Determining the burden of secondhand smoke exposure on the respiratory health of Thai children
More details
Hide details
Faculty of Public Health, Mahidol University, Bangkok, Thailand
Center of Excellence on Environmental Health and Toxicology, Bangkok, Thailand
Queen Sirikit National Institute of Child Health, Bangkok, Thailand
Center for the Study of Communication-Design, Osaka, Japan
Tobacco Control Research and Knowledge Management Center, Bangkok, Thailand
Submission date: 2012-11-16
Acceptance date: 2013-03-12
Publication date: 2013-03-18
Corresponding author
Nipapun Kungskulniti   

Faculty of Public Health, Mahidol University, Bangkok, Thailand
Tobacco Induced Diseases 2013;11(March):7
The impact of secondhand smoke (SHS) on Southeast Asian children’s health has been assessed by a limited number of studies. The purpose of this study was to determine whether in Thailand, pre- and postnatal exposure to SHS is associated with acute lower respiratory conditions in young children.

We conducted a case control study of 462 children under age five admitted with acute lower respiratory illnesses, including asthma and pneumonia, at a major hospital in Bangkok. We selected 462 comparison controls from the well-child clinic at the hospital and matched them by sex and age. We used a structured questionnaire to collect information about exposure to SHS and other factors. We conducted bivariate and multivariate analyses to identify risk factors for acute lower respiratory conditions.

The number of cigarettes smoked at home per day by household members was significantly greater among cases. A greater number of household caregivers of cases held and carried children while smoking as compared to controls (26% versus 7%, p <0.05). Cases were more likely to have been exposed to SHS in the household (adjusted OR = 3.82, 95% CI = 2.47-5.9), and outside (adjusted OR = 2.99, 95% CI = 1.45-6.15). Parental lower educational level and low household income were also associated with respiratory illnesses in Thai children under five.

Thai children who are exposed to SHS are at nearly 4 times greater risk of developing acute lower respiratory conditions. Continued effort is needed in Thailand to eliminate children’s exposure to SHS, especially at home.

