Exposure of Children with Asthma to Household ETS

描述（由申请人提供）：患有哮喘的儿童尤其 易受环境烟草烟雾（ETS）的影响。然而，尽管这一特殊 易受ETS的影响，哮喘儿童至少有可能生活在 吸烟的家庭和健康的儿童一样。然而，关于 有哮喘儿童的吸烟家庭成员是否 具体的策略，以减少他们吸烟对他们的有害影响， 吸烟的家庭成员的儿童多于健康儿童。的 这项病例对照研究的中心目的是检查原发性 来自低收入家庭的学龄哮喘儿童 与对照组儿童相比，家庭ETS暴露 将通过客观监测，特别是被动尼古丁 剂量计和儿童可替宁测定（主要假设），以及 母亲报告（次要假设）。90名儿童与医生 被诊断为哮喘和吸烟的母亲将根据年龄，性别， 种族/民族和其他相关变量，以90名健康儿童。所有 儿童将从丹佛市的诊所招募， 低收入、得不到充分服务的人群。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 由于其患病率和相关发病率的增加， 哮喘和吸烟我们还将研究如何具体的家庭 据母亲报告，吸烟行为与家庭 尼古丁和儿童可替宁水平。最后，我们提供了一套 精心挑选的措施，将在第三，探索性 分析，以帮助理解，澄清，并结合观察结果。 这项研究经过精心设计，以纠正严重的方法论 这方面的前期工作存在问题。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暴露量低于健康 儿童;（2）家庭吸烟行为的改变是否对此负责 差异;如果是，（3）哪些具体策略可以有效减少 儿童的ETS暴露，哪些不是？知道这些问题的答案 问题，以及是否有显着的种族/民族差异， 这些问题的答案对于正在进行的烟草干预和控制将是非常宝贵的 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.