Smoke-exposed children with flu more likely to need ICU care

"We know secondhand smoke contributes to chronic illnesses like asthma, but we haven't quantified the extent of what it can do to children with the flu," said Karen Wilson, M.D., M.P.H., assistant professor of Pediatrics at URMC and author of the abstract, which was funded by the Julius B. Richmond Center of Excellence. "This study indicatesthat secondhand smoke makes the condition much more severe in children hospitalized with the flu."

Researchers analyzed the medical charts for 91 children hospitalized for flu at Golisano Children's Hospital at URMC between 2002 and 2009. More than a third of the children were exposed to secondhand smoke. Researchers found that exposed children were more likely to need intensive care (31 percent versus 9 percent) and intubation to help with breathing (19 percent versus 2 percent). After controlling for underlying conditions, including asthma, researchers found that exposed children were almost five times more likely to need intensive care and more than 11 times more likely to need intubation.

The children's length of stay in the hospital was significantly associated with smoke exposure and chronic conditions. For children with no chronic conditions, exposure lengthened their stay from two to three days. For children with chronic conditions, exposure lengthened their stay from four days to more than 10. Wilson said these results indicate a larger burden on hospitals -- and on the families of these children.

"Parents need to be supported in their efforts to protect their children from tobacco smoke. The only way to protect them completely is for parents and close contacts to quit smoking completely," Wilson said. "The next best thing is to have a no no-smoking rule in homes and cars. Finally, while we recommend flu shots for all children now, it's especially important for children exposed to smoke to get their flu vaccine every year."