk.

Borrelli B, McQuaid EL, Wagener TL, Hammond SK.

ABSTRACT
INTRODUCTION: Secondhand smoke (SHS) exposure remains a public health problem. Few, if any, studies include both children with and without asthma to assess differences in caregiver smoking behavior, risk perception, and SHS.
METHODS: Participants were 738 daily U.S. smokers [443 caregivers of children with asthma (CG-AC) and 295 caregivers of healthy children (CG-HC); 50.9% White, 25% Black, 15% Latino). Data are cross-sectional. SHS was measured through self-report and passive dosimetry.
RESULTS: Compared with CG-HC, CG-AC had fewer risk factors for exposing children to SHS (lower nicotine dependence, higher motivation to quit, greater perceived benefits of cessation on child's health, and lower optimistic bias, all p values < .05). Specifically, 60.6% of CG-AC reported a household smoking ban versus 40.1% of CG-HC (p < .05), though >95% of both groups had detectable levels of SHS in their home. CG-AC self-reported lower SHS than CG-HC, but both groups had nearly equivalent SHS when measured objectively. CG-AC were almost twice as likely as CG-HC to report a home smoking ban when they had detectable levels of household SHS as measured by passive dosimetry (OR = 1.71; 95% CI = 1.2, 2.4; p = .003).
CONCLUSIONS: Caregivers of children with chronic health conditions, such as asthma, may be motivated to self-report lower levels of SHS. Child health status (e.g., asthma) may cue practitioners to inquire about SHS, but given the low proportion of household bans and high levels of actual exposure among both groups, SHS exposure assessment and reduction/elimination counseling should be prompted to occur for all children.

Nicotine Tob Res. 2013 Dec 4. [Epub ahead of print]