Smoking and Children’s Health
William B. Weil, MD*, Professor Emeritus, Pediatrics and Human Development, Michigan State University

It is shocking to learn that the Cotinine levers (a by-product of tobacco smoke) is twice as high in infants and children, age 3-11 years of age than it as in adults over 20 years of age. These data are from the Centers for Disease Control and just published this year. The implication for parents is that these children are being exposed to more tobacco smoke than are adults. This has critical implications for these children’s health. Although we haven’t been able to measure these levels in the fetus, the effects on this developing child may be just as serious as it is for children after birth and for the mothers themselves as well.

Smoking during pregnancy has been associated with increasing risk for spontaneous abortions, stillbirths, ectopic pregnancies and premature births. The infant may also demonstrate poorer intrauterine growth. Just as smoking can increase the risks of lung cancer, heart disease and lung problems in all adults, it has the same effects on the pregnant woman. Exposure to tobacco smoke in utero or as a breast feeding infant or later in childhood has been associated with increase risks for allergies and for the development of asthma. There is also some evidence that such early exposure to tobacco smoke may result in the child developing a variety of behavior problems such as Attention Deficit Hyperactivity Syndrome.

What to do? The obvious answer is to quit smoking and prohibit smoking in the home, car or other locations where the child is present. Smoking only outside the home is another alternative. Unfortunately, even this is easier said than done, as many smokers will testify. The one time that is critical for the infant is not smoking while pregnant or while breast feeding since cotinine can be transferred from the mother to the infant through the placenta and through breast milk. At the very least, the mother should not smoke while actually in the process of feeding. Other less critical changes can be made for the mother or other adults in the household. While these are less than ideal, they will reduce the child’s exposure and subsequent adverse outcomes. First would be to avoid smoking in the presence of the child in the home or in the car. Second on the list would be to avoid smoking in the room in which the child sleeps. Less helpful, but still of use would be to avoid anyone smoking within ten feet of the child when present in the same space as the smoker.

Finally, never give up the attempt to stop. You may wish to discuss this with your own physician or with the child’s physician as they may have other assistance available. And don’t forget that there are a number of sites on the WEB that discuss smoking issues and methods available to assist the smoker in cessation.

*Dr. Weil is a nationally known and highly respected pediatrician with varied interests and achievements; He contributed this article in support of the LDA of Michigan’s Healthy Children’s Initiative.