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Environmental tobacco smoke exposure among infants, children and young people: now is no time to relax
  1. Juliana Pugmire,
  2. Helen Sweeting,
  3. Laurence Moore
  1. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
  1. Correspondence to Professor Laurence Moore, MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, G2 3QB UK; Laurence.Moore{at}

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The detrimental effects of environmental tobacco smoke (ETS—also referred to as passive or secondhand smoke) exposure begin in utero as the placenta offers no barrier to ETS exposure. Maternal smoking during pregnancy increases a child's risk for reduced lung function, wheezing and asthma even in the absence of postnatal ETS exposure. Of course, many children exposed to tobacco in utero are also exposed postnatally. Compared with children raised in smoke-free environments, ETS-exposed children have a higher risk of sudden infant death syndrome, respiratory infection, ear infection, asthma, meningitis and reduced lung growth. Adding to this body of evidence, the systematic review found that children exposed to ETS had increased risk of respiratory adverse events during the perianaesthetic period of surgery.1

The harms of ETS exposure follow a child into adulthood. Even when children do not adopt parental smoking habits and assume a smoke-free lifestyle in adulthood, they are still more likely to experience persistent respiratory symptoms into adulthood.2 Beyond those risks, children with at least one smoking parent are about 60% more likely to take up smoking in adulthood themselves and the risk of uptake is much higher if both parents smoke3 compounding the risks of childhood ETS exposure with personal smoking in adulthood.

In 2016, the UK and the USA have smoking bans in most public indoor spaces. In the USA, smoking bans are increasingly extending outdoors, covering university campuses and around the entrances to office …

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