Smoking and Real Life Results of Children and Adolescents

Öz

Aim: Smoking is a chronic disease and children are the most affected group. In this study, we aimed to question the smoking habits of children and their parents and examine the level of exhaled carbon monoxide (eCO) to evaluate the usefulness of the method in an outpatient allergy clinic. Methods: A questionnare was applied to 29 children who were smoker or exposed to second-hand smoke (SHS) and their parents separately. eCO levels of the participants were measured with CO Smokerlyzer. Results: The median eCO level of children who smoked was 10 (7-14) ppm and was significantly higher than children exposed to SHS (P <0.001). The children who smoked were significantly older, the more they had friends who smoked. Children who were not exposed to tobacco products had lower rates of hospitalization due to recurrent lower respiratory tract infections, and family history of asthma was lower than children exposed to SHS (p <0.05). All the children were aware of the harmful effects of smoking. 34.5% of the parents were never questioned by their physicians about tobacco and its products and were not informed about smoking. Conclusions: Using eCO in the clinic is a useful method to predict smoking status in daily practice. Children's attitudes towards smoking and peer relationships and parents' ignorance of smoking and SHS are still an unresolved issue.

Anahtar Kelimeler

• smoking
• tobacco
• children
• adelosecent
• pasif smoking
• exhale carbon monoksit
• nicotin

Çocuklar ve Ergenlerin Sigara İçme ve Gerçek Yaşam Sonuçları

Öz

Amaç: Sigara içmek kronik bir hastalıktır ve çocuklar en çok etkilenen gruptur. Bu çalışmada, alerji polikliniğinde çocukların ve ebeveynlerinin sigara içme alışkanlıklarını sorgulamayı ve ekshale edilen karbon monoksit (eCO) yönteminin yararlılığını değerlendirilmesini amaçladık. Yöntemler: Sigara içen veya ikinci el dumana (SHS) maruz kalan 29 çocuk ve ebeveynlerine ayrı ayrı anket uygulandı. Katılımcıların eCO seviyeleri CO Smokerlyzer ile ölçüldü. Bulgular: Sigara içen çocukların medyan eCO düzeyi 10 (7-14) ppm idi ve pasif sigaraya maruz kalan çocuklarda anlamlı derecede yüksekti (P <0.001). Sigara içen çocukların yaşı daha büyüktü, ve sigara içen arkadaşları vardı. Tütün ürünlerine maruz kalmayan çocukların tekrarlayan alt solunum yolu enfeksiyonları nedeniyle hastaneye yatış oranları daha düşüktü ve ailede astım öyküsü daha azdı düşüktü (p <0.05). Bütün çocuklar sigaranın zararlı etkilerinin farkındaydı. Ebeveynlerin% 34,5'i tütün ve ürünleri hakkında hekimleri tarafından hiç sorgulanmamış ve sigara hakkında bilgilendirilmemişti. Sonuçlar: Klinikte eCO kullanmak, günlük pratikte sigara içme durumunu tahmin etmek için yararlı bir yöntemdir. Çocukların sigara içmeye ve akran ilişkilerine karşı tutumları ve ebeveynlerin sigara ve pasif sigara konusundaki bilgisizliği hala çözülmemiş bir konudur.

Anahtar Kelimeler

• Sigara
• tütün
• çocuk
• adelosan
• soluk havası karbon monoksit
• nikotin
• pasif içiçi

