Exploring the Association Between Passive Exposure to Household Smoking and Frequency of Recurrent Wheezing in Children

Abstract

Background: Recurrent wheezing in children is a prevalent respiratory condition that imposes substantial health and socioeconomic burdens, particularly in regions with high rates of household smoking. Objective: To determine the association between passive household smoking and the frequency of recurrent wheezing episodes among children aged 6 months to 12 years, with a focus on clinical outcomes and healthcare utilization. Methods: This cross-sectional observational study enrolled 185 children aged 6 months to 12 years with recurrent wheezing, defined as three or more physician-documented episodes in the preceding 12 months, at a tertiary care center. Children with chronic respiratory diseases were excluded. Data were collected through structured caregiver interviews and medical record review, assessing demographic variables, exposure to household smoking, and frequency of wheezing, hospitalizations, and emergency visits. Passive smoking was defined as at least one household member smoking indoors in the past month. The study received institutional ethical approval and adhered to the Helsinki Declaration. Analyses were performed using SPSS version 26; group comparisons utilized chi-square and t-tests, with multivariate logistic regression to adjust for confounders. Results: Of 185 participants, 52.4% were exposed to passive household smoking. Children exposed to passive smoking had significantly higher rates of ≥5 wheezing episodes per year (75.3% vs. 38.6%; OR: 4.72, 95% CI: 2.49–8.94, p < 0.001) and increased hospitalization (43.3% vs. 20.5%; OR: 2.89, 95% CI: 1.48–5.66, p = 0.002). Multivariate analysis confirmed passive household smoking as an independent predictor of frequent wheezing (AOR: 2.84, 95% CI: 1.52–5.30, p = 0.001). Conclusion: Passive household smoking is strongly associated with increased frequency and severity of recurrent wheezing in children, leading to greater healthcare utilization. Targeted clinical counseling and smoke-free home interventions are urgently needed to mitigate preventable pediatric respiratory morbidity.