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Childhood Illnesses & Diseases

Children are a population which is particularly at risk from exposure to second-hand smoke, for a variety of reasons. Second-hand smoke exposure has been linked to childhood asthma, middle ear disease and most recently, sudden infant death syndrome (SIDS). One of the most comprehensive reports on the health effects of tobacco smoke on children was completed in January 1999 by the Tobacco Free Initiative at the World Health Organization. The report is called the International Consultation on Environmental Tobacco Smoke and Child Health.

Groundbreaking research on SIDS authored by McMartin et al. and entitled, Lung tissue concentrations of nicotine in sudden infant death syndrome (SIDS) merits special mention. Lung concentrations of nicotine and cotinine (a nicotine metabolite) in a group of SIDS cases were compared to a group of non-SIDS control infants, stratified according to household smoking status. By measuring the levels of nicotine in the lungs of infants, the researchers found that the lungs of children who die from SIDS have significantly higher levels of nicotine than control children.

A recent study from Sweden addresses ways in which smoking outside the home can provide some protective measure against the effects of second-hand smoke. The article was published in the April 2004 issue of Pediatrics.

A comprehensive policy report from the American Legacy Foundation outlines the devastating impact of second-hand smoke on children. It can be viewed by clicking here and scrolling down to the document entitled "Secondhand smoke tearing families apart: The health and economic burden of smoking on children".

Most recently, the October 2004 Ontario Medical Association position paper entitled "Exposure to second-hand smoke: are we protecting our kids?" makes many recommendations to reduce children's exposure to second-hand smoke, including:

  • More public information for caregivers who smoke to understand the effects of SHS on children.
  • Banning the use of tobacco inside vehicles used to transport children.
  • Amending the Day Nurseries Act to ban smoking in any homes and/or facilities that provide childcare.
  • Publicly funding nicotine replacement therapies (NRTs) to encourage adults who smoke to choose NRTs to reduce tobacco consumption around children when in the home or car.

Statistics Canada confirmed the OMA's findings in their latest report, "Second-hand smoke exposure - who's at risk". Click here for the OMA's news release on these findings.

Because the vulnerability of second-hand smoke exposure in children can occur during the pre or post-natal stage, we cover children's diseases as a result of passive smoke exposure in three sections: The Health Effects of Prenatal Exposure to Second-Hand Smoke , The Health Effects of Postnatal Exposure to Second-Hand Smoke and Other Health Effects of Second-Hand Smoke Exposure on Children . Some of the key studies published since 1994 on these topics are as follows:

The Health Effects of Prenatal Exposure to Second-Hand Smoke

Prevalence of smoking associated with pregnancy in three Southern Ontario Health Units. Johnson, IL, Ashley, MJ, Reynolds, D et al. Can J Pub Health. 2004 May-Jun; 95(3): 209-13.

Elevated risk of tobacco dependence among offspring of mothers who smoked during pregnancy: a 30-year prospective study. Buka SL, Shenassa ED, Niaura R. Am J Psychiatry. Nov 2003; 160(11): 1978-84.

Differential effects on cognitive functioning in 13- to 16-year olds prenatally exposed to cigarettes and marihuana. Fried, P, Watkinson, B, Gray, R. Neurotoxicol. Teratol. 2003; 25: 427-436.

Smoking during pregnancy and newborn neurobehaviour. Pediatrics. June 2003; 111(6 Pt 1):1318-23.

Intimal preatherosclerotic thickening of the coronary arteries in human fetuses of smoker mothers.Matturri, L, Lavezzi, AM, Ottaviani, G et al. J Thromb Haemost 2003 Oct;1(10): 2234-8.

The impact of smoking and other substance use by urban women on the birthweight of their infants.Visscher, WA, Feder, M, Burns, AM et al. Subst Use Misuse 2003 Jun: 38(8): 1063-93.

Airway Alveolar Attachment Points and Exposure to Cigarette Smoke In Utero. Elliot J, et al. Am J Respir Crit Care Med. January 2003; 167: 45-49.

Contribution of maternal smoking during pregnancy and lead exposure to early child hood behaviour problems. Wasserman, GA, Liu, X, Pine, DS et al. Neurotoxicol. Teratol. 2001; 23: 13-21.

Differential effects of facets of attention in adolescents prenatally exposed to cigarettes and marihuana. Neurtoxciol. Teratol. 2001; 23: 421-430.

A prospective study of smoking during pregnancy and SIDS. Wisborg K., et al. Arch Dis Child. September 2000; 83(3): 203-6.

Does Passive Smoking in Early Pregnancy Increase the Risk Of Small-for-Gestational-Age Infants? Dejin-Karlsson Elisabeth, et al. American Journal of Public Health. October 1998; 88(10):1523-7.

Gene mutations with characteristic deletions in cord blood T lymphocytes associated with passive maternal exposure to tobacco smoke. Finette B.A. et al. Nature Medicine. October 1998; 4(10): 1144-1151.

