Asthma: Saving Children from Smoke

Asthma, or inflamed airways, is the most common cause of childhood
hospitalizations. The disease increased by 75 percent in the U.S. between
1980 and 1994 and is highest among preschool boys and low-income minority
youth.

Asthma is caused by environmental triggers including cat dander,
cockroaches, dust mites and tobacco smoke. The World Health Organization
estimates that 50 percent of the world's children are threatened by
environmental tobacco smoke. Almost one-half of American children live
with a smoker, and one-fifth of asthmatic children experience more severe
symptoms due to tobacco smoke. It is therefore imperative that families
reduce their asthmatic children's exposure to environmental irritants.
When researchers at the University of British Columbia advised parents to
reduce their newborn's exposure to asthma triggers, the number of infants
with asthma decreased by 44 percent. Unfortunately, these improvements
are not often sustained.

Parents can take measures to avoid smoking around their children,
even if they are unable to quit smoking altogether. These include smoking
outside or away from their child. Researchers at the University of North
Carolina found that nurses can be especially instrumental in modifying
the behavior of those parents whose children suffer pulmonary illnesses.
My colleagues and I found that health education for parents reduced
asthmatic children's exposure to environmental tobacco smoke. These
decreases were sustained for two years.

Researchers at the Harvard School of Public Health recorded similar
benefits after educating the parents of healthy children. We also found
that counseling as well as asthma-management education reduced reported
exposure to environmental tobacco smoke in Latino children.

Finally, researchers at the Palo Alto Medical Foundation Research
Institute in California found that asthmatic children were less likely to
need medical care after nurses provided parents with counseling.

These studies provide convincing evidence that behavioral changes
or "shaping procedures" directed at parents can protect asthmatic and
healthy children alike.