Tobacco Smoke Exposure and Early Childhood Illness

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Tobacco Smoke and Early Childhood Illness What
PRAMS and TOTS Can Tell Us
Michele Cote, MPH Dick Lorenz, MSPH Edd D.
Rhoades, MD, MPH Sara Reed DePersio, MD, MPH
Don Blose, MA
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What is TOTS?

• The Oklahoma Toddler Survey
• A longitudinal follow-up to PRAMS
• Active surveillance of issues affecting the
  health status of 2-year-olds in Oklahoma

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TOTS Methodology
Two Year Sample
Death before PRAMS
Birth Certificate Filing Error
PRAMS
Non-respondents
PRAMS Sample n?5,000
TOTS Sample
n3,350
Incorrect Mailing Information
Excluded Siblings
OK Resident Live Births
TOTS Respondents
n?93,000
n2,461 (73 response)
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Research Question Does exposure to tobacco smoke
during early childhood have adverse effects on a
childs health?
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37 missing
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173 missing
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Oklahoma TOTS 12/94-12/96 Data Set
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Current Source of Smoke Exposure Among those
Unexposed in the Perinatal Period
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Q In the past 30 days, how many different
times has your 2 year old had a cold or runny
nose with a fever or cough?
26.4 of children who are around tobacco smoke
daily have had 3 or more colds in the past 30
days, compared to 13.6 of children who are not
exposed to tobacco smoke.
plt0.05
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Q During the past 3 months, how many different
times was your 2 year olds activity limited due
to sickness?
15.5 of children who have daily exposure to
tobacco smoke have been ill enough to limit their
activities 3 or more days during the last 3
months, compared with 4.1 of children who are
not exposed to smoke.
plt0.05
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17.6
10.1
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Conditions Ever Diagnosed by a Health Care
Provider

• Asthma
• Croup, bronchitis, bronchiolitis
• Pneumonia
• Need for ear tubes

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14.3 of children who are exposed to smoke have
been told by a health care provider that they
have asthma, compared to 7.2 of children who are
unexposed to smoke.
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In this population, there was no difference
between toddlers that were exposed to smoke daily
and those that werent with respect
to Pneumonia Croup/Bronchitis Ear Tube
Insertions
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Considerations
As our sample size increases, we will be able
to further stratify and possibly see associations
with other risk factors and early childhood
illnesses. The ability to interview the
mothers twice, once about prenatal behaviors and
then about the childs health, may limit bias.
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Summary
Toddlers exposed to smoke are more likely to
have colds, and have them more frequently or take
longer to recover than their peers who are not
exposed to smoke. They are also more likely to
be diagnosed with asthma.
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Summary
Caretakers of children exposed to smoke miss
more work or school than those children who are
not exposed to smoke. Almost 20 of Oklahoma
toddlers live in an environment where both the
mother and her partner smoke.
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Questions?