Healthy Living

When a 2-year-old with severe asthma symptoms was recently released from the hospital, one of the things I discussed with his mother was the dangers of a second hand smoke.

General warnings from the surgeon general and the media mainly focus on smokers themselves. Enactment of laws in recent years banning smoking from restaurants and bars were done to prevent exposure to smoke by the general public. However, there is still no major initiative to educate people about the hazards of smoking for household members, especially children.

What is second hand smoke?

Smoke inhaled by non-smokers is referred to as second hand smoke. At present, 1.1 billion adults worldwide are smokers, making it inevitable that children and the two-thirds of adults who do not smoke are being exposed in some fashion.

Second hand smoke is a mixture of side stream smoke given off by the smoldering cigarette (or pipe or cigar) and of the mainstream smoke that is blown out in to the air by active smokers. Side stream smoke generated under the lower temperature conditions in the smoldering cigarette has a higher concentration of many of the toxic compounds, including nicotine and carbon monoxide. Effects can be much worse in the winter months because of indoor environments and cars with closed windows.

What are the consequences of second hand smoke?

There have been multiple public health reports in the United States and worldwide identifying the specific health risks associated with second hand smoke in children as well as in adults.

Risks for children include:
• Premature births and deaths among newborns
• Reduced birth weight
• Sudden infant syndrome (SIDS)
• Multiple chest infections
• Long lasting colds and chest infections
• Worsening of asthma and other chest conditions and poor lung function
• Multiple ear infections

Exposure to second hand smoke is a significant public health issue and affects both quality of life and healthcare costs.

On average, studies have shown that children exposed to smoke are more likely to be sick and miss school compared to children of non-smoking parents. Adverse effects of smoking by pregnant mothers and to mothers that are exposed to second hand smoking include reduced birth weights, more birth defects as well as an estimated 20-40% increase in sudden infant death syndrome, to name a few. The risk of Sudden Infant Death Syndrome increases with the number of cigarettes smoked per day.

There is increased incidence of cough, phlegm, and wheezing in the children of smokers. The risk of developing chest infection is as high as 50 % if either parent smokes compared to children of non-smoking parents. Those children who have asthma suffer from many more exacerbations (asthma attacks). Their asthma is much more severe and they end up having many more emergency room visits, hospital admissions and missed school days.

Other effects of the second hand smoke include increased incidence of dental problems and childhood cancers including leukemia, lymphoma and brain tumors.

What needs to be done?

Parents should consult their doctors and get help to quit smoking. Partners of pregnant women should avoid smoking around them, especially those with children with asthmas and allergies.

I cannot stress enough that the bad effects of exposure to smoke begin inside the uterus and continue throughout childhood. Avoid smoking at all costs -- your children’s health depends on it.

Ravi Prakash, MD, is a pediatrician on the Backus Hospital Medical Staff with a private practice in Norwich. This column should not replace advice or instruction from your personal physician. E-mail Dr. Prakash and all of the Healthy Living columnists at healthyliving@wwbh.org.