Hirayama T: Non-smoking wives of heavy smokers have a higher risk of lung cancer: a study from Japan. Br Med J. 1981, 282 (6259): 183-185. 10.1136/bmj.282.6259.183.
Cook DG, Strachan DP: Health effects of passive smoking-10: summary of effects of parental smoking on the respiratory health of children and implications for research. Thorax. 1999, 54 (4): 357-366. 10.1136/thx.54.4.357.
International Agency for Research on Cancer: IARC Handbooks of Cancer Prevention, Tobacco Control, Vol 13: Evaluating the effectiveness of smoke-free policies. 2009, Lyon, France: International Agency for Research on Cancer.
Singh RJ, Lal PG: Second-hand smoke: a neglected public health challenge. Indian J Publ Health. 2011, 55 (3): 192-198. 10.4103/0019-557X.89950.
Sritippayawan S, Prapphal N, Wong P, Tosukhowong P, Samransamruajkit R, Deerojanawong J: Environmental tobacco smoke exposure and respiratory syncytial virus infection in young children hospitalized with acute lower respiratory tract infection. J Med Assoc Thai. 2006, 89 (12): 2097-2103.
Ostrea EM, Villanueva-Uy E, Ngerncham S, Punnakanta L, Batilando MJ, Agarwal P, Pensler E, Corrion M, Ramos EF, Romero J, Thomas RL: An epidemiologic study comparing fetal exposure to tobacco smoke in three Southeast Asian countries. Int J Occup Environ Health. 2008, 14 (4): 257-262.
Anuntaseree W, Mo-Suwan L, Ma-A-Lee A, Choprapawon C: Prevalence and associated factors of passive smoking in Thai infants. Prev Med. 2008, 47 (4): 443-446. 10.1016/j.ypmed.2008.06.006.
Suzuki M, Thiem VD, Yanai H, Matsubayashi T, Yoshida LM, Tho LH, Minh TT, Anh DD, Kilgore PE, Ariyoshi K: Association of environmental tobacco smoking exposure with an increased risk of hospital admissions for pneumonia in children under 5 years of age in Vietnam. Thorax. 2009, 64 (6): 484-489. 10.1136/thx.2008.106385.
Lee SL, Lam TH, Leung TH, Wong WH, Schooling M, Leung GM, Lau YL: Foetal exposure to maternal passive smoking is associated with childhood asthma, allergic rhinitis, and eczema. Sci World J. 2012, 2012: 542983.
Hovell MF, Hughes SC: The behavioral ecology of secondhand smoke exposure: a pathway to complete tobacco control [review]. Nicotine Tob Res. 2009, 11 (11): 1254-1264. 10.1093/ntr/ntp133.
Kim S, Wipfli H, Navas-Acien A, Dominici F, Avila-Tang E, Onicescu G, Breysse P, Samet JM, FAMRI Homes Study Investigators: Determinants of hair nicotine concentrations in nonsmoking women and children: a multicountry study of secondhand smoke exposure in homes. Canc Epidemiol Biomark Prev. 2009, 18 (12): 3407-3414. 10.1158/1055-9965.EPI-09-0337.
Homish GG, Eiden RD, Leonard KE, Kozlowski LT: Social-environmental factors related to prenatal smoking. Addict Behav. 2012, 37 (1): 73-77. 10.1016/j.addbeh.2011.09.001.
Anuntaseree W, Mo-Suwan L, Ovatlarnporn C, Tantana C, Ma-a-Lee A: Exposure to environmental tobacco smoke among infants in southern Thailand: a study of urinary cotinine. Bull Environ Contam Toxicol. 2008, 80 (1): 34-37. 10.1007/s00128-007-9303-7.
US Center for Disease Control and Prevention: Current tobacco Use and secondhand smoke exposure among women of reproductive Age — 14 countries, 2008–2010. MMWR. 2012, 61 (43): 877-882.
Cooking fuel and risk of under-five mortality in 23 Sub-Saharan African countries: a population-based study
Patrick Opiyo Owili, Miriam Adoyo Muga, Wen-Chi Pan, Hsien-Wen Kuo
International Journal of Environmental Health Research
The application of subset correspondence analysis to address the problem of missing data in a study on asthma severity in childhood
G. Hendry, D. North, T. Zewotir, R.N. Naidoo
Statistics in Medicine
Factors associated with secondhand smoke exposure in different settings: Results from the German Health Update (GEDA) 2012
Florian Fischer, Alexander Kraemer
BMC Public Health
Associations Between Household Secondhand Smoke Exposure and Health Problems Among Non-Smoking Adolescents in the Republic of Korea
Sunhee Park
The Journal of Primary Prevention
Impact of Tobacco Smoke and Nicotine Exposure on Lung Development
Kevin Gibbs, Joseph M. Collaco, Sharon A. McGrath-Morrow
Secondhand smoke point-source exposures assessed by particulate matter at two popular public beaches in Thailand
Nipapun Kungskulniti, Naowarut Charoenca, Jeremiah Mock, Stephen Lorin Hamann
Journal of Public Health
A cross-country comparison of the prevalence of exposure to tobacco advertisements among adolescents aged 13–15 years in 20 low and middle income countries
Israel T Agaku, Akinyele O Adisa, Akindayo O Akinyamoju, Samuel O Agboola
Tobacco Induced Diseases
Brand Cigarillos — A Cheap and Less Harmful Alternative to Cigarettes? Particulate Matter Emissions Suggest Otherwise
Alexander Gerber, Alexander Bigelow, Michaela Schulze, David Groneberg
International Journal of Environmental Research and Public Health
Prevalence and Determinants of Secondhand Smoke Exposure Among Women in Bangladesh, 2011
Florian Fischer, Martina Minnwegen, Ulrike Kaneider, Alexander Kraemer, Md. Mobarak Hossain Khan
Nicotine & Tobacco Research
Household air pollution and household health in Uganda
Buyinza Faisal, Jakob Kapella, Senono Vicent
Development Southern Africa
Airway diseases
Makbule Akbay, Dilek Ernam