- Chen Y,
- Rennie DC,
- Lockinger LA,
- Dosman JA
Purpose of the Study
Although many studies have shown that exposure to environmental tobacco smoke increases the risk of respiratory symptoms in the pediatric population, it is not known how many other factors may increase this risk. The purpose of this study was to determine if children with a history of tonsillectomy or adenoidectomy (T/A) were at an increased risk of developing respiratory symptoms when exposed to environmental tobacco smoke.
The study was conducted in Humboldt, Saskatchewan, where subjects included all town residents between the ages of 6 and 17 years. Of the 1019 eligible subjects, 892 participated in the study.
The subjects were divided into different groups based on their responses to a questionnaire. Subjects were placed into the history of T/A group if they had ever had either their tonsils or adenoids removed. Exposure to environmental tobacco smoke was based on the number of smokers in the home and the amount the members smoked each day. Subjects who were placed in the “cough” group were further distinguished based on what time of day that the cough occurred, morning, day, or night. The effect of exposure to environmental tobacco smoke was evaluated in the T/A group and compared with the effect in the group with no history of T/A.
First, it was shown that the occurrence of current cough increased with increasing number of smokers in the home and with increased cigarette consumption by household smokers. It was also shown that children with a history of T/A had higher occurrences of current cough when compared with the children with no history of T/A when exposed to environmental tobacco smoke. A multiple logistic regression model was used to compare the joint effect of tobacco smoke exposure and history of T/A on current cough before and after adjusting for all the other variables. The adjusted odds ratio was 7.19 for children with a history of T/A if they were living in families who smoked more than 20 cigarettes/day as compared with an adjusted odds ratio of 1.64 among children without a history of T/A.
Subjects who lived in smoking families had an increased incidence of developing cough than those subjects who lived in nonsmoking families. T/A increased the influence of tobacco smoke on the development of a cough.
This study clearly demonstrated the influence of tobacco smoke in the home on children's respiratory symptoms. However, it was also apparent that tonsillectomy or adenoidectomy increased this risk to a significant degree. The authors suggested that the tonsil's and adenoid's role in the immune response of the body explain these findings. It may be beneficial to examine other mechanisms of how T/A increases a child's risk for cough in further studies.