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Indoor and Built Environment
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Review : Environmental Tobacco Smoke and Respiratory Health in Children: A Critical Review and Analysis of the Literature from 1969 to 19981

Raphael J. Witorsch

Department of Physiology, Medical College of Virginia, Virginia Commonwealth University, Richmond, Va., USA

Philip Witorsch

Departments of Medicine and Pharmacology, Georgetown University School of Medicine, Washington, D.C., USA

This analysis of parental/household smoking (a surro gate for environmental tobacco smoke, ETS) and respira tory symptoms and disease in children updates an ear lier analysis. Some 94 studies of preschool children and 152 studies of school-age or older children published between 1969 and 1998 were examined. Both analyses have shown an age dependency in the relationship between parental/household smoking and respiratory symptoms and disease in children. A statistically signifi cant, though moderate, relationship between parental/ household smoking and respiratory illness was ob served in most (86%) of the studies in preschool chil dren. While almost two thirds (98 of 152) of the studies of school-age children showed a statistically significant re lationship between parental/household smoking and re spiratory symptoms and disease, there was a general lack of consistency of statistical association for specific respiratory endpoints (e.g., asthma, wheeze, bronchitis,

Key Words: Environmental tobacco smoke • Children • Respiratory health • Asthma • Wheeze

Indoor and Built Environment, Vol. 9, No. 5, 246-264 (2000)
DOI: 10.1177/1420326X0000900503
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