The influence of maternal passive and light active smoking on intrauterine growth and body composition of the newborn.Luciano, A. et al. Eur J Clin Nutr. October 1998; 52(10): 760-63.

Nicotine Concentration in the Hair of Nonsmoking Mothers and Size of Offspring American Journal of Public Health. January 1998; 88(1): 120-4.

Maternal tobacco smoke exposure and persistent pulmonary hypertension of the newborn. Bearer, Cynthia, et al. Environmental Health Perspectives. February 1997;105(2): 202-206.

Hair Concentrations of Nicotine and Cotinine in Women and Their Newborn Infants. Eliopoulos C, et al. Journal of the American Medical Association. February 1994; 271(8): 621-623.

The Health Effects of Postnatal Exposure to Second-Hand Smoke

Households contaminated by environmental tobacco smoke: sources of infant exposures. Matt, GE, Quintana, PJE, Hovelle, MF et al. Tobacco Control. February 2004; 13: 29-37.

Attention Deficit Disorder Symtoms in Children Linked to Maternal Smoking. Thapar A, Fowler T, Rice F, Scourfield J, Van Den Bree M, Thomas H, Harold G, Hay D. November 2003 ;160(11):1985-9.

Altered arousal response in infants exposed to cigarette smoke. Chang A, et al. Archives of Disease in Childhood. January 2003; 88(1): 30-33.

Why is smoking a risk factor for Sudden Infant Death Syndrome?. Gordon A.E., et al. September 2002; 28(suppl 1):23-5.

Lung tissue concentrations of nicotine in sudden infant death syndrome (SIDS). McMartin et al. Journal of Pediatrics. February 2002; 140(2): 205-209.

Exposure of Young Infants to Environmental Tobacco Smoke: Breast-Feeding Among Smoking Mothers. Mascola MA, et al. American Journal of Public Health. June 1998; 88(6): 893-896.

The Burden of Environmental Tobacco Smoke Exposure on the Respiratory Health of Children 2 Months Through 5 Years of Age in the United States. Gergen Peter J, et al. Pediatrics. February 1998; 101(2): e8.

Passive smoking and sudden infant death syndrome : review of the epidemiological evidence. Anderson HR and Cook DG. Thorax. November 1997; 52(11): 1003-1009.

The Effect of Passive Smoking and Tobacco Exposure Through Breast Milk on Sudden Infant Death Syndrome. Klonoff-Cohen HS, et al. Journal of the American Medical Association. March 1995; 273(10): 795-798.

Other Health Effects of Second-Hand Smoke Exposure on Children

Effects of Tobacco Smoke Exposure on Asthma Prevalence and Medical Care Use in North Carolina Middle School Children. Sturm, JJ, Yeatts, K and Loomis, D. Am J Pub Health. 2004 Feb; 94(2): 308-313.

Protecting children from environmental smoke (ETS) exposure: A critical review. Gehrman, C.A. at al. Nicotine & Tobacco Research. June 2003; 5(3): 289-301.

Association of Pediatric Dental Caries with Passive Smoking. Aligne A., et al. Journal of the American Medical Association. March 2003; 289(10): 1258-1264.

Parental Smoking and Infant Respiratory Infection: How important is Not Smoking in the Same Room with the Baby?. Blizzard L, et al. American Journal of Public Health. March 2003; 93(3): 482-88.

Involuntary Smoking and Asthma Severity in Children: Data From the Third National Health and Nutrition Examination Survey. Mannino David M., Homa David M., Redd Stephen C. Chest. August 2002; 122(2): 409-415.

The effects of tobacco exposure on children's behavioral and cognitive functioning: implications for clinical and public health policy and future research.Weitzman, M, Byrd, R, Aligne, A, et al. Neurotoxicol Teratol 2002 May-Jun; 24(3):397-406.

Parental smoking and respiratory tract infections in children. Peat JK et al. Pediatric Respiratory Reviews. September 2001; 2(3): 207-213.

Second-hand smoke is a major contributor to asthma in children.Wilson, NW. W V Med J 2001 Jan-Feb; 97(1):27-8.

Environmental Tobacco Smoke and Middle Ear Disease in Preschool-Age Children. Adair-Bischoff CE and Sauve RS. Arch Pediatr Adolesc Med. 1998; 152:127-133.

Tobacco and Children: An Economic Evaluation of the Medical Effects of Parental Smoking. Aligne CA and Stoddard JJ. Arch Pediatr Adolesc Med. 1997;151: 648-653.

Passive Smoke Exposure Impairs Recovery After Hospitalization for Acute Asthma. Abulhosn RS, et al. Arch Pediatr Adolesc Med. 1997; 151: 135-139.

Environmental Tobacco Smoke Exposure and Health Effects in Children. Mannino DM, et al. Tobacco Control. 1996; 5(1): 13-18.

Morbidity and Mortality in Children Associated With the Use of Tobacco Products by Other People. DiFranza JF and Lew RA. Pediatrics. April 1996; 97(4): 560-568.




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