Economic burden of environmental tobacco smoke on Hong Kong families: scale and impact

STUDY OBJECTIVE: To examine the financial cost of doctor consultations for cough, phlegm, and wheeze in children living in a home where family members smoke compared with those not exposed to environmental tobacco smoke. To model these costs to provide the Territory of Hong Kong with estimates of potentially avoidable health care resource use. DESIGN: Cross sectional questionnaire survey. SUBJECTS AND SETTING: All children (10,615) in classes primary 3 to 6 (aged 8-13 years) attending 27 schools in two districts of Hong Kong in 1992 and their parents. MEASUREMENTS AND MAIN RESULTS: Doctor consultations during the previous three months for symptoms of either cough, phlegm or wheeze were higher in younger children, ranging from 22.9% in 8 year olds to 8.4% in those aged 12 or over. For those children living in homes with one, or more than one, smoker category (there were four categories of smokers: father, mother, siblings, others), the adjusted odds ratios (95% confidence intervals) for a doctor consultation for any of these symptoms were 1.15 (1.01, 1.31) and 1.38 (1.14, 1.67) respectively. Using US$15 as the minimum cost incurred per consultation, the expected direct cost per annum per child of doctor consultations was 14$338,042 to US$991,591. CONCLUSIONS: Exposure to environmental tobacco smoke not only provides a respiratory health risk for children but also an avoidable excess cost to the family's financial resources and health service providers.

Health of a Punjabi ethnic minority in Glasgow: a comparison with the general population.

OBJECTIVE--To compare common health experiences of a South Asian (predominantly Punjabi) population with that of the general population, according to sex, and to related patterns of health in the fourth decade of life to the pattern of hospital admission and mortality documented in the published reports. DESIGN AND SETTING--A cross sectional survey with interviews and physical measures was undertaken in a two stage stratified random cluster sample in the city of Glasgow. SAMPLE--This comprised 159 South Asians aged 30-40 years, mean age 35 (73.6% of those invited) and 319 subjects from the general population, all aged 35 years. MEASUREMENTS AND MAIN RESULTS--Body structure, lung function, pulse and blood pressure, history of physical and mental health, results of standardised questionnaires on mental health, angina and respiratory health, recent and past symptoms, history of accidents, and sickness behaviour were determined. South Asians were shorter, broader, and more overweight (women); they had lower values for forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC), a faster pulse, and higher diastolic pressure (men). Fewer South Asians had had accidents or digestive symptoms (men); more had psychosomatic and high total symptoms (women); fewer wore glasses, had lost teeth, or had long standing illness (men) (all p < 0.01). Women had a lower FEV1/FVC ratio (p < 0.05). CONCLUSIONS--South Asians were consistently disadvantaged only in terms of anthropometric measures. Otherwise, the many differences were balanced, with disadvantage being concentrated only among South Asian women. The health gap between sexes in South Asians seems higher than in the general population. The findings show patterns of health in the fourth decade of life which are consistent with patterns of hospital admission and mortality documented in the published reports