Children's Hospital and Medical Center: A Little Effort Goes A Long Way to Keep Asthma Patients Healthy at Home

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SEATTLE, May 20, 1997 -- Children treated for acute asthma attacks who went home to parents who smoke stayed healthier if care givers made regular follow up calls to check on measures to reduce the children's exposure to environmental tobacco smoke (ETS), according to a study by the Pulmonary Division at Children's Hospital and Medical Center in Seattle, Wash.

The monthly calls, which supplemented a smoking questionnaire and educational materials, made it easier for smokers to alter their behaviors and resulted in fewer symptoms in their children.

"We conclude that ETS exposure can be limited without significant family disruption by using a coordinated approach of education and personalized follow-up, and hypothesize that personal attention is a critical element in the intervention," said the study's authors.

The study was presented at the annual meeting of the American Thoracic Society in San Francisco on May 19. It was published in the February 1997 edition of the Archives of Pediatric and Adolescent Medicine. Editor Dr. Catherine D. DeAngelis urged readers to pass the study results on to smoking parents.

The incidence of asthma among children is 10-14%, according to study co-author Barbara Morray, RN, a research nurse at Children's. Nationally, it's estimated that between 200,000 and 1 million children with asthma have their conditions worsened by exposure to ETS, according to a 1992 U.S. Environmental Protection Agency report.

Some of the steps smokers can take to decrease exposure include not smoking in the house or the car and encouraging others to refrain, wearing a jacket or shirt when smoking outside that can be left outside because smoke and its poisons cling to clothes, and washing clothes and hair frequently, according to Morray.

ETS exacerbates asthma by irritating the sensitive airways which can cause them to swell and produce more mucus. Extra mucus in swollen narrow airways can block those small airways.

The study's authors devised their approach based on four assumptions: 1) About a quarter of all homes contain smokers; 2) Quitting smoking is difficult; 3) There are simple things people can do to limit exposure to ETS; and 4) Parents care about the health of their children.

Here's how the study was carried out; one hundred families whose children were seen at Children's Chest Clinic during a five-month period in 1994 completed a smoking behavior questionnaire and received educational materials about ETS. Thirty-two (32%) families with smokers were divided into two groups. Twenty-one families in Group 1 received monthly follow-up calls for three months asking about changes in their smoking behavior and were offered support for their efforts. Eleven families in Group 2 received one call six months after their clinic visit. Among the smoking families, 44% smoked in the house and 60% smoked in the car before intervention.

Results: Eighty-six percent of families in Group 1 had either no or moderate difficulty altering their smoking behavior, and 71% said they felt their child's ETS exposure was decreased. Within Group 2, 29% of families were able to alter their smoking behaviors and attributed their success to the personal attention of the hospital social workers who called them.

The study's lead authors are Dr. Greg Redding, head of the Pulmonary Division at Children's; Barbara Morray, RN, a research nurse in the division, and social workers Diane Wolman and Stacy Schink.

Children's Hospital and Medical Center in Seattle, Washington is the regional pediatric referral center for the Pacific Northwest, providing comprehensive, specialized medical, surgical, dental and psychosocial services for children ages birth to 21 in Washington, Alaska, Montana and Idaho.

CONTACT: Dean Forbes of Children's Hospital and Medical Center, 206-368-4817