title: Exposure to tobacco smoke among asthmatic children: parents' smoking habits and level of education.
abstract: METHODS
  Children's Hospital for Respiratory Diseases and Tuberculosis, Belgrade, Serbia.
  
  
  OBJECTIVE
  To compare parents' educational level and smoking habits with asthma in children exposed to environmental tobacco smoke (ETS) and in those not exposed.
  
  
  METHODS
  In this cross-sectional study, 231 asthmatic children (average age 10.6 years, 49% boys) from smoking and non-smoking families were compared by birth weight, birth length, first episode of wheezing, number of respiratory infections and exacerbations per year, severity of asthma, number of hospitalisations, total serum immunoglobulin E (IgE), skin prick tests and allergic manifestations.
  
  
  RESULTS
  In our study, 77% of the children were from smoking families: 45.9% had active smoking mothers and 51% active smoking fathers. Smoking was more common among parents with lower education level. The mother being the only smoker in the family had a greater impact on respiratory infections and asthma exacerbations in the first years of life; however, after the third year, the effect of having both smoking parents was important. Children exposed to ETS had more allergic manifestations. The percentage of children with both non-smoking parents decreased and that of children with both smoking parents increased with increasing asthma severity (χ(2) = 17.73, P < 0.05).
  
  
  CONCLUSIONS
  ETS has a negative impact on illness among children with asthma.
authors.affiliation: Children's Hospital for Respiratory Diseases and Tuberculosis, Belgrade, Serbia. drugari@hotmail.com
authors.forename: S D
authors.initials: SD
authors.lastname: Radic
authors.forename: B S
authors.initials: BS
authors.lastname: Gvozdenovic
authors.forename: I M
authors.initials: IM
authors.lastname: Pesic
authors.forename: Z M
authors.initials: ZM
authors.lastname: Zivkovic
authors.forename: V
authors.initials: V
authors.lastname: Skodric-Trifunovic
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D001724:Birth Weight; D049628:Body Size; D016009:Chi-Square Distribution; D002648:Child; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D006760:Hospitalization; D006776:Hospitals, Pediatric; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D007428:Intradermal Tests; D008297:Male; D010290:Parents / Q000193:education*; D018570:Risk Assessment; D012307:Risk Factors; D055771:Serbia / Q000453:epidemiology; D012720:Severity of Illness Index; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology; D011795:Surveys and Questionnaires; D013997:Time Factors; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*
chemical_list: D014028:Tobacco Smoke Pollution; D007073:Immunoglobulin E