The effect of secondhand smoke exposure on treatment outcomes in children hospitalized for community-acquired pneumonia

Background: Secondhand smoke exposure remains a major yet preventable contributor to pediatric respiratory illness, especially in low- and middle-income countries. Despite public regulations limiting tobacco use, secondhand smoke exposure within homes remains a persistent threat to children’s health. This study aimed to assess the impact of secondhand smoke exposure on clinical outcomes among children hospitalized for community-acquired pneumonia. Methods: A cross-sectional observational study was conducted at Adana City Training and Research Hospital, enrolling 563 pediatric patients aged 1 month to 18 years hospitalized with community-acquired pneumonia between July 2019 and June 2020. Secondhand smoke exposure was defined as the presence of at least one smoker in the child’s household. The primary outcome was length of hospital stay. Secondary outcomes included admission to the pediatric intensive care unit, use of invasive or non-invasive mechanical ventilation, PICU length of stay, and history of hospitalization due to lower respiratory tract infection. Results: Among the patients, 70.3% were exposed to secondhand smoke at home, and 41.4% lived with two or more smokers. Secondhand smoke exposed children had significantly longer hospital stays (p=0.023), increased rates of pediatric intensive care unit admission (12.1% vs. 6.6%, p=0.032), and a higher frequency of past hospitalizations for lower respiratory tract infection (p