Running Head: REDUCING ASTHMA IN CHILDREN
Reducing Asthma in Children
Kylie Muntz
Ferris State University
1
REDUCING ASTHMA IN CHILDREN
2
Asthma Reduction
Smoking has always been an extremely controversial issue. It has been said that when
people smoke, it will increase the likelihood that their child will have respiratory issues.
However, people around the world continue to be under educated about the harmful effects of
smoking. In order to understand this issue, research was done to statistically prove that smoking
(prenatal and postnatal) significantly increase the rate of asthma attacks and respiratory issues in
kids 18 and younger. The purpose of this paper is to find ways to decrease the number of
children suffering from respiratory issues related to parents smoking. If nurses and health care
providers can find a way to educate parents as well as children about the effects of smoking we
can improve the quality of life for so many children around the world.
PICO Question
The PICO question being researched is: “In pediatric patients with asthma, is there an
increased rate of asthma attacks when children live with patients that smoke in the home
compared to children that live with non smokers?” The “P” or population being studied is for
pediatric patients with asthma. The “I” or intervention is parents who are smokers. The “C” or
comparison is comparing parents who are smokers with non smokers. The “O” or outcome is
reduced rate of asthma attacks.
Research Findings
Burke et al. (2012) looked at the maternal and paternal rates of smokers, mothers
smoking while pregnant as well as after giving birth. “Thus far the largest review of the topic
reported to date, revealed that exposure to passive smoking, in particularly prenatal or postnatal
maternal smoking, is associated with significantly increased risks of onset of wheeze and asthma
REDUCING ASTHMA IN CHILDREN
3
in children” (p. 740). It was also found that, “the strongest significant effect was for prenatal
maternal smoking and incidence of asthma in children aged less than 2 years” (p. 738). Along
with that, “the most comparable data from our study revealed that maternal smoking was
associated with a 52% increased risk of wheeze and 20% increased risk of asthma at age 5 to 18
years” (p. 741).
Pattenden et al. (2006) look at three exposures; mothers who smoke during pregnancy,
parental smoking in first two years and current parental smoking. These factors were examined
and “there was strong evidence linking parental smoking to wheeze, asthma, bronchitis and
nocturnal cough, with mean odds ratios all around 1.15, with independent effects of prenatal and
postnatal exposures for most associations” (p. 294). It was concluded that “asthma was most
strongly associated with maternal smoking during pregnancy, but postnatal exposure showed
independent associations with a range of other respiratory symptoms. All tobacco smoke
exposure has serious consequences for children’s respiratory health and needs to be reduced
urgently” (p. 294).
Finally, Strachan and Cook (1998) noted that “the incidence of both wheezing and nonwheezing lower respiratory illnesses in infancy are increased to a similar extent if the parents
smoke, due at least in part to postnatal (environmental) exposure” (p. 211). They also found that,
“67% of the 265 cases who were exposed to parental smoking considered that it aggravated their
symptoms, and tobacco smoke exposure was considered a “significant factor” in 10% of children
(16/158) where one parent smoked, and in 20% (21/107) where both parents smoked” (p. 210)
Recommendations
Research plays such a huge role in the improvement of health and safety in patients.
When a problem is recognized, research can then be done to discover how to reduce the problem
REDUCING ASTHMA IN CHILDREN
4
through intervention and education. When researching a PICO question, it is extremely valuable
to use up to date evidence based findings. When these findings are put into practice the patients
quality of care and safety will be improved.
When dealing specifically with my PICO question, all of the research found that having
parents that smoke increases the chances of children having respiratory issues such as asthma
and wheezes. The articles selected were all meta-analysis, which are considered to be the highest
level of research. Although they are considered borrowed knowledge this information can still be
implemented into the practice of nursing. Education is such a huge tool in changing the lives of
patients. Most of the time, patients act a certain way or partake in certain activities because they
are not educated on how it impacts their lives. With this knowledge implementations should be
put educating newly pregnant moms as well as providing support groups to stop smoking. The
more support and education given to patients the more likely they are to change.
Based on these findings, what can we do as nurses? When findings such as this are
discovered it is our duty to bring light to the subject. In order to change policy or protocol it is
appropriate to first approach the manager and discusses the issue. Then most likely it will be
brought to attention by the policy and protocol committee. As we continue to bring to light
problems and then solutions to these issues change can take place.
Conclusion
In conclusion, smoking (prenatal and postnatal) greatly increases the likelihood of a child
to have respiratory issues, such as asthma. Through education and support groups, healthcare
providers, including nurses can greatly impact the number of incidence that occur. We are able to
provide patients with the highest level of evidence as well as provide them with the safest and
highest quality of care.
REDUCING ASTHMA IN CHILDREN
5
References
Burke, H., Leonardi-Bee, J., Hashim, A., Pine-Abata, H., Chen, Y., Cook, D., Britton, J., &
McKeever, T. (2012). Prenatal and passive smoke exposure and incidence of asthma and
wheeze: Systematic review and meta-analysis. Pediatrics, 129 (735), 735-744. doi:
10.1542/peds.2011-2196
Pattenden, S., Antova, T., Neuberger, M., Nikiforov, B., De Sario, M., Leticia, G., Heinrich, J.,
Hruba, F., Janssen, N., Luttmann-Gibson, H., Privalova, L., Rudnai, P., Splichalova, A.,
Zlotskowska, R., & Fletcher, T. (2006). Parental smoking and children’s respiratory
health: Independent effects of prenatal and postnatal exposure. Tobacco Control, 15, 294301. doi: 10.1136/tc.2005.015065
Strachan, D. P., & Cook, D. G. (1998). Parental smoking and childhood asthma: longitudinal and
case-control studies. Thorax, 53(3), 204-212.