1. Asthma Surveillance & Tobacco smoking effects on Patients with Asthma
Pascal Kalin, M.Sc.
Epidemiologist
Asthma Control program & Tobacco Prevention & Cession Program DHHS- Division of Public Health Services
Tel.

2. Outline Asthma Prevalence and Burden in NH 2. Asthma epidemiology
- Asthma distribution in New Hampshire
3. Asthma Control
- Asthma triggers
4. Tobacco/E-cigarette effects on asthma episodes

3. Asthma Burden
New Hampshire counts a prevalence rate of 13.11% of adults and 7.21% of children reporting current asthma (BRFSS 2015).
Of those, only 47.38% of adults have their asthma well controlled while 52.62% have asthma not well controlled according to the NH BRFSS -ACBS 2014.
These numbers show a decline in asthma control in
New Hampshire compared to the data in 2013
where approximately 50% of adults and 32% of
children did not have their asthma controlled.
• The New Hampshire rate of inpatent asthma discharges increased significantly between 2001 and 2009.

4. Asthma control
Of those who have asthma , only 47.38% of adults have their asthma well controlled while 52.62% have asthma not well controlled. (BRFSS -ACBS 2014).

5. Asthma disparities
Asthma appears with high prevalence rates among adults than children with 13.11% among adults and 7.21% New Hampshire children.
Asthma appears with high prevalence rates among low income and less educated.
Asthma prevalence is high among females than males.
Asthma appears with high Prevalence among Black and Hispanic community than whites of the

6. Adult with current asthma Prevalence, BRFSS 2015.

7. Adults whose Asthma is NOT well controlled, by Year 2011-2015

9. Estimated Percent of Children with Asthma by County, Manchester and Nashua (BRFSS 2015)

10. Estimated percent of population with Obesity who smoke, BRFSS 2015

11. What Causes or Triggers Asthma?
Some of the most common triggers are:
Tobacco Smoke. Tobacco smoke is unhealthy for everyone, especially people with asthma. ...
Dust Mites. Dust mites are tiny bugs that are in almost every home
Outdoor Air Pollution
Cockroach Allergen
Pets
Mold
Smoke From Burning Wood or Grass

12. Tobacco Smoking Prevalence by Current Asthma status

13. Is Tobacco use rate falling coincide with E-Cigarette Use among Youth?
NH Youth Risk Behavioral Survey (YRBS 2015) reveals that tobacco use rate is falling down with a three-fold decrease in trend from 20.8% in 2009 to 9.3% in 2015 among NH youths (graph below).
At the same time, e-cigarette use increases up to 25%, more than average of 24.1% in the whole nation.

14. Tobacco use trend among NH Youth, Percentage both genders in all grades, 2007-2015

15. Tobacco smoking and E-Cigarette use among NH Youths

16. E-cigarettes use among Youths
According to the CDC:
5 of every 100 middle school students (5.3%) reported in 2015 that they used electronic cigarettes in the past 30 days, an increase from 0.6% in 2011, and
16 of every 100 high school students (16.0%) reported in 2015 that they used electronic cigarettes in the past 30 days—an increase from 1.5% in 2011.

17. E-cigarettes and its components
E-cigarettes come in many shapes and sizes, but most have a battery, a heating element, and a place to hold a liquid.
The liquid contains nicotine which is the addictive drug in regular cigarettes, as well as chemicals like propylene glycol or glycerin and flavorings chemicals such aldehydes, and vanillin.

18. What attracts youths to e-cigarette use?
Even though, one of the reasons people rush to e-cigarette use is the desire to stop smoking, but, how about the new users who never smoked tobacco before?
A recent study on “association of e-cigarette vaping and progression to heavier patterns of cigarette smoking” conducted among youths of 10th grades Los Angeles, California concluded that most of e-cigarette users switch to tobacco smoking and that the frequency in vaping reflects to how soon one will switch to smoking, and also how heavier smoker will become11.

19. What attracts youths to e-cigarette use?
Instead, studies revealed other reasons declared in surveys particularly in young adults as:
The desire to use a product delivering nicotine but which is less harmful than smoking,
curiosity, others reported that were motivated by the
"cool/fun/something new" features of e-cigarettes.

20. What attracts youths to e-cigarette use?
E-cigarette use was strongly associated with having family members who smoke and having friends who smoke, also lower self-identified health level, greater stress level and a lower estimated household income.

21. How Does Tobacco Smoke Trigger Asthma?
When a person inhales tobacco smoke, irritating substances settle in the moist lining of the airways. These substances can cause an attack in a person who has asthma.
In addition, tobacco smoke damages tiny hair-like structures in the airways called cilia. Normally, cilia sweep dust and mucus out of the airways.
Smoke also causes the lungs to make more mucus than normal. As a result, more mucus can build up in the airways, triggering an attack.

22. NOHHHHHHH- Incompatibility

23. Questions? Comments? Feedback?
Thank you.
Questions? Comments? Feedback?
Pascal Kalin, M.Sc.
Epidemiologist
Asthma Control program & Tobacco Prevention & Cession Program Phone: (603) / Fax: