Table 6.11

Studies of wheeze prevalence associated with parental smoking

Odds ratio for smoking (95% confidence interval)
StudyPopulation age (years)/locationDefinition of wheezePrevalence 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
Most days1.42.86 (0.92–8.87)NR*NRNRNRNRNR
Schilling et al. 1977 7–15
United States
Ever11.71.99 (1.28–3.10)NR1.47 (0.90–2.4)4.57 (2.45–8.51)2.08 (1.14–3.79)1.07 (0.57–1.99)NR
Kasuga et al. 1979 6–11
Japan
Current (or asthma)9.82.08 (1.49–2.91)1.15 (0.83–1.61)NRNRNRNRDistance from a major road
Stanhope et al. 1979 12–18
New Zealand
Current (or asthma)NRNRNRNRNR0.53 (0.26–1.05)NRNR
Weiss et al. 1980 5–9
United States
Current and persistent1.85.89 (0.79–44.1)NR4.12 (0.52–32.9)7.52 (0.99–57.3)NRNRNR
Dodge 1982 8–12
United States
Ever27.91.32 (0.94–1.85)NR1.01 (0.67–1.52)1.8 (1.19–2.73)NRNRNR
Schenker et al. 1983 5–14
United States
Persistent7.20.93 (0.73–1.19)NR1.08 (0.82–1.40)0.74 (0.53–1.04)NRNRNR
Ware et al. 1984 6–9
United States
Persistent9.9NR1.2 (1.05–1.37)1.11 (0.95–1.29)1.32 (1.14–1.53)1.18 (0.95–1.48)1.08 (0.92–1.28)Age, gender, city
Burchfiel et al. 1986 0–19
United States
NR18.4NR1.28 (1.08–1.52)1.1 (0.87–1.39)1.53 (1.19–1.97)1.42 (0.85–2.36)1.03 (0.80–1.33)Age, gender, parental education
Goren and Goldsmith 1986 Grades 2–5
Israel
Wheeze with a cold12.71.27 (0.95–1.70)NRNRNR0.98 (0.66–1.46)1.44 (1.05–1.98)NR
McConnochie and Roghmann 1986a 6–10
United States
Current10.2NRNRNRNR2.16 (0.97–4.80)1.20 (0.55–2.62)NR
Strachan and Elton 1986 7–8
United Kingdom
Ever202.1 (0.87–5.1)NRNRNRNRNRNR
Somerville et al. 1988 5–11
United Kingdom
Ever111.09§ (0.95–1.26)1.22 (1.02–1.45)NRNRNRNRAge, gender, birth weight, obesity, socioeconomic status (SES), mother’s age, number of siblings
5–11
United Kingdom
Most days/nights31.66 (1.01–2.12)1.54 (1.16–2.04)NRNRNRNRAge, gender, birth weight, obesity, SES, mother’s age, number of siblings
Strachan 1988 7
United Kingdom
In the past year12.11.04 (0.72–1.52)NR1.0 (0.65–1.54)1.13 (0.67–1.90)NRNRNR
Hosein et al. 1989 7–17
United States
Current13NR1.23 (0.88–1.72)1.32 (0.91–1.91)1.14 (0.78–1.68)NRNRGender, active smoking
Stern et al. 1989a 7–12
Canada
Ever22.9NRNRNRNR1.59 (1.24–2.03)1.03 (0.80–1.31)NR
Stern et al. 1989b 7–12
Canada
Persistent9ΔNRNRNRNR1.26 (0.95–1.67)NRNR
Dijkstra et al. 1990 6–12
Netherlands
In the past year7.1ΔNR1.86 (0.99–3.49)NRNRNRNRAge, parental education
Chinn and Rona 1991 5–11
United Kingdom
EverNRNR1.11§ (1.0–1.22)NRNRNRNRAge, gender, country, birth weight, obesity, SES, mother’s age, number of siblings, ethnicity, gas cooking
5–11
United Kingdom
Most days or nightsNRNR1.31 (1.11–1.55)NRNRNRNRAge, gender, country, birth weight, obesity, SES, mother’s age, number of siblings, ethnicity, gas cooking
Dekker et al. 1991 5–8
Canada
Current7.21.6 (1.39–1.83)1.55 (NR)1.39 (1.17–1.65)1.72 (1.44–2.05)NRNRDampness, gas cooking
Henry et al. 1991 5–12
Australia
In the past year17.3NR1.4 (0.8–2.3)NRNRNRNRAge, gender, area, dust mite allergy
Duffy and Mitchell 1993 8 and 12
Australia
Ever22ΔNRNRNRNR1.36 (0.96–1.93)0.94 (0.70–1.26)NR
Halliday et al. 1993 5–12
Australia
CurrentNRNR1.02 (0.71–1.47)NRNRNRNRAge, gender, area, atopy
Jenkins et al. 1993 7
Australia
Ever (or asthma)NRNRNRNRNR1.35 (1.2–1.52)1.10 (0.97–1.23)NR
Brabin et al. 1994 5–11
United Kingdom
Ever181.32 (1.03–1.69)1.28 (1.0–1.64)NRNRNRNRArea
Shaw et al. 1994 8–13
New Zealand
Current221.0 (0.7–1.4)NRNRNRNRNRNR
8–13
New Zealand
