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Tobacco control policies in relation to child health and perinatal health outcomes
  1. Jasper V Been1,2,3,
  2. Aziz Sheikh3,4
  1. 1 Division of Neonatology, Department of Paediatrics, Erasmus MC – Sophia Children’s Hospital, Rotterdam, The Netherlands
  2. 2 Department of Obstetrics and Gynaecology, Erasmus MC – Sophia Children’s Hospital, Rotterdam, The Netherlands
  3. 3 Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
  4. 4 Division of General Internal Medicine and Primary Care, Brigham and Women’s Hospital/Harvard Medical School, Boston, Massachusetts, USA
  1. Correspondence to Dr Jasper V Been, Division of Neonatology, Department of Paediatrics, Erasmus MC – Sophia Children’s Hospital, 3000CB Rotterdam, The Netherlands; j.been{at}erasmusmc.nl

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Burden of tobacco-related harm

The global epidemic of tobacco use continues to cause a considerable burden of premature death and disease.1 2 Worldwide, over 1 billion people are regular smokers, and the societal costs of smoking have been estimated at over £1 trillion/year.1 3 Tobacco is relevant to child health in various ways. Unborn children may be exposed to tobacco when their mothers smoke, are exposed to secondhand smoke (SHS) or use smokeless tobacco products. Antenatal tobacco smoke exposure can lead to birth defects, preterm birth, intrauterine growth restriction and stillbirth.4–6 After birth, exposure to SHS increases the risks of neonatal and infant death, otitis media with effusion, respiratory tract infections (RTIs), meningococcal disease and asthma attacks.5 6 Furthermore, early-life tobacco smoke exposure increases the likelihood that the child will become a smoker later in life. In this paper, we discuss how tobacco control measures may improve early life health outcomes and highlight key knowledge gaps.

Controlling the tobacco epidemic

Based on international treaties, in particular, the Convention of the Rights of the Child, there is consensus that every child should have the right to grow up free from the adverse health effects of tobacco.7 Children, particularly when young, are entirely dependent on decisions made by adults in relation to tobacco and SHS exposure. Tobacco control policies can help guide these decisions, for example, by informing the public about the dangers of tobacco use and SHS exposure, prohibiting smoking in public places and in cars and reducing parental smoking through decreasing the attractiveness of tobacco products via price increases and marketing restrictions. To facilitate governments in applying what has been set out in the widely endorsed international Framework Convention for Tobacco Control (FCTC) treaty, the WHO has formulated six key (groups of) tobacco control policies that participating countries need to implement, represented by the MPOWER …

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