years of age in Vietnam admissions for pneumonia in children under 5 exposure with an increased risk of hospital Association of environmental tobacco smoking

ABSTRACTBackground: The association between environmentaltobacco smoking (ETS) and childhood pneumonia has notbeen established in developed or developing countries. Astudy was conducted to assess the effect and impact ofETS exposure on pneumonia among children in centralVietnam.Methods: A population-based large-scale cross-sectionalsurvey was conducted covering all residents of 33communes in Khanh Hoa Province, the central part ofVietnam. Information on demographics, socioeconomicstatus and house environment, including smoking statusof each household member, was collected from house-holders. Hospital admissions for pneumonia amongchildren aged ,5 years in each household in the previous12 months were recorded based on caregiver’s report.Results: A total of 353 525 individuals living in 75 828households were identified in the study areas. Of these,24 781 (7.0%) were aged ,5 years. The prevalence ofETS was 70.5% and the period prevalence of hospitaladmissions for pneumonia was 2.6%. Multiple logisticregression analysis showed that exposure to ETS wasindependently associated with hospital admissions forpneumonia (adjusted odds ratio 1.55, 95% CI 1.25 to1.92). The prevalence of tobacco smoking was higheramong men than women (51.5% vs 1.5%). It is estimatedthat 28.7% of childhood pneumonia in this community isattributable to ETS.Conclusions: Children in Vietnam are exposed tosubstantial levels of ETS which results in 44 000 excesshospital admissions due to pneumonia each year amongchildren aged ,5 years.Worldwide, pneumonia is a leading cause ofmortality and morbidity among children. TheWorld Health Organization (WHO) estimates thatabout 19% of all deaths among children aged,5 years are caused by pneumonia. Seventypercent of childhood deaths from pneumonia occurin Africa or south-east Asia.