Abstract
OBJECTIVES: Use of health services by children of smokers and nonsmokers was compared to assess whether exposure to environmental tobacco smoke resulted in greater use of health services among children of smokers. METHODS: Primary care and emergency room visits, asthma-related prescriptions, and inpatient stays over the 42-month study period were compared for children of smokers (n = 498) and nonsmokers (n = 1062) who were enrolled in a health maintenance organization. Parents of children aged 1 through 11 years were identified from participants in 2 randomized smoking cessation trials. RESULTS: After adjustment for parental age, education, and health status and for child's age, there were no differences between children of smokers and children of nonsmokers in use of primary care or emergency room visits, asthma-related prescriptions, or inpatient stays. However, among those with any preventive care visits, children of smokers had significantly fewer visits than children of nonsmokers. CONCLUSIONS: Further study is needed to elucidate whether parents who smoke underutilize health services for their children or use services differently from nonsmoking parents and whether these differences have cost implications.
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- Andersen R. M. Revisiting the behavioral model and access to medical care: does it matter? J Health Soc Behav. 1995 Mar;36(1):1–10. [PubMed] [Google Scholar]
- Black N. Surgery for glue ear--a modern epidemic. Lancet. 1984 Apr 14;1(8381):835–837. doi: 10.1016/s0140-6736(84)92280-3. [DOI] [PubMed] [Google Scholar]
- Bonham G. S., Wilson R. W. Children's health in families with cigarette smokers. Am J Public Health. 1981 Mar;71(3):290–293. doi: 10.2105/ajph.71.3.290. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Burchfiel C. M., Higgins M. W., Keller J. B., Howatt W. F., Butler W. J., Higgins I. T. Passive smoking in childhood. Respiratory conditions and pulmonary function in Tecumseh, Michigan. Am Rev Respir Dis. 1986 Jun;133(6):966–973. doi: 10.1164/arrd.1986.133.6.966. [DOI] [PubMed] [Google Scholar]
- Charlton A. Children's coughs related to parental smoking. Br Med J (Clin Res Ed) 1984 Jun 2;288(6431):1647–1649. doi: 10.1136/bmj.288.6431.1647. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Chen Y., Li W., Yu S. Influence of passive smoking on admissions for respiratory illness in early childhood. Br Med J (Clin Res Ed) 1986 Aug 2;293(6542):303–306. doi: 10.1136/bmj.293.6542.303. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Curry S. J., McBride C., Grothaus L. C., Louie D., Wagner E. H. A randomized trial of self-help materials, personalized feedback, and telephone counseling with nonvolunteer smokers. J Consult Clin Psychol. 1995 Dec;63(6):1005–1014. doi: 10.1037//0022-006x.63.6.1005. [DOI] [PubMed] [Google Scholar]
- Curry S. J., Wagner E. H., Grothaus L. C. Evaluation of intrinsic and extrinsic motivation interventions with a self-help smoking cessation program. J Consult Clin Psychol. 1991 Apr;59(2):318–324. doi: 10.1037//0022-006x.59.2.318. [DOI] [PubMed] [Google Scholar]
- DiFranza J. R., Lew R. A. Morbidity and mortality in children associated with the use of tobacco products by other people. Pediatrics. 1996 Apr;97(4):560–568. [PubMed] [Google Scholar]
- Fergusson D. M., Horwood L. J. Parental smoking and respiratory illness during early childhood: a six-year longitudinal study. Pediatr Pulmonol. 1985 Mar-Apr;1(2):99–106. doi: 10.1002/ppul.1950010208. [DOI] [PubMed] [Google Scholar]
- Gergen P. J., Mullally D. I., Evans R., 3rd National survey of prevalence of asthma among children in the United States, 1976 to 1980. Pediatrics. 1988 Jan;81(1):1–7. [PubMed] [Google Scholar]
- Gergen P. J., Weiss K. B. Changing patterns of asthma hospitalization among children: 1979 to 1987. JAMA. 1990 Oct 3;264(13):1688–1692. [PubMed] [Google Scholar]
