The Impact of Secondhand Smoke Exposure on Children with Cystic Fibrosis: A Review

Kopp, Benjamin T.; Ortega-García, Juan Antonio; Sadreameli, S. Christy; Wellmerling, Jack; Cormet‐Boyaka, Estelle; Thompson, Rohan; McGrath‐Morrow, Sharon A.; Groner, Judith A.

doi:10.3390/ijerph13101003

Cited by 32 publications

(16 citation statements)

References 60 publications

(96 reference statements)

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“…Secondary smoke exposure is as harmful as firsthand smoking. In CF it is observed that secondary smoke exposure activates MEK/ERK pathway and disrupts CFTR expression and function [189]. Interestingly, elevated calcium concentration (observed in CF) has also been shown also to activate the MEK/ERK signaling pathway.…”

Section: Discussionmentioning

confidence: 99%

Cystic fibrosis lung environment and Pseudomonas aeruginosa infection

et al. 2016

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BackgroundThe airways of patients with cystic fibrosis (CF) are highly complex, subject to various environmental conditions as well as a distinct microbiota. Pseudomonas aeruginosa is recognized as one of the most important pulmonary pathogens and the predominant cause of morbidity and mortality in CF. A multifarious interplay between the host, pathogens, microbiota, and the environment shapes the course of the disease. There have been several excellent reviews detailing CF pathology, Pseudomonas and the role of environment in CF but only a few reviews connect these entities with regards to influence on the overall course of the disease. A holistic understanding of contributing factors is pertinent to inform new research and therapeutics.DiscussionIn this article, we discuss the deterministic alterations in lung physiology as a result of CF. We also revisit the impact of those changes on the microbiota, with special emphasis on P. aeruginosa and the influence of other non-genetic factors on CF. Substantial past and current research on various genetic and non-genetic aspects of cystic fibrosis has been reviewed to assess the effect of different factors on CF pulmonary infection. A thorough review of contributing factors in CF and the alterations in lung physiology indicate that CF lung infection is multi-factorial with no isolated cause that should be solely targeted to control disease progression. A combinatorial approach may be required to ensure better disease outcomes.ConclusionCF lung infection is a complex disease and requires a broad multidisciplinary approach to improve CF disease outcomes. A holistic understanding of the underlying mechanisms and non-genetic contributing factors in CF is central to development of new and targeted therapeutic strategies.

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Section: Discussionmentioning

confidence: 99%

Cystic fibrosis lung environment and Pseudomonas aeruginosa infection

et al. 2016

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“…The effects of tobacco smoke exposure in CF are well known, 16 and the detrimental mechanisms have been recently identified, 17 as has been done for bronchiolitis. 18 In this study, parental smoking had been very frequently discussed during the follow-up visits of children with CF (46%) and a very high proportion of parents of children with respiratory disorders are aware of the harmful effects of second-hand smoke on their children's health.…”

Section: Discussionmentioning

confidence: 99%

Pediatrician intervention impacts parental smoking in cystic fibrosis, diabetes, and bronchiolitis

Lafont¹,

Morin

Arrouy

et al. 2021

Pediatric Pulmonology

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Background: Child exposure to cigarette smoke is harmful. It should be reduced through parental smoking cessation interventions. The aim of our study was to determine the impact of simple advice provided by the pediatrician on the smoking habits of parents of children with cystic fibrosis (CF), diabetes mellitus (DM), and infants hospitalized for bronchiolitis.Methods: Parents were interviewed on their smoking habits. Smoking cessation advice was provided by the pediatrician. A new smoking habits assessment was done at 3 months by phone interviews.Results: A total of 260 parents were interviewed (91 in the CF group, 136 in the DM group, and 33 in the bronchiolitis group). A total of 70 parents were active smokers: 33% of parents of children with CF, 23.5% of parents of children with DM, and 24.2% for those with infants hospitalized for bronchiolitis (p = .42). In the CF group, smoking cessation had been significantly more frequently discussed with the medical team previously. A total of 67 smoking parents (95.7%) answered the 3-month assessment: 29.8% reported having started a smoking cessation process; 10.4% had quit smoking. The quitting rate was significantly higher in the groups of patients followed for a respiratory disorder (37.5% for bronchiolitis, 15% for CF vs. 0% for DM, p = .005). Conclusion:This study shows the important role that information and simple advice from pediatricians can have in initiating smoking cessation in parents of patients followed in specialized clinics or who are hospitalized, with a greater efficiency in parents of patients suffering from lung disorders.

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“…Caregiver reported mental health diagnoses and social barriers to care were both significantly associated with smoking exposure. The deleterious impact of tobacco smoke exposure in infants and children with CF is well‐established 13,17,18 . While having a caregiver with mental health diagnoses and social barriers to care may cause challenges for an infant with CF, smoke exposure could add to the negative clinical outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…The deleterious impact of tobacco smoke exposure in infants and children with CF is well-established. 13,17,18 While having a caregiver to meet evidence-based practice recommendations. 3 Care should be taken by the CF team to offer emotional support to caregivers of infants with CF who are struggling with achieving goal weight gain.…”

Section: Discussionmentioning

confidence: 99%

Mental health history and social barriers impacting caregivers of infants with cystic fibrosis

Gillespie

Nemastil

Moore‐Clingenpeel

et al. 2020

Pediatric Pulmonology

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Objectives: Caregivers of infants with cystic fibrosis (CF) carry a heavy treatment burden for their child along with the inherent difficulties of raising an infant. This study investigated the impact of self-reported caregiver mental health diagnoses and social barriers during the 1st year of life on clinical outcomes. Methods: A retrospective chart review was conducted for infants seen in a large tertiary hospital CF clinic over a 5-year period. Baseline characteristics were collected, and documentation from physician and social work notes were reviewed. Demographics and clinical characteristics were compared by the presence or absence of self-reported mental health diagnoses, social barriers, and "emotional concern." Results: Analyses were conducted on 71 patients. Thirty-five percent of caregivers disclosed mental health diagnoses, 52% identified social barriers to care, and 55% reported feeling upset or fatigued. Having a caregiver with a self-reported mental health diagnosis was associated with tobacco smoke exposure (p < .001) and increased odds of hospitalizations (odds ratio [OR], 3.01; 95% confidence interval [CI], 1.49-6.06), emergency department/urgent care visits (OR, 3.17; 95% CI, 1.32-7.64), and longer lengths of stay (OR, 1.93; 95% CI, 1.69-2.20). Caregivers who expressed emotional concern had infants with significantly lower weight-for-length percentiles (p = .012). Discussion: Caregiver mental health and social barriers to care are important determinants to address as they may impact clinical outcomes in infants with CF. Identifying barriers and struggles early increases the likelihood that clinical teams can intervene and provide support. Further research into mental health and socioeconomic barriers faced by caregivers of infants with CF is crucial.

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The Impact of Secondhand Smoke Exposure on Children with Cystic Fibrosis: A Review

Cited by 32 publications

References 60 publications

Cystic fibrosis lung environment and Pseudomonas aeruginosa infection

Cystic fibrosis lung environment and Pseudomonas aeruginosa infection

Pediatrician intervention impacts parental smoking in cystic fibrosis, diabetes, and bronchiolitis

Mental health history and social barriers impacting caregivers of infants with cystic fibrosis

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