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May 21, 1997

Helping City Children Control Asthma

JAMA. 1997;277(19):1503-1504. doi:10.1001/jama.1997.03540430015004

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ASTHMA attacks can be effectively controlled even in the most adverse social circumstances when children and their primary caretakers are counseled properly, according to a national study now being analyzed. About one third of asthmatic children and their caretakers— parents or others—living in inner cities in the United States who participated in an asthma intervention trial had reductions in major symptoms and a significant increase in asthma-free days.

The key to success is the effective use of asthma care counselors who advise how to avoid such triggers of the disease as environmental pollutants and secondhand tobacco smoke. The counselors recommend, for example, that children not play outdoors when the atmosphere is particularly smoggy. They suggest that caretakers attend smoking cessation workshops, or smoke outside the home, or at least smoke away from the child. "It's a hierarchy," H. James Wedner, MD, professor of medicine at Washington University School of Medicine,