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	James L. Holly, M.D.

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Your Life Your Health - Tobacco: Not Smoking but Inhaling

James L. Holly,M.D.

September 09, 2004

Your Life Your Health - The Examiner

In one of the more amusing events in recent political history, a candidate for public office claimed that he had "smoked marijuana" but that he had never "inhaled." While that may be a "distinction without a difference," its converse is not. Everyday, millions of non-smokers, people who have never and would never place a tobacco product in their mouth and set it on fire, inhale tobacco smoke.

Many parents, who smoke, are eager to keep their children from "smoking," while every day, they cause them to "inhale" the toxins and poisons contained in tobacco smoke. Recently, a patient indicated an absolute unwillingness to stop smoking. I asked, "Do you smoke around your children?" The answer was, "Yes," to which I responded, "Then, while your children may not be smoking, they are inhaling." Sometimes, what we will not do for ourselves, we will do for our children. Hopefully, every parent, grandparent, aunt, uncle, brother or sister, who is not motivated to stop smoking themselves, will be motivated to stop causing their loved ones to inhale.

Environmental Tobacco Smoke (ETS) is a mix of more than 4,000 compounds, over fifty of which are known to cause cancer. In 1992, the U.S. Environmental Protection Agency (EPA) classified environmental tobacco smoke as a "Group A" carcinogen - a substance that produces cancer in humans. ETS from parental smoking can cause children to suffer the following health effects:

Pregnant women who smoke and nonsmoking pregnant women exposed daily to tobacco smoke are more likely to have low birth weight babies at risk for death and disease in infancy and early childhood.
Nursing mothers who smoke can pass along harmful chemicals from cigarettes to their babies in breast milk.
It is estimated that more than one-third (35 percent) of all deaths from Sudden Infant Death Syndrome (SIDS) are due to maternal tobacco use. U.S. Children are three times more likely to die from SIDS caused by maternal smoking than die from homicide or child abuse.
Children of parents who smoke have a higher prevalence of symptoms of respiratory irritation such as cough, phlegm, and wheeze.
An estimated 1.67 million physician visits for cough each year in the United States are due to involuntary smoking.
Exposure to ETS substantially increases the risk of lower respiratory tract infections, and is responsible for an estimated 350,000 cases of bronchitis and 152,000 cases of pneumonia annually or 16 percent of all lung infections in U.S. children under the age of five.
Involuntary exposure to tobacco smoke is responsible for an estimated 1.2 million ear infections each year in the United States, or approximately 7 percent of the total.
Children exposed to household smoking are at greater risk of requiring surgery for recurrent ear infections or tonsillitis; an estimated 86,000 tube insertions (14 percent of the total) and 18,000 tonsillectomies/adenoidectomies (removal of the tonsils or adenoids - 20 percent of the total) each year in the United States are attributable to ETS.
ETS exposure is associated with higher risk of developing asthma and more frequent and severe asthma attacks in children who already have the disease. Each year in the United States, an estimated 11 percent of all asthma cases and more than half a million physician visits for asthma are due to smoking in the home.
Exposure to the smoking of one or both parents has also been shown to be a highly important predictor of smoking among adolescents.
It is difficult to quantify the exposure of nonsmokers to ETS. Smoking in confined spaces, such as in a small enclosed room or a car, can greatly increase concentrations of environmental tobacco smoke.
It takes more than three hours to remove 95 percent of the smoke from one cigarette from the room once smoking has ended.
In general terms, most adults (87 percent) believe people have a right to be free from breathing other people's second-hand smoke.
Parents who restrict smoking to the outdoors are more likely to be highly educated, older, come from nonsmoking households, and have higher incomes.
Courts in Canada, the United States, and Australia have begun to consider parental smoking as one of the factors that must be weighed in assessing "the best interest" of the child in custody and access proceedings.

How parents can protect their children from ETS

If you are a smoker - quit! It's one of the most important things you can do for the health of your children and the best way to prevent your child from being exposed to ETS. If you are having trouble quitting smoking, ask your doctor for help. Also, contact your local chapter of the American Lung Association, American Heart Association, the American Cancer Society, or other groups that sponsor stop-smoking classes. As a parent, you are a role model. Children watch what their parents do. If your child sees you smoking, he or she may want to try smoking and grow up to become a smoker as well. Cigarette smoking by children and adolescents causes the same health problems that affect adults.

Tobacco-free environments for children

Parents need to be aware of the many places where their children can be exposed to ETS. Even if there are no smokers in your home, your children can still be exposed to ETS in other places, including:

In the car or on a bus
In a restaurant
At a friend's or relative's house
At the mall
At the babysitter's house
At sports events or pop music concerts

How do you avoid being around smokers? One way is to ask people not to smoke around your children, or remove your child from places where there are smokers. The following tips may help you keep your children from being exposed to ETS:

Don't let people smoke in your house. Don't put out any ashtrays - this will discourage people from lighting up. Remember, air flows throughout a house, so smoking in even one room allows smoke to go everywhere.
Don't let people smoke in your car. Opening windows is not enough to clear the air.
Choose a babysitter who doesn't allow smoking in the house.
Avoid crowded, smoky restaurants when you are with your child.
When you are with your child in public places - shopping malls, restaurants, bowling alleys - sit in "nonsmoking" sections.
Help get your child's school to be smoke-free. Get your children involved in this effort as well.

Almost 50% of the homes in the United States have at least one smoker living there. This means that millions of children in the United States are breathing in ETS in their own homes. If you smoke around your child or allow your child to be exposed to ETS in other places, you may be putting him or her into more danger than you realize. Parents need to make every effort to keep their children away from smokers and ETS. Parents who smoke should think about quitting, not just for their own sake, but for the health of their children.

Smoking and children -- A fire hazard

In addition to the dangers of ETS, smoking around children can also pose fire and burn dangers. Children can get burned if they play with lit cigarettes, cigars, or with lighters or matches. Keep the following guidelines in mind to keep your child safe from injury:

Never smoke while you are holding your baby.
Never leave a lit cigarette, cigar, or pipe unattended.
Keep matches and lighters out of your child's reach.

Cigarette lighters are especially dangerous. Cigarette lighters can be found in almost 30 million homes in the United States. Each year children under 5 years old playing with lighters cause more than 5,000 home fires resulting in about 150 deaths and more than 1,000 injuries.

The Consumer Product Safety Commission (CPSC) now requires that butane cigarette lighters be made child-resistant. This new rule will prevent hundreds of deaths and fire-related injuries to children each year. But remember, lighters can be made child-resistant, not childproof. It is still very important to keep lighters and matches away from children.

Remember, it is not only your life and it is not only your health, it is your child's life and it is your child's health.

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