The danger of second-hand smoke
About the article
This is a digitised version of an article from The Cayman Compass's print archive. Occasionally, the digitisation process introduces transcription errors, or other problems.
See the article in its original context from June 1990.
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Passive smoking is fundamentally different from active smoking. The latter habit is driven by a mixture of "free choice" and social conditioning, the former is usually an incurred hazard.
Although legislative measures can ban smoking in public places, will it ever be prohibited in the home? Smoking is a private, personel choice, yet parents can put their children's health in jeopardy because of this. The baby in the womb has no choice if its mother smokes. But this very baby has a increased risk of being born with a lower weight than that of a nonsmoking mother, have more respiratory illness and slower growth, because it has unwittingly absorbed the toxic elements in cigarettes.
If a child lives in a home with smokers, then its exposure to exhaled smoke is equivalent to smoking some 80 cigarettes a year, or the nicotine of a quarter cigarette each day. The risks of passive, or involuntary smoking are now being increasingly investigated and the results from studies as far apart as the United States, Japan, India and several other countries are startling.
The more we learn about the effects of cigarette smoking, the better we realize how pernicios, wide-ranging and long-lived they are.
For many years the effect of tobacco smoke was studied mainly in relation to the smoker, since the harm done was more directly observable. But now passive smoking is becoming a cause for concern. Also known as involuntary smoking, it is called "the exposure of subjects to environmental tobacco smoke (ETS)", in other words the exhaled smoke and that released between puffs by cigarette smokers. The sidestream smoke contains a complex combination of chemicals composed of several thousand substances and has higher concentrations at the source of toxic chemicals than mainstream smoke that is inhaled by the smoker.
It has become clear that exposure to involuntary smoking now has to be examined in relation to its adverse health effects (respiratory disease and other health problems) and its extent (the home, working environment and other places).
The Threat to Health
It is imperative that smokers realize that their habit affects the health of a larger number of peoples. Especially vulnerable are babies, the children and adolescents. According to the 1986 Report of the US Surgeon General, evidence shows that: 1) involuntary smoking is a cause of disease, including lung cancer, in healthy non-smokers; 2) the children of parents who smoke have more respiratory infections and slightly diminished growth of lung functions than of parents who do not; 3) separation of smokers and nonsmokers within the same space reduces, but does not eliminate, exposure to tobacco smoke.
Babies in Danger
Passive smoking starts from birth. It effects the foetus, but also the baby once it is born.
The newborn (breastfed or not), the toddler, the schoolgoer and the adolescent all are affected. Studies in India also show harmful effects on babies of women who chew tobacco. The stillborn rate for women who had this habit was 50 per 1000 live births, compared to 17 per 1000 for women who did not.
Smoking during pregnancy causes Foetal Tobacco Syndrome, defined by the US Centers for Disease Control. This occurs when the mother has smoked 5 or more cigarettes a day throughout pregnancy. It can lead to lower birth weights, poor growth and size at birth and posible congenital defects and infections.
The number of cigarettes a pregnant woman consumes affects the birthweight of her baby. Studies show that light and heavy smokers have a 54 per cent and 130 per cent increased risk respectively of having babies who weigh less than 2.5 kg. A study in Oska of 3,478 "pregnant" women showed that the rate of prevalence of low birth increased with the intensity of exposure: it was 3.8 per cent for nonsmoking women with nonsmoking husbands but 9.3 per cent for smoking wives and husbands. It is worrying to note that the fathers' smoking can affect the unborn baby, and that the mothers who had been smokers, but stopped during pregnancy, were more likely to have low-birthweight babies than those who had never smoked.
Studies in both industrialized and developing countries have produced similar results. Smoking during pregnancy has been associated with premature babies, spontaneous abortions, foetal deaths and those around the time of birth (perinatal death). It is directly linked to low birth weight. There is also some link of congenital defects.
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There is some doubt of the role that passive smoking by the baby plays in perinatal death. But recent studies of 360,000 births in Missouri, in USA and another in Sweden of 281,808 births have shown that passive smoking is a significant factor, especially when combined with other biological risk factors such as high maternal age and multiple births. The Swedish study showed that smoking was responsible for 11 percent of late foetal deaths and 5 percent of early neonatal deaths.
In some developed countries, if all women stopped smoking, feotal and infant deaths would drop by approximately 10 per cent. The sudden infant death sydrome has also been related to maternal smoking. Smoking is thus probably one important preventable risk factor for perinatal death.
Most women in the industrialized countries are aware of the risks of smoking during pregnancy. The nicotine and carbon monoxide in their blood are carried into their baby's bloodstream, damaging the supply route for oxygen and food. What women do not appreciate is that the risks continue after birth, and affect the newborn baby and any other children in the home. Few regular smokers are aware that their children are passively smoking from 30 to 80 cigarette's-worth of nicotine a year, or a quarter of a cigarette a day.
When breastfeeding, a baby is absorbing harmful chemicals from its smoking mother's milk. Japanese schoolchildren were found, as a result fo their parents' smoking, to have smoke-related chemicals in their urine in proportion to the number of cigarettes their parents smoked. A British study of children between 11 and 16 years confirmed the same findings, and showed nicotine increase depending on the number of smokers at home.
Ill health can also follow from children living in a smoking family. One wonders if parents realize they are creating the Moday Morning Syndrome for their children. This does not mean that they are reluctant to go to school but that they have been in a smoke-filled home all weekend. The children develop ear infections (otitis) or respiratory problems on Sunday evening and have to see the doctor on Monday morning.
These children may also have difficulties at school, learn and progress more slowly than their classmates who have parents that do not smoke, because they are often ill and cannot do their best. Smoking parents may also be passing on their own respiratory problems to their children.
The First Few Years
The child who is constantly exposed to cigarette smoke and continues to breathe toxic substances, is affected by a series of health problems in the first few years of life. The problems are exacerbated if the mother smokes because she has the longest contact with the child, if she does not work.
-There is a higher incidence of respiratory infections in children of parents who smoke in their first year and an increased possibility of hospitalization. Furthermore acute respiratory infection in childhood makes the lungs more susceptible and even moreso if the child grows up to be a smoker; -Chronic cough, phlegm and wheezing is more common in children of smoking parents, especially the mother. A study of 650 children aged 5 to 10 years showed that wheezing occured in 1.9 per cent of children with nonsmoking parents; 6.9 per cent with one smoking parent; and 11.8 per cent in children where both parents smoked; -There is slower growth and lung development in children of smoking parents, especially the mother. Height may also be affected; -Chronic middle ear infections can be related to parental smoking.
