Exposure to tobacco smoke and chronic asthma symptoms

The objective was to determine if tobacco exposure is associated with year-round asthma symptoms. We analyzed baseline data from a multistate survey of 896 pediatric patients with asthma participating in a randomized controlled trial. Daytime symptoms, nocturnal symptoms, and limitations in activity because of asthma tend to increase during the winter season (p < 0.05 for all comparisons, except spring to winter daytime symptoms). One hundred forty of 896 (16%) children had year-round symptoms (i.e., active asthma symptoms during every season). Using separate multivariate analyses, we found that having a parent who smokes (odds ratio [OR]: 2.22; 95% confidence interval [CI]: 1.35, 3.64) or a member of the household who smokes (OR: 1.94; 95% CI: 1.29, 2.93) was associated with a higher likelihood of year-round symptoms, controlling for region of residence, insurance status, and use of a daily controller medication. Asthma symptoms are more likely to increase in the winter season. In anticipation of these patterns, clinicians should consider initiating controller medication therapy or reinforcing asthma education prior to these time periods for those patients at risk for seasonal exacerbations. Exposure to tobacco smoke is associated with year-round asthma symptoms, highlighting the importance of health care providers identifying and counseling about smoking cessation, especially for children with year-round asthma symptoms.