SAN DIEGO —Household exposure to e-cigarettes increases the risk of asthma flare-ups in children, challenging the assumption that e-cigarettes are a "safer" source of secondhand smoke, according to research presented during the American Academy of Pediatrics 2026 National Conference & Exhibition in San Diego.
Authors of an abstract, "Parent-Reported Household Tobacco and E-cigarette Exposure and Asthma Control in Children: A Cross-Sectional Study," used electronic health record data from a large, diverse pediatric primary care network to study more than 48,000 clinic visits over a 33-month period where parents of children age 1 or older with asthma reported on household tobacco and e-cigarette use. Household use of tobacco and e-cigarettes was reported in 5% of clinic visits, tobacco-only in 9%; and e-cigarette-only in 3% of the encounters.
"There is no safe level of tobacco or e-cigarette exposure when it comes to children. Parents and caregivers who use any tobacco or nicotine products should make every effort to quit, using evidence-based options like varenicline, nicotine replacement therapy, and counseling," said Brian Jenssen, MD, MSHP, FAAP, associate professor of pediatrics, Children's Hospital of Philadelphia.
Researchers found that children exposed to both combustible tobacco and e-cigarettes in the home had the broadest and strongest links to poor asthma control: more flares, more night-time and activity-related symptoms, more rescue inhaler use, and more hospital admissions. Tobacco-only exposure showed more modest effects across fewer measures. But even e-cigarette-only exposure, on its own, was independently linked to more asthma flares and more activity-related symptoms.
"It reinforces the need for pediatric care teams to screen for all forms of household nicotine and tobacco use — not just cigarettes — and to offer cessation support for both, as part of routine asthma care," he said.
"Many parents believe e-cigarettes are a safer alternative to cigarettes, both for themselves and for their children's health. Our findings suggest that assumption doesn't fully hold up for kids with asthma."
The work was funded by the National Institutes of Health (grant R37-CA282153, PI: Brian Jenssen).
