Objective: To determine the effect of passive smoking on otitis media with
effusion (OME) and recurrent otitis media (ROM).
Design: A case-control study of children who received ventilation tubes and
who were followed up for 1 year to determine the risk of developing postop
erative otorrhea and early extrusion in relation to exposure to passive cig
arette smoke.
Setting: Otorhinolaryngology Clinic of Istanbul School of Medicine, Istanbu
l, Turkey.
Patients: A total of 166 children 3 to 7 years old who required tympanostom
y tubes because of OME and ROM (case group) compared with an age-matched co
ntrol group of 166 children. The control group consisted of children who di
d not meet and never had met criteria for insertion of tympanostomy tubes.
Main Outcome Measures: Statistical analysis of factors associated with a hi
gher prevalence of OME or ROM, postoperative otorrhea, and early tube extru
sion.
Results: Passive smoking was a significant risk factor for OME and ROM. The
case group was exposed to a mean of 19.6 cigarettes per day vs 14.4 cigare
ttes per day for the control group (P<.004). Only maternal smoking was a si
gnificant factor (P<.001); no association was found with paternal smoking.
Prospective follow-up of the case group showed no significant difference in
the clinical course of OME and ROM between maternally exposed and non-mate
rnally exposed children.
Conclusions: Passive smoking increases the risk of OME and ROM in children
between 3 and 7 years-old. The avoidance of daily exposure to domestic toba
cco smoke could have a public health impact.