The effects of environmental tobacco smoke on health services utilization in the first eighteen months of life.
OBJECTIVE
To examine the effects of environmental tobacco smoke (ETS) on health services use in Chinese infants with nonsmoking mothers.


METHODS
Prospective, population-based birth cohort.


METHODS
General population of Hong Kong in 1997-1998.


METHODS
A total of 8327 parent-infant pairs who were followed up for 18 months.


METHODS
Doctor consultations and hospitalizations. Results. After adjusting for the age, education level, and employment status of mothers-as well as infants' birth weight, method of delivery, breastfeeding status, and birth order-ETS exposure through the mother in utero was positively associated with higher consultation (adjusted odds ratio [OR]: 1.26; 95% confidence interval [CI]: 1.14, 1.39) and hospitalization (OR: 1.18; 95% CI: 1.05, 1.31) use in infants with nonsmoking mothers attributable to any illness. In addition, postnatal exposure to ETS at home was linked to higher rates of hospitalizations for any illness compared with nonexposed infants (OR: 1.12; 95% CI: 1.00, 1.25), although the relationship did not hold for outpatient consultation visits. The OR for higher hospital use in infants exposed to 2 or more smokers at home was 1.30 (95% CI: 1.08, 1.58).


CONCLUSIONS
The use of tobacco products by household members, even among nonsmoking mothers, has an enormous adverse impact on the health of children, as well as increases health services use and cost. The present data support the revision of public policy to reflect an evidence-based approach to the promotion of smoking cessation in all household members during and after pregnancy. environmental tobacco smoke, health services, infants.
Lam
T H
TH
Department of Community Medicine, University of Hong Kong Medical Center, Pokfulam, Hong Kong.
Leung
G M
GM
Ho
L M
LM
D000328:Adult; D002662:Child Health Services / Q000191:economics / Q000706:statistics & numerical data*; D015331:Cohort Studies; D004781:Environmental Exposure / Q000706:statistics & numerical data*; D005192:Family Health; D005260:Female; D005500:Follow-Up Studies; D006723:Hong Kong / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008425:Maternal Behavior / Q000523:psychology; D008427:Maternal Health Services / Q000191:economics / Q000706:statistics & numerical data*; D009819:Office Visits / Q000706:statistics & numerical data; D011446:Prospective Studies; D012907:Smoking / Q000453:epidemiology / Q000523:psychology; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*
D014028:Tobacco Smoke Pollution