Clinical Edge

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Second Hand Smoke Exposure in Children with Asthma

J Asthma; ePub 2018 Oct 11; Butz, et al

Among urban children with poorly controlled asthma, second hand smoke (SHS) exposure did not result in increased symptom frequency, while caregiver stress and symptoms in the fall season may increase risk for day/nighttime symptoms. This according to a recent study that examined the association between SHS exposure and caregiver daily stress in children with poorly controlled asthma. Children were enrolled in an RCT to test the efficacy of an environmental control behavioral intervention vs and attention control group and followed over 12 months. Among the findings:

  • 222 children were included (mean age 6.3 years, 65% male, 94% African American, 94% Medicaid insurance, 54% had poorly controlled asthma).
  • Symptoms in the fall season and increased caregiver daily life stress were significantly associated with increased symptom days when controlling for cotinine level, intervention status, child age, and home and care smoking restrictions.
  • Close monitoring of symptoms and medication use during the fall season may decrease asthma morbidity in children with poorly controlled asthma.


Butz AM, Tsoukleris M, Bollinger ME, et al. Association between second hand smoke (SHS) exposure and caregiver stress in children with poorly controlled asthma. [Published online ahead of print October 11, 2018]. J Asthma. doi:10.1080/02770903.2018.1509989.