Is It Too Late for Children of Smokers?

Even though tobacco use continues to fall in the United States, hundreds of thousands of Americans still die every year from smoking-related causes, according to a new report released Thursday by the Institute of Medicine (IOM).

In fact, nearly 45 million people in the United States continue to light up, despite health warnings.

But a separate study released last week shows that smokers may be putting more than their own health at risk. It turns out that children of smokers, even if they appear healthy, can suffer permanent lung damage if their parents smoke.

"This research helps us [to detail] the deleterious impact of secondhand smoke on children, but delves deeper [than prior research]," said Dr. Christina Master, associate pediatric residency program director at the Children's Hospital of Philadelphia.

Other physicians agree that the message comes not a moment too soon.

"In my mind [smoking] is a form of child abuse," said Dr. Lisa Bellini, vice chair for education in medicine at the Hospital of the University of Pennsylvania.

The study, presented at the American Thoracic Society meeting in San Francisco on Sunday, looked at 244 Dutch children ages 4 to 12 who had no lung problems at all. The children then performed pulmonary function tests, or PFTs, as they are more commonly known. These tests essentially look at how well the lungs work.

The study found that children of smokers had decreased lung ability when tested against children of nonsmokers, even though both sets of children were asymptomatic.

The study also showed that smoking after pregnancy seemed to be more harmful than during pregnancy alone, which may add weight to the arguments for the dangerous nature of secondhand smoke.

"I have advised my patients for a while that they should not smoke in the home, around their children or in the car with children," Bellini said.

New Secondhand Smoke Concerns

A 2006 report by the office of the surgeon general detailed the dangers of secondhand smoke, including the fact that it has been named a known human carcinogen, or cancer-causing agent.

Dr. Bert Arets, one of the authors of the study looking at the lungs of smokers' children, said that though we may have known about some of the dangers of secondhand smoke, "until now we haven't known if lung function is impaired in children of smokers who don't have any respiratory complaints."

Up to this point, children of smokers have been shown to have a higher risk of sudden infant death, more severe asthma, and more pneumonia and episodes of bronchitis, but there have been no studies looking at the lung function of these children.

"[This study] takes us beyond simply recognizing the increased rates of illness in children exposed to secondhand smoke [and identifies] negative health consequences that are not as apparent but may have significant long-term consequences for these apparently 'asymptomatic' children," noted Master.

"Hopefully the [new] data will compel parents to protect their children from smoke's harmful effects," Bellini said.

Another Reason to Quit

Given the results of this research, the study authors have now expanded the group to include 2,000 "healthy" children of smokers -- an expanded group that could shed more light on the dangers of secondhand smoke in children.

"Physicians should continue to advocate for smoking cessation in smoking households, for the benefit of both the children in the home as well as the adults," Master said. "We should seek to partner with [patients] in whatever ways we can in order to promote this agenda."

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