Exposure of Children with Asthma to Household ETS

描述(申请人提供)：哮喘儿童 易受环境烟草烟雾(ETS)影响。然而，尽管有这一特殊的 易受ETS影响，哮喘儿童至少有同样的可能性生活在 吸烟家庭，健康的儿童也是如此。然而，存在争议的是关于 有哮喘儿童的家庭的吸烟成员是否使用 减少吸烟对他们的有害影响的具体策略 吸烟儿童多于健康儿童家庭的吸烟成员。这个 这项病例对照研究的中心目标是检查 来自低收入家庭的学龄儿童哮喘发病率较低 家庭ETS暴露水平明显高于对照组儿童。家庭ETS暴露 将通过客观监测，特别是被动尼古丁来衡量 剂量计和儿童可替宁分析(主要假设)，以及 母亲--报告(第二个假设)。90个孩子和医生在一起 诊断为哮喘和吸烟的母亲将按年龄、性别、 种族/民族和其他相关变量对90名健康儿童的影响。全 儿童将从大都会丹佛诊所招募，提供服务 低收入、服务不足的人群。该样本将包含相同数量的 非裔美国人、西班牙裔和白人。招聘将针对低收入人群 人口，因为他们的患病率增加，以及相关的发病率 哮喘和吸烟都是如此。我们还将研究具体的家庭如何 根据母亲的报告，吸烟行为与家庭有关 尼古丁和儿童可替宁水平。最后，我们包含了一组 精心选择的措施，将在第三、探索性的 有助于理解、澄清观察到的结果并将其与环境联系起来的分析。 这项研究是经过精心设计的，以纠正严肃的方法论 这方面的前期工作存在的问题。因此，拟议的研究将 能够解决一些极其重要的儿童健康问题 主要的理论和实践意义：(1)哮喘儿童是否有 通过客观监测测量的家庭ETS暴露低于健康 孩子；(2)家庭吸烟行为的改变会导致这种情况吗？ 差异；若有，。(3)哪些具体策略可有效减少 儿童接触ETS，哪些不是？知道这些问题的答案 问题，以及是否存在显著的种族/民族差异 这些答案对正在进行的烟草干预和控制将是无价的。 在哮喘儿童家庭以及其他弱势群体中的努力 人口。

DESCRIPTION (provided by applicant): Children with asthma are particularly vulnerable to environmental tobacco smoke (ETS). However, despite this special vulnerability to ETS, children with asthma are at least as likely to live in smoking households, as are healthy children. Controversy exists, however, about whether or not the smoking members of households with children with asthma use specific strategies to reduce the harmful effects of their smoking on their children more than the smoking members of households of healthy children. The central aim of this case-control study is to examine whether or not primary school-aged children with asthma from low-income households have lower household ETS exposure than matched control children. Household ETS exposure will be measured by both objective monitoring, specifically passive nicotine dosimeters and child cotinine assays (the primary hypothesis), and maternal-report (the secondary hypothesis). Ninety children with physician diagnosed asthma and smoking mothers will be matched by age, gender, race/ethnicity, and other relevant variables to 90 healthy children. All children will be recruited from Metro Denver clinics providing services to low-income, underserved populations. The sample will contain equal numbers of African Americans, Hispanics, and Whites. Recruitment will target low-income populations due to their increased prevalence of, and associated morbidity from both asthma and tobacco smoking. We will also examine how specific household smoking behaviors, as reported by mothers, are associated with household nicotine and child cotinine levels. Finally, we have included a set of carefully chosen measures that will be examined in tertiary, exploratory analyses to help understand, clarify, and contextualize the observed results. This study has been carefully designed to correct the serious methodological problems of the prior work in this area. Accordingly, the proposed study will be able to resolve a number of extremely important child health questions of major theoretical and practical importance: (1) do children with asthma have less household ETS exposure as measured by objective monitoring than healthy children; (2) do alterations in household smoking behavior account for this difference; and if so, (3) which specific strategies are effective in reducing children's ETS exposure and which are not? Knowing the answers to these questions, as well as whether there is significant racial/ethnic variability in the answers, will be invaluable to ongoing tobacco intervention and control efforts in families of children with asthma, as well as other vulnerable populations.