title: Parental ease in asking others not to smoke and respiratory symptoms and illness among children.
abstract: OBJECTIVE
  Childhood exposure to secondhand tobacco smoke (SHS) increases a child's burden of respiratory conditions, but parental smoking bans may reduce such morbidity. This study evaluated household smoking bans and their relationship to respiratory illness in an outpatient otolaryngology clinic.
  
  
  METHODS
  The study was performed at the Heim Pal National Children's Hospital, Ear, Nose and Throat (ENT) Department (Budapest, Hungary) from July to November, 2010. A consecutive series of children's caregivers were approached to participate in a survey measuring household smoking bans, upper and lower respiratory tract symptoms and illnesses, and socioeconomic factors. Bivariate and multivariate logistic regression analyses were performed.
  
  
  RESULTS
  Of the 215 caregivers recruited for the study, 208 agreed to participate (response rate of 96.7%). More than half of the children were male (54%), and 39% lived in a household with at least one member who smoked. Smoking was frequently banned inside the car (91.3%) and home (85.1%). Respondents felt it easiest to ask friends (97.1%) and family members not living in the household (98.1%) to refrain from smoking inside the home. Respondents also found it easier to ask a stranger (81.7%) or a family member (61.1%) not to smoke around the child. Logistic regression showed that respondents for children with a history of pneumonia found it less difficult to ask visitors in the home not to smoke compared to children without pneumonia (OR = 0.23, 95% CI = 0.06-0.98). Conversely, respondents for children who had had adenoidectomy found it over three times more difficult to ask strangers not to smoke near the child compared to those of children without adenoidectomy (OR = 3.20, 95% CI = 1.43-6.38).
  
  
  CONCLUSIONS
  In a population of children visiting an outpatient ENT clinic in Budapest, Hungary, we found a high degree of exposure to SHS. The ease with which caregivers felt towards asking others not to smoke predicted specific respiratory conditions. Since the ENT clinic offers a wonderful opportunity for clinicians to counsel parents on tobacco cessation, increased tobacco education of these providers is needed.
authors: Department of Family and Community Medicine, Wake Forest School of Medicine, Wake Forest University, Winston-Salem, NC 27157, USA. jspangle@wakehealth.edu.
authors: John
authors: J
authors: Spangler
authors: Department of Otorhinolaryngology, Heim Pal Children's Hospital, ENT Department Üllói út 86. H-1089 Budapest, Hungary. csakanyi.zsuzsanna@gmail.com.
authors: Zsuzsanna
authors: Z
authors: Csákányi
authors: RTI International, 351 California Street, Suite 500, San Francisco, CA 94104, USA. trogers@rti.org.
authors: Todd
authors: T
authors: Rogers
authors: Department of Otorhinolaryngology, Heim Pal Children's Hospital, ENT Department Üllói út 86. H-1089 Budapest, Hungary. csakanyi.zsuzsanna@gmail.com.
authors: Gábor
authors: G
authors: Katona
mesh_terms: D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D010290:Parents / Q000193:education / Q000523:psychology*; D012044:Regression Analysis; D012140:Respiratory Tract Diseases / Q000517:prevention & control*; D012907:Smoking / Q000523:psychology*; D014028:Tobacco Smoke Pollution / Q000517:prevention & control*
chemical_list: D014028:Tobacco Smoke Pollution