title: Asthma diagnosis in a child and cessation of smoking in the child's home: the PIAMA birth cohort.
abstract: Second hand smoke (SHS) exposure is associated with increased incidence and severity of childhood asthma. We investigated whether, in turn, asthma diagnosis in a child is associated with cessation of smoking exposure in the child's home. In the PIAMA birth cohort (n=3963), parents reported on smoking in their home and on asthma diagnosis in their child, annually from birth to 8 years. We used generalized estimating equations to assess the association between asthma diagnosis in a child and cessation of smoking in the child's home. Among children with residential SHS exposure, smoking stopped in 23.7% of the homes of children with newly diagnosed asthma as compared with 16.2% of the homes of children without asthma diagnosis (P=0.014). For children with an asthma diagnosis, the relative risk of smoking cessation in their home was 1.36 (one-sided 95% confidence interval: 1.09, inf.) and changed little after adjustment for maternal education, parental allergy and child's age. In most smokers' households (76.3%), smoking continued when the child got an asthma diagnosis. Nevertheless, an asthma diagnosis in the child increased the probability of a smoke-free home for the child and its parents and siblings. Cross-sectional associations between SHS exposure and asthma may underestimate true associations, because exposure may have been reduced following diagnosis of the disease.
authors.affiliation: Center for Nutrition, Prevention, and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
authors.forename: Alet H
authors.initials: AH
authors.lastname: Wijga
authors.affiliation: Center for Nutrition, Prevention, and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
authors.forename: Maarten
authors.initials: M
authors.lastname: Schipper
authors.affiliation: Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands.
authors.forename: Bert
authors.initials: B
authors.lastname: Brunekreef
authors.affiliation: Department of Pediatric Pulmonology and Pediatric Allergology, UMCG, GRIAC Research Institute, Beatrix Children's Hospital, University of Groningen, Groningen, The Netherlands.
authors.forename: Gerard H
authors.initials: GH
authors.lastname: Koppelman
authors.affiliation: Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Gehring
mesh_terms: D001249:Asthma / Q000175:diagnosis*; D002648:Child; D015331:Cohort Studies; D006801:Humans; D012111:Residence Characteristics; D016540:Smoking Cessation; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*
chemical_list: D014028:Tobacco Smoke Pollution