title: Passive smoking after tympanostomy and risk of recurrent acute otitis media.
abstract: OBJECTIVE
  Exposure to environmental tobacco smoke has been reported to be a risk factor for childhood otitis media. The effect of parental smoking on the risk of otitis media after the insertion of tympanostomy tubes is unknown. We evaluated the effect of parental smoking on the risk of recurrent otitis media in children who had received tympanostomy tubes.
  
  
  METHODS
  We enrolled 217 children aged 1-4 years who underwent insertion of tympanostomy tubes because of middle ear disease. The children were followed-up for 12 months. Otitis media episodes were recorded in patient diaries by primary care physicians. Parental smoking habits were assessed by a questionnaire at the start of the trial and after the 12 month follow-up had ended. The main outcome measure was risk of recurrent otitis media as defined by four or more otitis media episodes after tympanostomy. Altogether 198 children completed the follow-up.
  
  
  RESULTS
  Maternal smoking was associated with a highly increased risk of recurrent acute otitis media (OR 4.15, 95% CI 1.45-11.9) after the insertion of tympanostomy tubes.
  
  
  CONCLUSIONS
  Exposure to passive smoking is associated with four-fold risk of recurrent otitis media after tympanostomy. This finding should be used to encourage parents to stop smoking even after the insertion of tympanostomy tubes to their children.
authors.affiliation: Department of Otorhinolaryngology, Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: Sari
authors.initials: S
authors.lastname: Hammarén-Malmi
authors.forename: Harri
authors.initials: H
authors.lastname: Saxen
authors.forename: Jussi
authors.initials: J
authors.lastname: Tarkkanen
authors.forename: Petri S
authors.initials: PS
authors.lastname: Mattila
mesh_terms: D000208:Acute Disease; D002675:Child, Preschool; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008425:Maternal Behavior; D008876:Middle Ear Ventilation / Q000706:statistics & numerical data*; D010033:Otitis Media / Q000453:epidemiology*; D015995:Prevalence; D012008:Recurrence; D012306:Risk; D012959:Socioeconomic Factors; D014028:Tobacco Smoke Pollution / Q000706:statistics & numerical data*
chemical_list: D014028:Tobacco Smoke Pollution