The impact of parental smoking on asthma and wheezing. SIDRIA Collaborative Group. Studi Italiani sui Disturbi Respiratori nell'Infanzia e l'Ambiente

To evaluate the impact of parental smoking on childhood asthma and wheezing, we studied two random samples of subjects ages 6-7 and 13-14 years in ten areas of northern and central Italy. Standardized questionnaires were completed by parents of 18,737 children and 21,068 adolescents (response rates, 92.8\% and 96.3\%, respectively) about their smoking habits and the respiratory health of their children. Adolescents were asked about their respiratory health and personal smoking. We compared two groups of cases with healthy subjects: (1) "current asthma" (children, 5.2\%; adolescents, 6.2\%) and (2) "current wheezing" not labeled as asthma (children = 4.5\%, adolescents = 8.5\%). Exposure to smoke of at least one parent increased the relative risk of current asthma among children [odds ratio (OR) = 1.34; 95\% confidence interval (CI) = 1.11-1.62] and of current wheezing among adolescents (OR = 1.24; 95\% CI = 1.07-1.44). Maternal smoking had a stronger effect than paternal smoking. Maternal smoking during pregnancy was associated with current asthma (OR = 1.62; 95\% CI = 1.34-1.96) and current wheezing in children (OR = 1.31; 95\% CI = 1.06-1.62); the effects were lower among adolescents. Among subjects with a negative history of parental asthma, maternal smoking was associated with current wheezing in both age groups, whereas among those with a positive history of parental asthma it was associated with current asthma in children, but not in adolescents. We estimated that 15\% (95\% CI = 12-19) of the current asthma cases among children and 11\% (95\% CI = 8.3-14) of the current wheezing cases among adolescents are attributable to parental smoking in Italy.