Research Article
Healthcare Costs of Secondhand Smoke Exposure at Home for U.S. Children

https://doi.org/10.1016/j.amepre.2018.08.013Get rights and content

Introduction

The purpose of this study is to estimate healthcare utilization and healthcare costs due to secondhand smoke exposure at home for children in the U.S.

Methods

Using data from the 2000, 2005, and 2010 U.S. National Health Interview Surveys, the authors analyzed the association between secondhand smoke exposure at home and utilization of three types of healthcare services (hospital nights, emergency room visits, and doctor visits) for children aged 3–14 years (N=16,860). A zero-inflated Poisson regression model was used to control for sociodemographic characteristics and the number of months without health insurance. The authors determined excess healthcare utilization attributable to secondhand smoke exposure at home for children and then estimated annual secondhand smoke–attributable healthcare costs as the product of annual excess healthcare utilization and unit costs obtained from the 2014 Medical Expenditures Panel Survey. This study was conducted from 2016 to 2018.

Results

The prevalence of secondhand smoke exposure at home for children in 2000, 2005, and 2010 was 25.0%, 12.3%, and 9.1%, respectively. Secondhand smoke exposure at home was positively associated with emergency room visits, but was not significantly associated with nights at the hospital or doctor visits for children. Secondhand smoke exposure at home for children resulted in an excess of 347,156 emergency room visits in 2000, 124,412 visits in 2005, and 101,570 visits in 2010, which amounted to $215.1 million, $77.1 million, and $62.9 million in excess annual healthcare costs (2014 dollars) in 2000, 2005, and 2010, respectively.

Conclusions

Although U.S. healthcare costs attributable to secondhand smoke exposure at home for children are declining, interventions to reduce secondhand smoke exposure at home for children are still needed to reduce the economic burden attributable to secondhand smoke exposure.

Section snippets

INTRODUCTION

Secondhand smoke (SHS) exposure, also known as passive smoking, is made up of side stream smoke from the burning tip of the cigarette and mainstream smoke drawn through the cigarette and exhaled by the smoker.1 SHS exposure has several adverse health effects on children, including ear infections, asthma, respiratory symptoms, respiratory infections (bronchitis and pneumonia), sudden infant death syndrome, and attention-deficit hyperactivity disorder.2, 3, 4

Several studies have shown that SHS

METHODS

This study was conducted from 2016 to 2018. Two data sources were used. The National Health Interview Survey (NHIS) is a nationally representative household face-to-face interview survey of ≅100,000 people conducted annually since 1957. In each sampled household, one adult and one child are randomly selected to provide detailed health information. For children, a knowledgeable adult (usually a parent) in the household answers questions about the child. The NHIS Sample Child file contains

RESULTS

Of the 16,860 children studied, a total of 2,780 (16.4%) of children were exposed to SHS at home (Table 1). The prevalence of SHS exposure at home for children in 2000, 2005, and 2010 was 25.0%, 12.3%, and 9.1%, respectively. Most of the children were aged 6–14 years, slightly more than half were male, 60.1% were non-Hispanic white, more than half lived in households with middle incomes or greater, and 21.0% had parents with a college degree or more education. On average, 16.6% of studied

DISCUSSION

This study shows that the prevalence of SHS exposure at home for children decreased from 25.0% in 2000 to 9.1% in 2010. These findings are almost identical to those reported in a previous published study in 2016,9 although the current study focuses on children aged 3–14 years whereas the other study included those aged 0–17 years. This study found that children who were exposed to SHS at home were significantly more likely to have excess ER visits than children who were not exposed. This is

CONCLUSIONS

This study found that SHS exposure-attributable healthcare utilization and costs for children results in a large economic burden relative to all ER visits by children aged 3–14 years. The findings suggest that interventions to reduce SHS exposure at home for children are needed to reduce the economic burden attributable to SHS.

ACKNOWLEDGMENTS

The authors appreciate the helpful comments of the members of the University of California, San Francisco Tobacco Center of Regulatory Science.

The research reported in this publication was supported by grant number 1P50CA180890 from the National Cancer Institute at NIH, and the Food and Drug Administration Center for Tobacco Products. The content is solely the responsibility of the authors and does not necessarily represent the official views of NIH or the Food and Drug Administration.

No

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