- Harlap S., Davies A. M. Infant admissions to hospital and maternal smoking. Lancet. 1974 Mar 30;1(7857):529–532. doi: 10.1016/s0140-6736(74)92714-7. [DOI] [PubMed] [Google Scholar]
- Iversen M., Birch L., Lundqvist G. R., Elbrønd O. Middle ear effusion in children and the indoor environment: an epidemiological study. Arch Environ Health. 1985 Mar-Apr;40(2):74–79. doi: 10.1080/00039896.1985.10545893. [DOI] [PubMed] [Google Scholar]
- Lieu T. A., Black S. B., Ray P., Chellino M., Shinefield H. R., Adler N. E. Risk factors for delayed immunization among children in an HMO. Am J Public Health. 1994 Oct;84(10):1621–1625. doi: 10.2105/ajph.84.10.1621. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Marbury M. C., Maldonado G., Waller L. The indoor air and children's health study: methods and incidence rates. Epidemiology. 1996 Mar;7(2):166–174. doi: 10.1097/00001648-199603000-00011. [DOI] [PubMed] [Google Scholar]
- Martinez F. D., Cline M., Burrows B. Increased incidence of asthma in children of smoking mothers. Pediatrics. 1992 Jan;89(1):21–26. [PubMed] [Google Scholar]
- Pearson D. C., Grothaus L. C., Thompson R. S., Wagner E. H. Smokers and drinkers in a health maintenance organization population: lifestyles and health status. Prev Med. 1987 Nov;16(6):783–795. doi: 10.1016/0091-7435(87)90018-1. [DOI] [PubMed] [Google Scholar]
- Pedreira F. A., Guandolo V. L., Feroli E. J., Mella G. W., Weiss I. P. Involuntary smoking and incidence of respiratory illness during the first year of life. Pediatrics. 1985 Mar;75(3):594–597. [PubMed] [Google Scholar]
- Schenker M. B., Samet J. M., Speizer F. E. Risk factors for childhood respiratory disease. The effect of host factors and home environmental exposures. Am Rev Respir Dis. 1983 Dec;128(6):1038–1043. doi: 10.1164/arrd.1983.128.6.1038. [DOI] [PubMed] [Google Scholar]
- Strachan D. P., Jarvis M. J., Feyerabend C. Passive smoking, salivary cotinine concentrations, and middle ear effusion in 7 year old children. BMJ. 1989 Jun 10;298(6687):1549–1552. doi: 10.1136/bmj.298.6687.1549. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Strachan D. P., Jarvis M. J., Feyerabend C. The relationship of salivary cotinine to respiratory symptoms, spirometry, and exercise-induced bronchospasm in seven-year-old children. Am Rev Respir Dis. 1990 Jul;142(1):147–151. doi: 10.1164/ajrccm/142.1.147. [DOI] [PubMed] [Google Scholar]
- Taylor A. K., Beauregard K. M., Vistnes J. P. Who belongs to HMOs: a comparison of fee-for-service versus HMO enrollees. Med Care Res Rev. 1995 Sep;52(3):389–408. doi: 10.1177/107755879505200304. [DOI] [PubMed] [Google Scholar]
- Venters M. H., Jacobs D. R., Jr, Luepker R. V., Maiman L. A., Gillum R. F. Spouse concordance of smoking patterns: the Minnesota Heart Survey. Am J Epidemiol. 1984 Oct;120(4):608–616. doi: 10.1093/oxfordjournals.aje.a113922. [DOI] [PubMed] [Google Scholar]
- Vogt T. M. Effects of parental smoking on medical care utilization by children. Am J Public Health. 1984 Jan;74(1):30–34. doi: 10.2105/ajph.74.1.30. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Vogt T. M., Schweitzer S. O. Medical costs of cigarette smoking in a health maintenance organization. Am J Epidemiol. 1985 Dec;122(6):1060–1066. doi: 10.1093/oxfordjournals.aje.a114187. [DOI] [PubMed] [Google Scholar]
- Wright A. L., Holberg C. J., Martinez F. D., Halonen M., Morgan W., Taussig L. M. Epidemiology of physician-diagnosed allergic rhinitis in childhood. Pediatrics. 1994 Dec;94(6 Pt 1):895–901. [PubMed] [Google Scholar]
- Wright A. L., Taussig L. M., Ray C. G., Harrison H. R., Holberg C. J. The Tucson Children's Respiratory Study. II. Lower respiratory tract illness in the first year of life. Am J Epidemiol. 1989 Jun;129(6):1232–1246. doi: 10.1093/oxfordjournals.aje.a115243. [DOI] [PubMed] [Google Scholar]