title: US prevalence and trends in tobacco smoke exposure among children and adolescents with asthma.
abstract: OBJECTIVE
  To examine exposure to tobacco smoke products (TSPs), environmental tobacco smoke (ETS), and in-home smoke among youth with asthma in the United States.
  
  
  METHODS
  Nationally representative, cross-sectional data from 2250 youth aged 4 to 19 years with current asthma in the 1988-1994, 1999-2004, and 2005-2010 National Health and Nutrition Examination Survey (NHANES) were analyzed. Outcomes were use of TSPs (serum cotinine level >10 ng/mL or self-reported recent use of cigarettes, cigars, or pipes) and, among non-TSP users, ETS exposure (serum cotinine ≥0.05 ng/mL) and in-home smoke exposure (reported). Multiple logistic regression analyses assessed the associations between the outcomes and age, gender, race/ethnicity, and family income.
  
  
  RESULTS
  Among adolescents (aged 12-19 years) with asthma in 2005-2010, 17.3% reported TSP use. Among youth (aged 4-19 years) with asthma who did not use TSPs, 53.2% were exposed to ETS and 17.6% had in-home smoke exposure. Among low-income youth, 70.1% and 28.1% had exposure to ETS and in-home smoke, respectively. After controlling for sociodemographic factors, higher prevalence of exposure to ETS and in-home smoke persisted among low-income youth. Between 1988-1994 and 2005-2010, there was a decline in ETS and in-home smoke exposure (both P < .001).
  
  
  CONCLUSIONS
  ETS exposure among youth with asthma declined between 1988-1994 and 2005-2010, but a majority remained exposed in 2005-2010, with higher exposure among low-income youth. More than 1 in 6 youth with asthma in 2005-2010 were exposed to in-home smoke and a similar portion of adolescents used TSPs.
authors: Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD, USA. igd0@cdc.gov
authors: Brian K
authors: BK
authors: Kit
authors: Alan E
authors: AE
authors: Simon
authors: Debra J
authors: DJ
authors: Brody
authors: Lara J
authors: LJ
authors: Akinbami
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000097:blood / Q000453:epidemiology*; D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D003367:Cotinine / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D009749:Nutrition Surveys / Q000639:trends; D015995:Prevalence; D012907:Smoking / Q000009:adverse effects* / Q000097:blood / Q000453:epidemiology*; D014028:Tobacco Smoke Pollution / Q000009:adverse effects* / Q000517:prevention & control; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D015415:Biomarkers; D014028:Tobacco Smoke Pollution; D003367:Cotinine