Kaynakça

1. 1. Oberg M1, Jaakkola MS, Woodward A, Peruga A, Prüss-Ustün A. Worldwide burden of disease from exposure to second-hand smoke: a retrospective analysis of data from 192 countries. Lancet. 2011; 377:139-46.
2. 2. Difranza JR, Aligne CA, Weitzman M. Prenatal and postnatal environmental tobacco smoke exposure and children’s health. Pediatrics 2004; 113:1007-15.
3. 3. Centers for Disease Control and Prevention. Health Effects od Secondhand Smoke. Available online at https://www.cdc.gov/tobacco/data_statistics/fact_sheets/secondhand_smoke/health_effects/index.htm; accessed June 22, 2019.
4. 4. Moritsugu KP. The 2006 Report of the Surgeon General: the health consequences of involuntary exposure to tobacco smoke. Am J Prev Med. 2007;32:542-3.
5. 5. Maritz GS, Harding R. Life-long programming implications of exposure to tobacco smoking and nicotine before and soon after birth: evidence for altered lung development. Int J Environ Res Public Health. 2011;8:875-98.
6. 6. Apelberg BJ, Hepp LM, Avila-Tang E, Gundel L, Hammond SK, Hovell MF et al. Environmental monitoring of secondhand smoke exposure. Tob Control. 2013;22:147-55.
7. 7. Middleton ET, Morice AH. Breath carbon monoxide as an indication of smoking habit. Chest. 2000;117, 758–763.
8. 8. Shie HG, Pan SW, Yu WK, Chen WC, Ho LI, Ko HK. Levels of exhaled carbon monoxide measured during an intervention program predict 1-year smoking cessation: a retrospective observational cohort study. NPJ Prim Care Respir Med. 2017; 16:59

9. 9. World Health Organization. Second-hand tobacco smoke and children. Available online at https://www.who.int/ceh/capacity/tobacco1.pdf; accessed June 22, 2019.
10. 10. World Health Organization. WHO Global Report on trends in prevalence of tobacco smoking 2000-2025, second edition. Geneva: World Health Organization;2018. Available online at https://apps.who.int/iris/bitstream/handle/10665/272694/9789241514170-eng.pdf; accessed June 22, 2019.
11. 11. Global Adult Survey Turkey Report 2012. Ministry of Health, Publication No: 948, Ankara 2014. Available online at https://www.who.int/tobacco/surveillance/survey/gats/report_tur_2012.pdf; accessed June 22, 2019.
12. 12. Vançelik S, Beyhun NE, Acemoğlu H. Interactions between exhaled CO, smoking status and nicotine dependency in a sample of Turkish adolescents. Turk J Pediatr. 2009; 51: 56-64.
13. 13. Deveci SE, Deveci F, Acik Y, Ozan AT. The measurement of exhaled carbon monoxide in healthy smokers and non-smokers. Respir Med. 2004; 98: 551–556.
14. 14. Larenjeira R, Pillon S, Dunn J. Environmental tobacco smoke exposure among non-smoking waiters: measurement of expired carbon monoxide levels. Sao Paulo Med J. 2000;118:89–92.
15. 15. Sandberg A, Sköld CM, Grunewald J, Eklund A, Wheelock ÅM. Assesing recent smoking status by measuring exhaled carbon monoxide levels. Plos One. 2011;6:e28864
16. 16. Yamaya M, Hosoda M, Ishizuka S, Monma M, Matsui T, Suzuki T et al. Relation between exhaled carbon monoxide levels and clinical severity of asthma. Clin Exp Allergy. 2001; 31:417-22.
17. 17. Jesenak M, Banovcin P, Havlicekova Z, Dobrota D, Babusikova E. Factors influencing the levels of exhaled carbon monoxide in asthmatic children. J Asthma. 2014;51:900-6.
18. 18. Ozge C, Toros F, Bayramkaya E, Camdeviren H, Sasmaz T. Which sociodemographic factors are important on smoking behaviour of high school students? The contribution of classification and regression tree methodology in a broad epidemiological survey. Postgrad Med J. 2006;82:532–541.
19. 19. Kim DJ, Kim SJ. Impact of nearby smoking on adolescent smoking behavior in Korea. Medicine (Baltimore). 2018 ;97:e13125.
20. 20. Oberg M, Jaakkola MS, Woodward A, Peruga A, Prüss-Ustün A. Worldwide burden of disease from exposure to second-hand smoke: a retrospective analysis of data from 192 countries. Lancet. 2011;377:139-146.