Learning Objectives: Explain the longitudinal health effects of ETS exposure on adults with asthma
Abstract: PROBLEM. Because they have chronic airway inflammation, adults with asthma may be particularly susceptible to ETS. Despite the importance of this problem, the impact of ETS exposure on adults with asthma has not been well-characterized.
METHODS. We used data from a prospective cohort study of 349 adults with asthma who underwent structured telephone interviews at baseline and 18-month follow-up. We examined the prospective impact of ETS exposure on asthma health outcomes.
RESULTS. A substantial minority of adults with asthma reported some ETS exposure during the past 7 days (25%; 95% CI 21 to 31%). ETS exposure at baseline interview was associated with impaired health status at longitudinal follow-up. Compared to respondents with no baseline self-reported ETS exposure, higher level baseline ETS exposure (>7 times / week) was associated with worse follow-up severity-of-asthma scores, controlling for sociodemographic factors (mean score increment 1.5 points; 95% CI 0.4 to 2.6). Higher level baseline ETS exposure was also related to poorer physical health status (mean score decrement -4.9 points; 95% CI -8.4 to -1.3) and asthma-specific quality of life (mean score increase 4.4 points; 95% CI -0.2 to 9.0). Higher level baseline ETS exposure were associated with a greater risk of emergency department visits (OR 3.4; 95% CI 1.1 to 10.3) and hospitalization for asthma (OR 12.2; 95% CI 1.5 to 102).
CONCLUSIONS. ETS exposure is associated with a clear impairment in health status among adults with asthma. This should provide further impetus for public policies that promote smoke-free environments.
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