Table 6.10

Studies of asthma prevalence associated with parental smoking

Odds ratio for smoking (95% confidence interval)
StudyPopulation age (years)/locationDefinition of asthmaPrevalence in unexposed (%)Either parent (unadjusted)Either parent (adjusted)One parent only vs. neitherBoth parents vs. neitherMother only vs. neitherFather only vs. neitherConfounders adjusted for
Lebowitz and Burrows 1976 0–15
United States
Physician diagnosis7.63.53 (2.13–5.86)NR*NRNRNRNRNR
Dodge 1982 8–12
United States
NR4.11.61 (0.78–3.33)NR1.36 (0.57–3.21)1.94 (0.81–4.50)NRNRNR
Burchfiel et al. 1986 0–19
United States
NR11.5NR1.14 (0.92–1.41)0.84 (0.63–1.13)1.62 (1.18–2.22)1.28 (0.68–2.40)0.76 (0.56–1.04)Age, gender, socioeconomic status (SES), family size
Goren and Goldsmith 1986 2nd and 5th graders
Israel
Ever8.91.07 (0.74–1.56)NRNRNR1.36 (0.87–2.14)0.91 (0.59–1.39)NR
Strachan and Elton 1986 5–7
United Kingdom
Wheeze consultations131.60 (0.56–4.60)NRNRNRNRNRNR
Somerville et al. 1988 5–11
United Kingdom
An attack in the past year41.0 (0.78–1.28)1.18 (0.86–1.62)NRNRNRNRChild’s age, gender, birth weight, and triceps skinfold; mother’s age and education; number of siblings; and father’s social class and job
Stern et al. 1989a 7–12
Canada
Current3.6NRNRNRNR1.11 (0.63–1.98)1.41 (0.80–2.48)NR
Stern et al. 1989b 7–12
Canada
Physician diagnosis (ever)4§NRNRNRNR1.43Δ (1.09–1.88)NRNR
Chinn and Rona 1991 5–11
United Kingdom
In the past yearNRNR1.02 (0.86–1.20)NRNRNRNRBirth weight; father’s social class and job; mother’s age, education, and smoking during pregnancy; and family size and ethnic origin
Dekker et al. 1991 5–8
Canada
Current4.81.53 (1.30–1.81)1.49 (NR)1.4 (1.13–1.73)1.59 (1.28–1.98)NRNRDampness, gas cooking, type of heating, pets
Forastiere et al. 1992 7–11
Italy
Ever (or symptoms)6.31.4 (NR)1.3 (0.9–1.8)NR1.50 (1.04–2.20)1.70 (1.04–2.70)1.0 (0.70–1.50)Age, gender, area, SES
Schmitzberger et al. 1993 6–15
Austria
Physician diagnosis3.4NRNRNRNR2.11 (1.22–3.67)NRNR
Brabin et al. 1994 5–11
United Kingdom
Ever171.09 (0.85–1.41)1.06 (0.83–1.37)NRNRNRNRArea
Soto-Quiros et al. 1994 6–12
Costa Rica
NRNRNRNRNRNR1.53 (1.14–2.04)1.19 (0.97–1.45)NR
Goren and Hellmann 1995 2nd and 5th graders
Israel
Ever9.61.19 (1.01–1.41)NR1.13 (0.94–1.36)1.33 (1.07–1.66)1.27 (1.04–1.55)1.19 (1.0–1.41)NR
Kay et al. 1995 3–11
United Kingdom
Current (definition unclear)171.42 (1.05–1.92)1.31 (0.96–1.81)NR1.81 (1.16–2.84)1.13 (0.71–1.80)1.3 (0.86–1.97)SES
Lau et al. 1995 3–10
Hong Kong
Current (definition unclear)71.35 (0.60–3.06)NRNRNRNRNRNR
Moyes et al. 1995 6–7
New Zealand
Ever251.06 (0.89–1.27)NRNRNRNRNRNR
13–14
New Zealand
Ever230.94 (0.79–1.13)NRNRNRNRNRNR
Soyseth et al. 1995 7–13
Norway
Ever7.7NRNRNRNR1.17 (0.66–2.07)0.72 (0.39–1.31)NR
7–13
Norway
EverNRNRNRNRNR1.26** (0.71–2.25)NRNR
7–13
Norway
EverNRNRNRNRNR1.99†† (1.08–3.67)NRNR
Volkmer et al. 1995 4–5
Australia
EverNRNot significantNot significantNRNRNRNRNR
Beckett et al. 1996 1–18
United States
Physician diagnosis10.31.56 (1.30–1.88)1.40 (1.13–1.72)NRNRNRNREthnicity, gas stove, mold, maternal age, maternal allergy, number of children at home
Bener et al. 1996 6–14
United Arab Republic
Ever12.71.28 (0.82–1.99)NRNRNRNRNRNR
Chen et al. 1996 ‡‡ 6–17
Canada
Physician diagnosis (ever)10.01.14 (0.72–1.79)NR0.92 (0.53–1.63)1.55 (0.84–2.84)1.17 (0.71–1.95)1.0 (0.61–1.64)NR
Peters et al. 1996 8–11
Hong Kong
Current physician diagnosis (definition unclear)6.1§NR0.90 (0.69–1.17)0.76 (0.55–1.07)1.22 (0.78–1.92)NRNRNR
Farber et al. 1997 5–17
United States
Ever15.9§NR1.39 (1.11–1.72)NRNRNRNRAge, gender, ethnicity
Forsberg et al. 1997 6–12
Scandinavia