Current18NRNRNRNR1.4 (1.0–2.1)NRNR
8–13
New Zealand
Current§22NRNRNRNR0.9** (0.7–1.4)NRNR
Bråbäck et al. 1995 10–12
Sweden
NR11.9NRNRNRNR0.73 (0.41–1.29)NRGender, atopy, dampness, overcrowding
10–12
Poland
NR9.4NRNRNRNR1.54 (0.91–2.60)NRGender, atopy, dampness, overcrowding
10–12
Estonia
NR7.1NRNRNRNR1.45 (0.94–2.24)NRGender, atopy, dampness, overcrowding
Cuijpers et al. 1995 6–12
Netherlands
Ever (definition unclear)14.7ΔNR1.08 (0.67–1.74)NRNRNRNRAge, gender, dampness, father’s education, dog, unvented geyser
Goren and Hellmann 1995 2nd and 5th graders
Israel
Wheeze with a cold13.11.25 (1.09–1.44)NR1.24 (1.07–1.45)1.27 (1.06–1.53)1.25 (1.06–1.48)1.27 (1.10–1.47)NR
Moyes et al. 1995 6–7
New Zealand
Current231.06 (0.88–1.27)NRNRNRNRNRNR
13–14
New Zealand
Current281.16 (0.98–1.37)NRNRNRNRNRNR
Stoddard and Miller 1995 0–17
United States
Current (or asthma)§NRNRNRNRNR1.36 (1.14–1.62)0.83 (0.67–1.02)Gender, race, area, SES, family size
0–2
United States
Current (or asthma)11.6NRNRNRNR1.90 (1.23–2.94)NRGender, race, area, SES, family size
3–5
United States
Current (or asthma)8NRNRNRNR1.53 (0.99–2.37)NRGender, race, area, SES, family size
6–12
United States
Current (or asthma)7.5NRNRNRNR1.35 (1.01–1.81)NRGender, race, area, SES, family size
13–17
United States
Current (or asthma)8.5NRNRNRNR1.07 (0.76–1.49)NRGender, race, area, SES, family size
Volkmer et al. 1995 4–5
Australia
In the past yearNR1.12 (NR)Not significant§NRNRNRNRMethod of heating and ventilating
4–5
Australia
EverNR1.24 (NR)1.18 (1.08–1.30)NRNRNRNRMethod of heating and ventilating
Abuekteish et al. 1996 6–12
Jordan
In the past 3 years12.4ΔNRNRNRNR1.87 (1.28–2.75)1.31 (1.05–1.63)NR
Peters et al. 1996 10–13
Hong Kong
NR7.1ΔNR1.01 (0.79–1.29)0.94 (0.69–1.28)1.70 (1.15–2.54)NRNRAge, gender, district, father’s education, housing
Wright et al. 1996 6
United States
Current26.41.32 (0.98–1.80)NRNRNRNRNRNR
Austin and Russell 1997 12 and 14
United Kingdom
Current16.61.13 (0.87–1.48)NRNRNR1.15 (0.84–1.56)NRNR
Butland et al. 1997 7.5–8.5
United Kingdom
≤4 attacks in the past year; parent questionnaire6.6NRNRNRNR1.27** (0.93–1.74)1.04†† (0.76–1.43)Study period
7.5–8.5
United Kingdom
>4 attacks in the past year; parent questionnaire2.6NRNRNRNR1.55** (1.02–2.34)1.06†† (0.69–1.62)Study period
Hu et al. 1997 10–11
United States (Chicago)
In the past year29.0NRNRNRNR0.79 (0.51–1.21)NRNone
Leung et al. 1997 13–14
Hong Kong
Current‡‡12Δ1.14 (0.92–1.42)NRNRNRNRNRNR
13–14
Hong Kong
Severe attack‡‡2.4Δ1.05§ (0.64–1.74)NRNRNRNRNRNR
Maier et al. 1997 5–9
United States (Washington state)
In the past year (no asthma diagnosis)7Δ1.7 (1.0–2.9)1.8 (1.0–3.2)NRNRNRNRGender, ethnicity, allergy, SES, parental asthma
Selçuk et al. 1997 7–12
Turkey
Ever16.11.29 (1.10–1.51)1.25§ (1.05–1.48)NRNRNRNRAge, gender, place, animals, atopic family, breastfeeding
7–12
Turkey
Current4.11.39 (1.02–1.90)1.52 (1.10–2.09)NRNRNRNRNR
Chhabra et al. 1998 4–17
India
Current wheeze15.31.62 (1.27–2.05)NRNRNRNRNRNR
Kendirli et al. 1998 6–14
Turkey
Wheeze (ever)8.41.63 (1.29–2.08)NRNRNRNRNRNR
Lam et al. 1998 12–15
Hong Kong
In the past 3 months4.8NRNR1.21 (0.91–1.60)NR1.71 (0.84–3.49)1.24†† (0.93–1.64)Age, gender, area, housing type
Lewis and Britton 1998 16
United Kingdom
Current wheezeNRNRNRNRNR1.27** (1.16–1.39)NRGender, SES, breastfeeding, maternal age, parity, birth weight, gestational age
Lewis et al. 1998 8–11
Australia
