Secondhand Smoking and Children

Deborah Stang, a Pediatric Nurse Practitioner with Dedham Medical Associates in Norwood, Massachusetts, sees at least five children with asthma during her 20-hour workweek (they may not be visiting for that reason). "It becomes a diagnosis for the child," she says about the term "passive smoker" on the patient's problem sheet. She then flags the child's file so she can follow up.

Sometimes Stang smells smoke on the parents' clothing and breath. This indicates the parents smoke at home near the children, she says. "The smoke persists; it clings to the furniture, to the curtains."

"Anytime I see a baby with a recurrent ear infection, I ask [the parents] if there's anyone smoking in the house," says Stang. Doctors see 700,000 to 1.6 million children with middle-ear problems caused by secondhand smoke, according to the American Lung Association.

The Pediatric Environmental Health Center at Children's Hospital in Boston, Massachusetts, does not list secondhand smoke on its website with other environmental toxins such as lead, mercury, or pesticides. Questions about indoor smoking do, however, arise as part of a routine environmental assessment, says Suzanne Giroux, coordinator of the program. "Our doctors are aware of it as a health problem," Giroux says. "We see an increasing number of respiratory problems."

Pregnancy and Breastfeeding

The best time for a woman to quit smoking is during pregnancy or in its planning stage, according to the American Lung Association. If a woman continues to smoke while pregnant, the placenta will absorb the cigarette's poisons, such as nicotine and carbon monoxide. The pregnant woman should also avoid second-hand smoke, which increases health risks. The risks of smoking during pregnancy include:

• Greater chance of loss of the baby.
• Premature birth, before the baby's lungs are fully developed.
• A low-weight baby.
• Reduced IQ, according to a recent Environmental Health Perspectives study that shows passive smoking lowers a child's IQ by two to five points.

A woman who quits smoking during her pregnancy should note that resuming the habit after childbirth is still unsafe. Even if the mom does not smoke around her infant after delivery, the child is still at risk if mom is breastfeeding, since a baby will also absorb the poisons through the breast milk.

Reducing Risk to Children

So what's the best way to keep your children from becoming secondhand smokers? The American Lung Association and the Nemours Foundation offer the following solutions:

• The obvious one: quit smoking. It is possible. According to the Centers for Disease Control (1994), one half of all living adult smokers have quit.
• If a pregnant woman quits within the first three or four months of her pregnancy, she reduces the chances of health problems for the baby.
• Stand at least 10 feet away from children when smoking, and don't allow your kids to stand near others who are smoking.
• Tell visitors to smoke outside of the home.

Fifty years ago, smoking was pervasive. "It was so much a part of our lives, I don't remember it being odd," my mother says.

Today, research and awareness has changed. More benefits than drawbacks can result from not smoking. If adults ceased from using tobacco, and children didn't take up the habit, the Environmental Protection Agency predicts that 30 percent of all cancer deaths would be prevented.