Advising parents of asthmatic children on passive smoking: randomised controlled trial

Irvine, Linda; Crombie, Iain K.; Clark, R A; Slane, Peter W; Feyerabend, C.; Goodman, K; Cater, J. I.

doi:10.1136/bmj.318.7196.1456

Cited by 102 publications

(71 citation statements)

References 23 publications

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“…[12][13][14][15][16][17][18][19][20][21][22][23] Only from 1 of those studies was a sustained reduction in exposure to environmental tobacco smoke, measured as cotinine levels, reported, and from another study a significant reduction in the number of unscheduled asthma visits was reported. 12,13 Collectively, these trials raise serious questions about whether it is prudent to continue to rely on anticipatory guidance to reduce children's exposure to tobacco smoke.…”

Section: Discussionmentioning

confidence: 99%

“…11 Numerous studies have tested the efficacy of anticipatory guidance to reduce SHS exposure for children, but the majority failed to show significant reductions in children's SHS exposure by using measurements of cotinine, a metabolite of nicotine, or improvements in asthma symptoms. [12][13][14][15][16][17][18][19][20][21][22][23] This problem might be overcome if there was a technology to reduce SHS exposure passively, such as highefficiency, particulate-arresting (HEPA) air cleaners.…”

mentioning

confidence: 99%

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Effects of HEPA Air Cleaners on Unscheduled Asthma Visits and Asthma Symptoms for Children Exposed to Secondhand Tobacco Smoke

2010

PEDIATRICS

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WHAT'S KNOWN ON THIS SUBJECT:Exposure to secondhand smoke (SHS) is associated with asthma exacerbations in children. Anticipatory guidance has failed to reduce SHS in controlled trials. It is not known whether high-efficiency, particlearresting (HEPA) air cleaners can reduce SHS or improve asthma symptoms in children. WHAT THIS STUDY ADDS:HEPA air cleaners led to reductions in unscheduled asthma visits and fine airborne particle levels but not asthma symptoms or cotinine levels. HEPA air cleaners may be useful as part of a multifaceted strategy to reduce asthma morbidity among children. abstract OBJECTIVE:The goal was to test the effects of high-efficiency, particulatearresting (HEPA) air cleaners on unscheduled asthma visits and symptoms among children with asthma exposed to secondhand smoke. METHODS:We enrolled 225 eligible children who were 6 to 12 years of age, had physician-diagnosed asthma, and were exposed to Ն5 cigarettes per day. We conducted a double-blind, randomized trial. Children were assigned randomly to receive 2 active or inactive HEPA air cleaners. RESULTS:Of 225 enrolled children, 110 (49%) were assigned to the intervention group and 115 (51%) to the control group; 215 (95%) completed the trial. During the trial, there were 42 fewer unscheduled asthma visits among children in the intervention group (18.5% [95% confidence interval: 1.25%-82.75%]; P ϭ .043), compared with those in the control group, after adjustment for baseline differences. There was a significant difference in the reductions of levels of particles of Ͼ0.3 m according to group assignment; there was a 25% reduction in particle levels in the intervention group, compared with a 5% reduction in the control group (P ϭ .026). There were no significant differences in parent-reported asthma symptoms, exhaled nitric-oxide levels, air nicotine levels, or cotinine levels according to group assignment. CONCLUSIONS:These results hold promise for using HEPA air cleaners as part of a multifaceted strategy to reduce asthma morbidity, but further research is necessary before they can be recommended routinely for the medical management of asthma.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Effects of HEPA Air Cleaners on Unscheduled Asthma Visits and Asthma Symptoms for Children Exposed to Secondhand Tobacco Smoke

2010

PEDIATRICS

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“…Finally, a study by Irvine et al 40 examining exposure to ETS among asthmatic children in Scotland also failed to produce significant effects for a counseling intervention. Subjects for this study were families identified through the health care system as having an asthmatic child and at least 1 parent who smokes.…”

Section: Reducing Ets Exposure Health Effects Of Ets On Childrenmentioning

confidence: 99%

The Pediatrician's Role in Reducing Tobacco Exposure in Children

et al. 2000

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ABSTRACT. Objective. Pediatricians have a unique and important role to play in the prevention and treatment of childhood and adolescent tobacco use, the protection of patients from the harmful effects of environmental tobacco smoke, and the encouragement of smoking cessation among parents. However, because recent research indicates that physician training in tobacco dependence is woefully weak and lacks a model for training, this article constructs a useful approach to this problem.Methodology. A comprehensive review of the literature served as the basis for the development of a new model for pediatrician training in tobacco dependence.Results. A comprehensive model is presented for training pediatricians in the areas of reducing infant and child exposure to environmental tobacco smoke, preventing youth smoking initiation, and providing smoking cessation assistance for adolescents and parents.Conclusions. Pediatricians have been called on to play an active role in the antitobacco arena. Because of their unique opportunity to interact with children, adolescents, and parents, pediatricians can and should be antitobacco interventionists. For this to occur, however, additional guidance should be provided to pediatricians during their training to better prepare them to carry out effective assessment and intervention practices. Pediatrics 2000;106(5). URL: http://www.pediatrics.org/ cgi/content/full/106/5/e66; smoking initiation, smoking prevention, smoking cessation, environmental tobacco smoke, pediatricians.

