TUESDAY, July 9, 2002 (HealthDayNews) -- Tobacco smoke and pet dander are proven triggers of asthma attacks in children.

Yet, the number of smokers and pets in homes with asthmatic children doesn't appear to be any lower than in other households, says a new report.

The study in the July issue of The Journal of Pediatrics shows significant differences between families with smokers and those with pets, and suggests that doctors need to tailor their treatments to address those differences.

Researchers with the National Jewish Medical and Research Center in Denver interviewed 152 asthmatic children, aged 7 to 18 years old, and at least one of their parents.

They found that at least one smoker lived in 38 percent of the homes, which equals the estimated 35 percent to 45 percent of American homes with at least one smoker.

In addition, about 67 percent of the asthmatic children lived in homes with a furred or feathered pet, which is higher than the 59 percent of U.S. homes reported to have pets.

"These rates were around the same, if not more, than are found in the regular population. So, that tells us that having a child who is vulnerable to asthma reactions doesn't appear to impact the prevalence of rates of smoking or pet ownership," says study author Dr. Frederick Wamboldt.

"That suggests that health-care professionals just aren't having a major impact" educating children and their parents about the threats to those with asthma, adds Wamboldt, head of the center's Division of Psychosocial Medicine.

In trying to learn more about the families in the study, the researchers were surprised to find certain demographic, socioeconomic and "psycho-social" differences between families with smokers and those with pets.

Families with smokers were generally found to be poorer and non-white, with low levels of asthma awareness and high levels of stress.

Families without smokers but pets were typically found to be white, with older children, greater asthma awareness and less stress.

Wamboldt says that while the study's findings are somewhat general, they still serve as an important starting point for doctors who need to offer more effective treatment approaches that are better tailored to a family's circumstances.

"With smokers, this tells us treatment should focus on repeatedly discussing the importance of smoking cessation, rather than just offering the advice once," he says.

Doctors should also advise parents on ways to reduce a child's exposure to smoke, such as having the parent smoke outside, he adds.

For families with pets, doctors need to determine whether the child is allergic to the animal and, if so, help come up with ways to reduce the child's exposure to dander.

Dr. Linda Ford, an allergist and a spokeswoman for the American Academy of Allergy, Asthma and Immunology, agrees that doctors need to take note of more than a patient's asthma -- they need to learn about a family's background and lifestyle.

"Too often, doctors are rushed into cookie-cutter care," she says. "It's absolutely important, for instance, to know the socioeconomic factors of your patients. You have to find out if there are barriers -- if they can't go out and get a dust mite cover, for instance, you need to know that."

"Or if you're prescribing drugs that the patient can't afford. Doctors will sometimes blame the patient for not taking the medicines, and they'll simply label them as non-compliant patients," Ford says. "But the fault may be the physician's for not simply taking that extra step to find out about the patient's ability to pay."

Wamboldt concurs that it's wrong to assume that all so-called "non-compliant patients" are the same.

"I believe that many doctors have two basic asthma patients in their minds: Good ones who take their medicine and avoid all irritants and allergens, and bad ones who smoke, have pets and don't take their medications,? he says.

"We have learned that the picture is decidedly more complex than that," Wamboldt says.

What To Do

This American Academy of Asthma, Allergy and Immunology site, Just for Kids, offers lots of fun activities to help children manage their asthma. The American Lung Association offers this Asthma in Children fact sheet.

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