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October is National Home Indoor Air Quality & Awareness Month

Secondhand Smoke & Children's Health

Developed by Healthy Indoor Air for America's Homes Program and supported by Presidential Proclamation, each week focuses on a different home indoor air topic.

Healthy Indoor Air for America's Homes


























































Your Home Environment Resource - University of Nebraska Cooperative Extension in Lancaster County

Healthy Homes - Indoor Air Quality

About Secondhand Smoke & Children's Health

Secondhand Smoke and Children's HealthCurrently, about 9 - 12 million young children are regularly exposed to their parents’ cigarette smoke at home. This translates into approximately 27% of American households with young children that allow smoking indoors. The Environmental Protection Agency’s (EPA) goal is to reduce this figure to 15% by 2005, in part by implementing a new outreach campaign. The key message of the campaign is until you can quit, smoke outside for your kids.

Infants and young children whose parents smoke are among the most seriously affected by exposure to secondhand smoke, being at increased risk for a number of health problems, including lower respiratory tract infections such as pneumonia and bronchitis. EPA estimates that secondhand smoke is responsible for between 150,000 and 300,000 lower respiratory tract infections in infants and children under 18 months of age annually, resulting in between 7,500 and 15,000 hospitalizations each year. Children exposed to secondhand smoke are also more likely to suffer symptoms of respiratory irritation like coughing, wheezing, and excess phlegm. Secondhand smoke can also lead to a buildup of fluid in the middle ear, the most common cause of hospitalization of children for an operation.

Children with asthma are especially at risk. EPA estimates that between 200,000 and 1,000,000 children with asthma have had their condition worsened by exposure to secondhand smoke. This pollutant may also cause thousands of children without asthma to develop the condition each year.

What is Secondhand Smoke?

  • Secondhand tobacco smoke is the smoke inhaled by nonsmokers -- smoke in the air from someone smoking cigarettes, cigars, or pipes in the indoor environment.
  • Secondhand smoke is sometimes called "environmental tobacco smoke," "ETS," "involuntary smoking," or "passive smoke."
  • Tobacco smoke contains over 4,000 chemicals, 200 of which are known poisons. About 40 of these chemicals could cause cancer.
  • In the late 1980s, the Surgeon General and the National Academy of Sciences National Research Council reported involuntary smoke could cause cancer in healthy nonsmokers.

  • Secondhand smoke can be an irritant to the body -- it can cause other acute and chronic health problems.
  • For example, exposure to secondhand smoke increases irritation of the eyes, nose, and throat. Lung irritation from exposure to secondhand smoke can cause coughing, excess phlegm, chest discomfort, and reduced lung capacity.
  • Newer studies show secondhand smoke could increase the risk factors for heart disease. Also highly important, secondhand smoke causes serious health problems in children.
  • Secondhand smoke actually includes 2 types of smoke:
    • "Mainstream smoke" is the smoke that the cigarette, pipe, or cigar smoker inhales and exhales.
    • "Sidestream smoke" is the smoke which goes directly into the air from the burning cigarette, pipe, or cigar while it rests in the ashtray or is held by the smoker. Sidestream smoke is the primary source of smoke in room air. Sidestream smoke has a high concentration of dangerous chemicals.
  • Secondhand smoke is a health concern, especially for young children.
    • The lungs of young children are still developing and are particularly sensitive to the effects of secondhand smoke.
    • Children are also vulnerable to exposure to secondhand smoke because they must depend on parents, care-givers, and other adults to keep their environment healthy. Children are typically exposed involuntarily to secondhand smoke.

About Young Children and Secondhand Smoke.

In 1986, the American Academy of Pediatrics (AAP) estimated that 9-12 million children under age 5 are exposed to secondhand smoke in the home. The health consequences are immense. For example, from 200,000 to 1 million children with asthma have had their condition worsened by exposure to secondhand smoke.

Children of smokers experience a wide variety of acute and chronic health risks:

  • Increased instances of disease and hospitalization
  • Increased risk of premature death
  • Increased medical expenses
  • Interference with growth and development
  • Hindered quality of life

A recent article in Archives of Pediatric and Adolescent Medicine reviewed all research on children’s health and tobacco smoking from 1980 to 1996. This article concluded that parental smoking is a major health risk for children and results in annual direct medical expenses of $4.6 billion in their children -- 8% of all pediatric medical spending. This includes 5.4 million excess cases of disease and 6,200 excess childhood deaths.

The Archives of Pediatric and Adolescent Medicine article also showed that as a group, children of smokers who are regularly exposed to secondhand smoke experience:

  • Higher rates of bronchitis and pneumonia, especially in the first 2 years
  • Impaired lung function as they get older
  • Asthma episodes aggravated or triggered by secondhand smoke
  • Increased likelihood to develop asthma
  • Increased numbers of acute respiratory illnesses
  • More ear infections and hearing problems
  • Longer recovery from colds and other illnesses
  • More days of school missed due to illnes
  • Living with secondhand smoke can mean that children suffer from recurrent coughs, wheezing, stuffy noses, headaches, sore throats, eye irritation, ear infections, hoarseness, dizziness, nausea, loss of appetite, lack of energy, and fussiness.

In addition, the same article reviewed medical research that strongly suggests infants of women smokers have an increased risk of Sudden Infant Death Syndrome (SIDS).

A 1997 California EPA study on children’s health reinforced many of the findings in the Archives of Pediatric and Adolescent Medicine article, and uncovered some additional, definitive results as well. The California EPA study found that secondhand smoke exposure to children also causes lung and nasal sinus cancer and heart disease.

Another study links secondhand smoke exposure and children with asthma. U.S. EPA’s 1992 Risk Assessment on secondhand smoke found that exposure:

  • Caused additional episodes and increased severity of symptoms in children with asthma
  • Worsened physical conditions in an estimated 400,000 to 1 million children with asthma

If you are a parent:

Give your children an opportunity to grow up in a smoke-free environment. If you cannot quit smoking, then make every effort to remove secondhand smoke from your children’s environment.

What can parents do to reduce their children’s exposure to secondhand smoke?

  • Do not smoke in the home
  • Do not smoke in cars that children ride in
  • Ask others to avoid smoking in the home or car
  • Investigate the smoking policies of the places where your children spend time -- such as schools, pre-schools, daycare providers, homes of friends, and community centers -- to make sure that children are guaranteed a smoke-free environment.

Ask your health care provider about the health risks to your children if they spend time in a home with a smoker.

If a child does live with a smoker, ask that this be noted on their medical records. This will be useful information if the child develops health problems in the future.

What can you do to reduce your and your family’s exposure to secondhand smoke and the resulting health risks?

  • Do not allow smoking in your home.
  • Secondhand smoke is a major health risk, especially to children. It is a health risk that is preventable. Although you can take measures to reduce exposure to secondhand smoke, such as increasing ventilation, opening windows, or using exhaust fans, nothing is as effective as simply not smoking in the home.

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