>3 episodes of wheeze in the past year8.6NR1.16 (0.85–1.59)NRNRNRNRAge, gender, PM10§§, SO2ΔΔ, gas heating, maternal allergy
Peters et al. 1998 8–13
Hong Kong
Physician consultation for wheeze in the past 3 months2.21.22 (0.96–1.57)NR1.04 (0.76–1.41)1.57 (1.02–2.43)NRNRAge, gender, housing type, area, father’s education
Saraçlar et al. 1998 7–14
Turkey
Ever (International Study of Asthma and Allergy in Childhood [ISAAC])4.7ΔNR1.33 (1.03–1.76)NRNRNRNRAge, gender, pets, parental atopy, SES
Withers et al. 1998 14–16
United Kingdom
Current wheeze18.2ΔNR1.48 (1.17–1.88)NRNRp >0.05p >0.05Maternal asthma, child eczema and hay fever, atopic sibling, pets, gas cooking; active smoking was “not significant”
Agabiti et al. 1999 6–7
Italy
Wheeze in the past year (no asthma diagnosis); parent questionnaire5.21.09 (0.90–1.32)1.13 (0.93–1.37)NR1.24 (0.99–1.56)1.18 (1.0–1.39)1.14 (0.97–1.36)Age, gender, area, father’s education, crowding, dampness, gas heating, parental asthma, other smokers
13–14
Italy
Wheeze in the past year (no asthma diagnosis); child questionnaire8.41.42 (1.23–1.63)1.24 (1.07–1.44)NR1.31 (1.11–1.56)1.26 (1.13–1.41)1.09 (0.96–1.24)Age, gender, area, father’s education, crowding, dampness, gas heating, parental asthma, other smokers, active smoking
Belousova et al. 1999 8–11
Australia
Wheeze in the past year23.8NRNRNRNR1.33 (1.2–1.5)NRAtopy, parental asthma, early life bronchitis
Burr et al. 1999 12–14
United Kingdom
Wheeze in the past 12 months; child questionnaire31.81.22 (1.15–1.28)1.14¶¶ (1.09–1.19)NRNRNRNRGender, area, pets, cooking fuel, heating fuel, housing type, active smoking
12–14
United Kingdom
Speech-limiting wheeze in the past 12 months7.61.40 (1.28–1.52)1.27§,¶¶ (1.17–1.36)NRNRNRNRGender, area, pets, cooking fuel, heating fuel, housing type, active smoking
Chhabra et al. 1999 5–17
India
Current wheeze (definition unclear)10.81.69 (NR)1.61 (1.47–1.78)NRNRNRNRAge, gender, family atopy
Lam et al. 1999 8–13
Hong Kong
Wheeze (ever)9.6NR1.12 (0.89–1.41)¶¶NRNRNRNRAge, gender, area, active smoking
Shamssain and Shamsian 1999 6–7
United Kingdom
Wheeze in the past year15.5NRNR1.11 (NR)1.50 (NR)1.15 (0.86–1.54)NRNone
6–7
United Kingdom
Speech-limiting attack in the past year2.7NRNRNRNR1.12 (0.66–1.90)NRNone
6–7
United Kingdom
Wheeze (ever)25.6NRNRNRNR1.46 (1.19–1.79)NRNone
Wang et al. 1999 11–16
Taiwan
Wheeze in the past year; video; written questionnaires13.21.02 (0.99–1.05)1.08 (1.05–1.12)NRNRNRNRAge, gender, parental education, area, Chinese incense, exercise, active smoking, alcohol consumption
Csonka et al. 2000 6–13
Finland
Current wheeze or asthma>9.61.6 (1.0–2.6)NRNRNRNRNRNR
Qian et al. 2000 5–14
China
Wheeze (ever)6.9–17.4NR1.31 (0.96–1.78)NRNRNRNRAge, gender, ventilation, family history, mother’s education, coal use, area
*

NR = Data were not reported.

Mother currently smoked vs. did not smoke.

Father currently smoked vs. did not smoke.

§

Not included in the meta-analysis.

Δ

Overall prevalence.

Primary caregiver smoked vs. did not smoke.

**

Mother smoked vs. did not smoke prenatally.

††

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

‡‡

Based on a written questionnaire.

§§

PM10 = Particulate matter (levels of particles [particulate pollution] with an aerodynamic diameter of less than 10 micrometers).

ΔΔ

SO2 = Sulfur dioxide.

¶¶

Derived from pooled results of all household smokers.

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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