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The Association between Secondhand Smoke Exposure and Childhood Asthma: A Systematic Review and Meta-Analysis

22 Pages Posted: 29 Jul 2019

See all articles by Zonglin He

Zonglin He

Sun Yat-sen University (SYSU) - Department of Obstetrics and Gynaecology

Siyu Zhang

Sun Yat-sen University (SYSU) - Department of Obstetrics and Gynaecology

Huailiang Wu

Sun Yat-sen University (SYSU) - Department of Obstetrics and Gynaecology

Yuchen Lin

Sun Yat-sen University (SYSU) - Department of Obstetrics and Gynaecology

Rui Li

Sun Yat-sen University (SYSU) - Department of Obstetrics and Gynaecology

Lijie Xie

Sun Yat-sen University (SYSU) - Department of Obstetrics and Gynaecology

Zibo Li

Sun Yat-sen University (SYSU) - Department of Obstetrics and Gynaecology

Weiwei Sun

Sun Yat-sen University (SYSU) - Department of Obstetrics and Gynaecology

Xinyu Huang

Sun Yat-sen University (SYSU) - Department of Obstetrics and Gynaecology

Casper J. P. Zhang

The University of Hong Kong - School of Public Health

Wai Kit Ming

Jinan University - Department of Public Health and Preventive Medicine

More...

Abstract

Background: Secondhand smoke (SHS) exposure can trigger asthma exacerbations in children. Different studies have linked increased asthma symptoms and even deaths in children with SHS, but the risk has not been quantified uniformly across studies. We aimed to investigate the role of second-hand smoke (SHS) exposure as a risk factor of asthma among children.

Methods We performed a systematic review in PubMed, Scopus, and Google Scholar from June 1975 to November 16, 2018. Effect estimates were pooled using random-effects models. Publication and small study biases were reduced using funnel plots.

Findings: Of the 24,319 studies, we identified 8 eligible studies (5 cross-sectional, 2 cohort, and 1 case-control), with a total of 24,573 children included in the meta-analysis. Positive and significant exposure-response relationship between SHS exposure and childhood asthma was observed among the total cohort of the children included (OR 1.15, 95% CI 1.08-1.22, P<0.01). Interestingly, we found that in children aged 6 years old or older, the SHS exposure has more impact on the occurrence of childhood asthma than those aged less than 6-year-old (OR 1.30, 95%CI 1.11-1.51, P<0.05). There was no evidence of significant publication or small study bias (Egger test, P = 0.02).

Interpretation: The results show a moderate positive association between secondhand smoking exposure and childhood asthma. Thus, these results lend support to continued efforts to reduce childhood exposure to secondhand smoke.

Funding Statement: The authors stated: "There was no funding source for this study."

Declaration of Interests: Authors declare they have nothing to disclose.

Ethics Approval Statement: The reporting of this systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statements to identify studies related to SHS exposure and asthma and we referred to PRISMA checklists one by one during the research process.

Keywords: childhood asthma, environmental tobacco smoke, secondhand tobacco smoke, meta-analysis, systematic review

Suggested Citation

He, Zonglin and Zhang, Siyu and Wu, Huailiang and Lin, Yuchen and Li, Rui and Xie, Lijie and Li, Zibo and Sun, Weiwei and Huang, Xinyu and Zhang, Casper J. P. and Ming, Wai Kit, The Association between Secondhand Smoke Exposure and Childhood Asthma: A Systematic Review and Meta-Analysis (July 14, 2019). Available at SSRN: https://ssrn.com/abstract=3420401 or http://dx.doi.org/10.2139/ssrn.3420401

Zonglin He

Sun Yat-sen University (SYSU) - Department of Obstetrics and Gynaecology

Guangzhou
China

Siyu Zhang

Sun Yat-sen University (SYSU) - Department of Obstetrics and Gynaecology

Guangzhou
China

Huailiang Wu

Sun Yat-sen University (SYSU) - Department of Obstetrics and Gynaecology

Guangzhou
China

Yuchen Lin

Sun Yat-sen University (SYSU) - Department of Obstetrics and Gynaecology

Guangzhou
China

Rui Li

Sun Yat-sen University (SYSU) - Department of Obstetrics and Gynaecology

Guangzhou
China

Lijie Xie

Sun Yat-sen University (SYSU) - Department of Obstetrics and Gynaecology

Guangzhou
China

Zibo Li

Sun Yat-sen University (SYSU) - Department of Obstetrics and Gynaecology

Guangzhou
China

Weiwei Sun

Sun Yat-sen University (SYSU) - Department of Obstetrics and Gynaecology

Guangzhou
China

Xinyu Huang

Sun Yat-sen University (SYSU) - Department of Obstetrics and Gynaecology

Guangzhou
China

Casper J. P. Zhang

The University of Hong Kong - School of Public Health

Hong Kong, Pokfulam
China

Wai Kit Ming (Contact Author)

Jinan University - Department of Public Health and Preventive Medicine ( email )

601 Huangpu W Ave, Tianhe District
Guangzhou, Guangdong Province 510632
China
+86 85228852 (Phone)