The Impact of Secondhand Smoke on Children. Michael Warren, MD MPH FAAP Division of Family Health and Wellness Tennessee Department of Health

Transcription

1 The Impact of Secondhand Smoke on Children Michael Warren, MD MPH FAAP Division of Family Health and Wellness Tennessee Department of Health

2 Take-Home Points Children who have never smoked die from tobacco smoke. Children who have never smoked suffer serious morbidity from tobacco smoke.

3 What Is Secondhand Smoke? Smoke inhaled by nonsmokers that contaminates indoor spaces and outdoor environments 1 Two components: Sidestream smoke: Smoke produced by burning end of cigarettes, pipes, cigars Mainstream smoke: Exhaled by smoker Sources: 1. Surgeon General s Report, The Health Consequences of Involuntary Exposure to Tobacco Smoke.

4 Secondhand Smoke Exposure in Children Hopper et al (2000) 76% Detroit, MI Cornelius et al (2003) 71% 79% (Cotinine) Chilmonczyk et al (1990) 40% 64% (Cotinine) Pittsburgh, PA Portland, ME Kum-Nji et al (2004) 71% Clarksdale, MS Overpeck and Moss (1991) 49% National NHIS (2002) 35% National NHANES II (1996) 43% National NHANES III (1998) 38% National

5 Secondhand Smoke is Dangerous >4,000 identifiable chemicals in secondhand smoke 1 Some of these chemicals also found in wood varnish, the insect poison DDT, arsenic, nail polish remover, and rat poison Detectable amount of chemicals can be found in body fluids of exposed non-smokers 2 No safe level/duration of exposure for children 3 Sources: 1. CDC: 2. Matt GE, et al. Households contaminated by environmental tobacco smoke: sources of infant exposures. Tobacco Control 2004;13: Surgeon General s Report, 2004 and 2006.

6 Secondhand Smoke: Health Consequences for Children Increased risk of SIDS 1 Increased incidence of respiratory illnesses 1 Ear infections Asthma Wheezing episodes Cough Bronchiolitis Pneumonia Asthmatics exposed to secondhand smoke have more flare-ups, more ED visits, & more likely to be intubated 2 Sources: 1. UpToDate, Secondhand Smoke Exposure: Effects in Children. Accessed 09/11/ DiFranza JR, Aligne CA. Prenatal and postnatal environmental tobacco smoke exposure and children s health. Pediatrics. 2004; 113; 1007.

7 Secondhand Smoke: Medical Costs Illness attributable to secondhand smoke 1 : 150, ,000 cases of lower respiratory tract infections per year in infants and young children 800,000 visits for ear infections per year Up to 1 million asthma flare-ups Parental smoking related to: $4.6 Billion per year in health care costs for children 2 19% of all expenditures for childhood respiratory 3 conditions Sources: 1. California Environmental Protection Agency: Air Resources Board. Proposed Identification of Environmental Tobacco Smoke as a Toxic Air Contaminant. Published 06/24/ Aligne CA, Stoddard JJ. Archives of Pediatric and Adolescent Medicine Oct; 151(10): Stoddard JJ, Gray B. Maternal smoking and medical expenditures for childhood respiratory illnesses. American Journal of public Health Feb; 87(2):

8 Limiting Exposure to Secondhand Smoke Only effective way to eliminate secondhand smoke is to stop smoking Air filtration or purification systems do not completely eliminate secondhand smoke Ventilation systems do not completely eliminate secondhand smoke Source: Asthma & Allergy Foundation of America. Available at: Accessed 09/11/2013.

9 Would You Jump In? Non-Peeing Section Peeing Section

10 Limiting Exposure to Secondhand Smoke Cotinine is frequently measured nicotine metabolite Urinary cotinine levels reduced in children when smoking bans in place Source: Wakefield, et al. Restrictions on smoking at home and urinary cotinine levels among children with asthma. American Journal of Preventive Medicine, (3):

11 Take-Home Messages for Parents Do not allow anyone to smoke near your child. Do not smoke or allow others to smoke in your home or car. Opening a window does not protect your children from smoke. Use a smoke-free day care center. Do not take your child to restaurants or other indoor public places that allow smoking. Teach children to stay away from secondhand smoke. Source: CDC. Available at:

12 Take-Home Points For Public Health Professionals Children who have never smoked die from tobacco smoke. Children who have never smoked suffer serious morbidity from tobacco smoke.