What question did this study set out to answer?

To identify the role of tobacco smoke exposure as a risk factor for asthma exacerbation and severity in children.

April 22, 2026Academic and Clinical Pediatrics0 citationsOpen Access

Tobacco Smoke Exposure as a Risk Factor of Asthma Exacerbation and Severity in Children Aged 6–18 Years

NSNi Made SukewantiCentro de Implantología Cirugía Oral y Maxilofacial NPNi Putu Siadi Purniti IPI Gusti Ngurah Sanjaya PutraUdayana University

Key Points

To identify the role of tobacco smoke exposure as a risk factor for asthma exacerbation and severity in children.
Conducted a prospective cohort study involving asthmatic children aged 6–18 years.
Monitored subjects over 6 weeks for asthma attack frequency and severity through interviews and observations.
Performed data analysis using Poisson and ordinal logistic regression tests to assess risk factors.
Children exposed to tobacco smoke had a 1.9 times higher rate of asthma exacerbation compared to non-exposed children.
Exposure was linked to a 3.9 times higher risk of severe asthma episodes.
Statistical significance was indicated with p-values less than 0.05.

Abstract

Abstract Background: Asthma can arise due to increased inflammatory response and bronchial hyper-reactivity toward trigger factors. One of the environmental factors that can trigger asthma exacerbation is tobacco smoke. Tobacco smoke contains more than 4000 substances, some of which are highly active, antigenic, cytotoxic, mutagenic, and carcinogenic. Objective: To determine whether exposure to tobacco smoke is a risk factor for asthma exacerbation and severity in children. Methods: This is a prospective cohort study. The research subjects were asthmatic patients aged 6–18 years treated at the Pediatric Outpatient Clinic of Ngoerah Hospital, Bali, Indonesia. Interviews and observations were conducted for 6 weeks to observe the frequency and severity of the asthma attacks. Data analysis was conducted using the Poisson regression test and the ordinal logistic regression test. Risk factors are expressed in Relative Risk (RR) and adjusted RR (ARR). Statistical significance was set at P < 0.05. Results: There were 60 subjects enrolled in this study, divided into two groups: Subjects with exposure to tobacco smoke (30 subjects) and without exposure (30 subjects). This study found that subjects with tobacco smoke exposure had higher asthma exacerbation (RR: 1.9 (95% confidence interval (CI): 1.155–3.168, P = 0.012); ARR: 1.87 (95% CI: 1.087–3.199, P = 0.024) compared to the nonexposure group. Based on the severity of asthma, the exposure group had a higher tendency to develop more severe asthma (RR: 3.9; (95% CI: 1.412–10.617, P = 0.009); ARR: 4.1 (95% CI: 1.212–13.778, P = 0.023). Conclusion: Household tobacco smoke exposure is an independent risk factor for both increased frequency and greater severity of asthma exacerbations in children aged 6–18 years.

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