--- title: "Parents' smoking and children with asthma. | Sutter Health" description: "Understanding parental beliefs about secondhand smoke exposure and readiness to change is important, as secondhand smoke triggers childhood asthma." url: "https://www.sutterhealth.org/research/publications/parents-smoking-and-children-with-asthma-1055312631" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Parents' smoking and children with asthma. # Secondhand tobacco smoke in children with asthma: sources of and parental perceptions about exposure in children and parental readiness to change. Farber HJ, Knowles SB, Brown NL, Caine L, Luna V, Qian Y, Lavori P, & Wilson SR. _Chest. 133(6):1367-74. doi: 10.1378/chest.07-2369. Epub 2008 Mar 13._ 2008-06-01 ## Abstract #### BACKGROUND: Secondhand smoke triggers childhood asthma. Understanding sources of exposure, parental beliefs about exposure, and readiness to change that exposure are important for designing smoke exposure reduction interventions. #### METHODS: As part of screening for a clinical trial of a smoke exposure reduction intervention, 519 smoke-exposed children 3 to 12 years old with asthma provided urine specimens for cotinine testing, and their primary caregivers completed questionnaires. #### RESULTS: The urine cotinine to creatinine ratio (CCR) was lowest if neither the primary caregiver nor day-care provider smoked (mean CCR, 14.0; SD, 14.4), greater if either smoked (mean CCR, 22.2; SD, 21.3; and mean, CCR, 26.3; SD, 22.2, respectively), and greatest if both smoked (mean CCR, 39.6; SD, 27.5; p < 0.01). Parental perception of their child's exposure was weakly associated with the child's CCR (r(2) = 0.11, p < 0.001). Most parents (58.3%) reported that tobacco smoke exposure had small/no negative effect on their child's asthma. Substantial proportions of those for whom a specific exposure reduction action was relevant were classified as contemplating, preparing, or had recently taken action to reduce their child's exposure, including smoking cessation (61.3%), keeping the child out of smoke-exposed places (72.7%), and making the child's home (49.2%) and areas out of the home smoke free (66.9%). #### CONCLUSIONS: Smoking by the primary caregiver and day-care provider are important sources of exposure for children with asthma. Parental assessment of their child's exposure is associated with biologically confirmed exposure but cannot be relied on to assess that exposure. Although the harm of smoke exposure was frequently underestimated, many parents appeared receptive to considering action to reduce their child's exposure. #### TRIAL REGISTRATION: (Clinicaltrials.gov). Identifier: NCT00217958. [PubMed abstract](http://www.ncbi.nlm.nih.gov/pubmed/18339788) ## Research topics - [Asthma](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Asthma%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Asthma outcomes: Quality of life](https://www.sutterhealth.org/research/publications/asthma-outcomes-quality-of-life-1055312634) Wilson SR, Rand CS, Cabana MD, Foggs MB, Halterman JS, Olson L, Vollmer WM, Wright RJ, Taggart V J Allergy Clin Immunol. 129:S88-123. (e-published March 1 2012). Doi: 10.1016/j.jaci.2011.12.988) 2012 Mar 01 - Publication ### [Mediators of asthma outcomes](https://www.sutterhealth.org/research/publications/mediators-of-asthma-outcomes-1055312653) Rand CS, Wright RJ, Cabana MD, Foggs MB, Halterman JS, Olson L, Vollmer WM, Wilson SR, Taggart V. J Allergy Clin Immunol. 129(3 Suppl):S136-41. 2012 Mar 01 - Publication ### [Asthma in the elderly: Current understanding and future research needs-a report of a National Institute on Aging (NIA) workshop.](https://www.sutterhealth.org/research/publications/asthma-elderly-understanding-future-research-1055312553) Hanania NA, King MJ, Braman SJ, Saltoun C, Wise RA, Enright P, Falsey AA, Mathur SK, Ramsdell JW, Rogers L, Stempel DA, Lima J, Fish JE, Wilson SR, Boyd C, Patel K, Irvin CG, Yawn BP, Halm EA, Ledford DL J Allergy Clin Immunol. 128(3 Suppl):S4-24. doi: 10.1016/j.jaci.2011.06.048. 2011 Oct 01 - Publication ### [Performance of the Asthma Impact on Quality of Life Scale (A-IQOLS) in diverse asthma research populations and demographic sub-groups.](https://www.sutterhealth.org/research/publications/asthma-impact-on-quality-of-life-scale-performance-in-pops-1055312339) Wilson SR, Wise RA, Castro M, Mulligan MJ, Ayala E, Chausow A, Huang Q, Gummidipundi S. J Allergy Clin Immunol. pii: S0091-6749(18)30634-1. doi: 10.1016/j.jaci.2018.02.056. \[Epub ahead of print\] 2018 May 03 - Publication ### [Obesity, insulin resistance and the prevalence of atopy and asthma in US adults.](https://www.sutterhealth.org/research/publications/obesity-insulin-resistance-atopy-asthma-adults-1055312557) Ma J, Xiao L, Knowles SB. Allergy. 65(11):1455-63. doi: 10.1111/j.1398-9995.2010.02402.x. 2010 Nov 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/parents-smoking-and-children-with-asthma-1055312631#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Parents' smoking and children with asthma."}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/parents-smoking-and-children-with-asthma-1055312631#medicalscholarlyarticle","name":"Secondhand tobacco smoke in children with asthma: sources of and parental perceptions about exposure in children and parental readiness to change.","headline":"Parents' smoking and children with asthma.","abstract":"BACKGROUND: Secondhand smoke triggers childhood asthma. Understanding sources of exposure, parental beliefs about exposure, and readiness to change that exposure are important for designing smoke exposure reduction interventions. METHODS: As part of screening for a clinical trial of a smoke exposure reduction intervention, 519 smoke-exposed children 3 to 12 years old with asthma provided urine specimens for cotinine testing, and their primary caregivers completed questionnaires. RESULTS: The urine cotinine to creatinine ratio (CCR) was lowest if neither the primary caregiver nor day-care provider smoked (mean CCR, 14.0; SD, 14.4), greater if either smoked (mean CCR, 22.2; SD, 21.3; and mean, CCR, 26.3; SD, 22.2, respectively), and greatest if both smoked (mean CCR, 39.6; SD, 27.5; p \u003c 0.01). Parental perception of their child's exposure was weakly associated with the child's CCR (r(2) = 0.11, p \u003c 0.001). Most parents (58.3%) reported that tobacco smoke exposure had small/no negative effect on their child's asthma. Substantial proportions of those for whom a specific exposure reduction action was relevant were classified as contemplating, preparing, or had recently taken action to reduce their child's exposure, including smoking cessation (61.3%), keeping the child out of smoke-exposed places (72.7%), and making the child's home (49.2%) and areas out of the home smoke free (66.9%). CONCLUSIONS: Smoking by the primary caregiver and day-care provider are important sources of exposure for children with asthma. Parental assessment of their child's exposure is associated with biologically confirmed exposure but cannot be relied on to assess that exposure. Although the harm of smoke exposure was frequently underestimated, many parents appeared receptive to considering action to reduce their child's exposure. TRIAL REGISTRATION: (Clinicaltrials.gov). 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