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“…Désirée Larenas-Linnemann, 1 Jorge Salas-Hernández, 2 Juan Carlos Vázquez-García, 3 Ignacio Ortiz-Aldana, 4 Margarita Fernández-Vega, 5 Blanca Estela Del Río-Navarro, 6 María del Carmen Cano-Salas, 7 Jorge Agustín Luna-Pech, 8 José Antonio Ortega-Martell, 9 Jade Romero-Lombard, 10 Erika del Carmen López-Estrada, 11 Jimena Villaverde-Rosas, 12 José Luis Mayorga-Butrón, 13 Mario Humberto Vargas-Becerra, 14 Martín BedollaBarajas, 15 Noel Rodríguez-Pérez, 16 Ambrocio Aguilar-Aranda, 17 Carlos Adrián Jiménez-González, 18 Carlos García-Bolaños, 19 Claudia GarridoGalindo, 20 David Alejandro Mendoza-Hernández, 21 Enrique Mendoza-López, 22 Gerardo López-Pérez, 21 Guillermo Hideo Wakida-Kuzonoki, 23 Héctor Hernán Ruiz-Gutiérrez, 24 Héctor León-Molina, 25 Héctor Martínez-De la Lanza, 26 Héctor Stone-Aguilar, 27 Javier Gómez-Vera, 28 Jorge…”

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Guía Mexicana del Asma: GUIMA 2017

Larenas-Linnemann¹,

Salas-Hernández²,

Vázquez-García³

et al. 2017

RAM

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Este artículo debe citarse como: Larenas-Linnemann D, Salas-Hernández J, Vázquez-García JC, Ortiz-Aldana I, Fernández-Vega M, Del Río-Navarro BE, et al. Guía Mexicana del Asma 2017. Rev Alerg Mex. 2017;64 Supl 1:s11-s128. AbstractBackground: The need for a national guideline, with a broad basis among specialists and primary care physicians was felt in Mexico, to try unifying asthma management. As several high-quality asthma guidelines exist worldwide, it was decided to select the best three for transculturation. Methods: Following the internationally recommended methodology for guideline transculturation, ADAPTE, a literature search for asthma guidelines, published 1-1-2007 through 31-12-2015 was conducted. AGREE-II evaluations yielded 3/40 most suitable for transculturation. Their compound evidence was fused with local reality, patient preference, cost and safety considerations to draft the guideline document. Subsequently, this was adjusted by physicians from 12 national medical societies in several rounds of a Delphi process and 3 face-to-face meetings to reach the final version. Results: Evidence was fused from British Thoracic Society Asthma Guideline 2014, Global Initiative on Asthma 2015, and Guía Española del Manejo del Asma 2015 (2016 updates included). After 3 Delphi-rounds we developed an evidence-based document taking into account patient characteristics, including age, treatment costs and safety and best locally available medication. Conclusion: In cooperation pulmonologists, allergists, ENT physicians, paediatricians and GPs were able to develop an evidence-based document for the prevention, diagnosis and treatment of asthma and its exacerbations in Mexico.Keywords: Clinical practice guideline; Asthma; Asthmatic exacerbation; Bronchodilator; Inhaled corticosteroid; Spirometry; Immunotherapy. IntroducciónLa presentación de este documento muestra la importancia del asma en México por su alta prevalencia, pero también por su subdiagnóstico y tratamiento deficiente, que propician un mal control de los pacientes con asma, crisis más frecuentes y sintomatología activa. En consecuencia, el asma tiene un impacto socioeconómico considerable para el paciente y la sociedad en su conjunto, al igual que afecta la calidad de vida del paciente y su familia. En México, el paciente con asma puede recibir atención médica en los ámbitos pú-blico o privado, en los diferentes niveles de salud y por múltiples especialidades. Todas estas particularidades de la situación nacional indican la necesidad de un documento guía actualizado, con base amplia en múltiples gremios médicos, tanto de primer nivel de atención como de especialidad.El objetivo de la GUIMA 2017 es facilitar la reducción de la morbimortalidad por asma en México, no solo al mejorar el conocimiento acerca de esta patología, sino también al ayudar a la parte administrativa del Sector Salud a gestionar la selección y adquisición más precisa de los medicamentos necesarios para su tratamiento a nivel de la salud pública. Para tal fin se ofrecen lineamientos par...

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Advising parents of asthmatic children on passive smoking: randomised controlled trial

Cited by 102 publications

References 23 publications

Effects of HEPA Air Cleaners on Unscheduled Asthma Visits and Asthma Symptoms for Children Exposed to Secondhand Tobacco Smoke

Effects of HEPA Air Cleaners on Unscheduled Asthma Visits and Asthma Symptoms for Children Exposed to Secondhand Tobacco Smoke

The Pediatrician's Role in Reducing Tobacco Exposure in Children

Guía Mexicana del Asma: GUIMA 2017

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