Treatment by physician in the past 12 months3.5§NR1.4 (1.1–1.7)NRNRNRNRAge, gender, area, fitted carpets, pets, mold, stove use, parental asthma, early day care
Hu et al. 1997 10–11
United States (Illinois)
Physician diagnosis (ever)25.3NRNRNRNR1.22 (0.79–1.89)NRNone
Maier et al. 1997 5–9
United States (Washington state)
Physician diagnosis (ever)11§1.5 (1.0–2.4)1.6 (0.9–2.7)NRNRNRNRGender, ethnicity, allergy, SES, parental asthma
Selçuk et al. 1997 7–12
Turkey
Ever13.11.41 (1.19–1.67)1.35 (1.12–1.62)NRNRNRNRAge, gender, place, animals, atopic family, breastfeeding
7–12
Turkey
Current4.61.34 (1.02–1.77)1.28 (0.94–1.75)NRNRNRNRNR
Kendirli et al. 1998 6–14
Turkey
Ever (by questionnaire)12.9§1.41 (1.16–1.72)NRNRNRNRNRNR
Lam et al. 1998 12–15
Hong Kong
Physician diagnosis (ever)8.5NRNR0.89 (0.69–1.12)NR1.32 (0.71–2.45)0.92§§ (0.72–1.17)Age, gender, area, housing type
Rönmark et al. 1998 7–8
Sweden
Physician diagnosis and current6.4§NRNRNRNR1.6ΔΔ (1.1–2.3)NRGender, area, pets, dampness, family history
Withers et al. 1998 14–16
United Kingdom
Physician diagnosis (ever)22.3§NRp >0.05NRNR1.50 (1.14–1.98)p >0.05Parent and child atopy, sibling with asthma
Agabiti et al. 1999 6–7
Italy
Asthma with symptoms in the past year5.01.33 (1.10–1.60)1.34 (1.11–1.62)NR1.35 (1.09–1.69)1.46 (1.13–1.87)1.26 (1.01–1.58)Age, gender, area, father’s education, crowding, dampness, gas heating, parental asthma, other smokers
13–14
Italy
Asthma with symptoms in the past year5.91.26 (1.07–1.49)1.17 (0.99–1.39)NR1.29 (1.06–1.56)1.23 (0.98–1.53)1.04 (0.86–1.27)Age, gender, area, father’s education, crowding, dampness, gas heating, parental asthma, other smokers, active smoking
Chhabra et al. 1999 5–17
India
Current10.81.61 (NR)1.51 (1.34–1.69)NRNRNRNRAge, gender, atopic family
Lam et al. 1999 8–13
Hong Kong
Physician diagnosis (ever) (definition unclear)6.8NR0.91¶¶ (0.69–1.18)NRNRNRNRAge, gender, area, active smoking
Nilsson et al. 1999 13–14
Sweden
Ever (International Study of Asthma and Allergy in Childhood [ISAAC] child questionnaire)9.3§1.0 (0.7–1.4)NRNRNR1.4** (1.0–2.0)NRNone
Shamssain and Shamsian 1999 6–7
United Kingdom
Ever20.6NRNR1.35 (NR)1.55 (NR)1.39 (1.12–1.74)NRNone
Ponsonby et al. 2000 6–7
Australia
Has your child ever had asthma30.01.16 (0.85–1.57)1.03 (0.83–1.26)NRNR1.08** (0.90–1.30)NRGender, family history, breastfeeding, gas heat, mother’s education, number in household
Qian et al. 2000 5–14
China
Recall of asthma ever with physician diagnosis0.8–3.6NR2.11 (0.79–5.66)NRNRNRNRAge, gender, ventilation, family history, mother’s education, coal use, area
Räsänen et al. 2000 16
Finland
Physician diagnosis (ever) by questionnaire3.2NRNRNRNR1.49*** (1.02–2.18)NRGender, parental asthma and hay fever, number of older siblings, father’s occupation
*

NR = Data were not reported.

Mother currently smoked vs. did not smoke.

Father currently smoked vs. did not smoke.

§

Overall prevalence.

Δ

Mother smoked vs. did not smoke during pregnancy and infancy.

Not included in the meta-analysis.

**

Mother smoked vs. did not smoke prenatally.

††

Mother smoked vs. did not smoke postnatally.

‡‡

Estimates were determined by combining data for allergic and nonallergic participants.

§§

Father smoked vs. neither parent smoked where only 2.5% of the mothers smoked.

ΔΔ

Approximate confidence limits were derived from the given p value.

¶¶

Analyses excluded active smokers.

***

Mother ever vs. never smoked.

From: 6, Respiratory Effects in Children from Exposure to Secondhand Smoke

Cover of The Health Consequences of Involuntary Exposure to Tobacco Smoke
The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General.
Office on Smoking and Health (US).

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