As More Homes Become Smoke-Free, Fewer Children Get Ear Infections

Cigarette ashtray and secondhand smokeIt's long been known that secondhand smoke at home from a parent who puffs up increases the risk of ear infection in that home's children. Luckily, it seems that the message for two decades about the dangers of secondhand smoke and the importance of providing smoke-free homes has indeed paid off. Fewer children visited a doctor or a hospital for ear infections in the 13 years of research from Harvard School of Public Health (HSPH) and the TobaccoFree Research Institute Ireland.

This is quite the reversal from the previous 15 years when children's visits for otitis media -- the scientific name for middle-ear infection -- increased steadily from 9.9 million in 1975 to 24.5 million in 1990. The economic burden of otitis media was estimated in the 1990s at $3 billion to $5 billion.

But as the public has become more aware and the number of smoke-free homes rose, that trend reversed. From 1993 to 2006, the percentages of homes with children and no-smoking rules nearly doubled from 45.5% in 1993 to 86.1%.

Health-Related Costs Cut in Half

And as smoke-free homes increased, ear infections have declined. The study, funded by the Flight Attendant Medical Research Institute, found the average annual number of doctor visits for otitis media in children aged 6 years and younger dropped from 17.5 million in 1993 to 10.9 million in 2006, and hospital discharges fell from 35,832 in 1993 to 10,050 in 2006.

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By 2007, the total medical expenditures for otitis media among children ages 6 years and less were $2 billion, approximately half the amount in the mid-1990s, the researchers note.

"Our study is the first to demonstrate the public-health benefits to children of the increase in smoke-free homes across the nation," said lead author Hillel Alpert, research scientist in HSPH's Department of Society, Human Development and Health, in a statement.

While the researchers note that other factors may have contributed to the decline, specifically a pneumonia vaccine that was introduced in 2000, Alpert adds that "Smoke-free rules in homes are extremely important to protect children, given the many adverse effects that secondhand tobacco smoke exposure has on child health."

Further Benefits Are Possible

Secondhand smoke has already declined significantly, thanks to laws banning smoking in public places. There might be a need for more regulation in public housing, researchers say. Indeed, the U.S. Department of Housing and Urban Development in 2009 strongly encouraged public housing authorities to implement no-smoking policies to protect children and others.

Still, as of 2008, 40% of nonsmokers still showed traces of nicotine. Given the halving of the economic cost of ear infections by smoke-free homes, reducing secondhand smoke even further would also reduce the cost of other diseases associated with secondhand smoke -- from respiratory problems to lung cancer to heart disease.
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