Chapter 1 Index

A. General Information about the well child examination

B. Nutrition Issues

C. Sleep Issues

D. Dental Issues

E. Anticipatory Guidance
--Discipline: Normal Toddlers
--Discipline: To Spank or Not to Spank
--Toilet Training: or Once Upon a Potty
--Reach Out and Read
--Anticipatory Guidance: Other Items to Ask Birth – 6 years of age

Smoking: Adverse Effects on Children

Introduction: Passive cigarette smoke has many adverse effects on children.  As pediatricians, it is our job to try and get parents, grandparents, and caregivers to stop smoking.  While not smoking in the house is better than smoking in the house for children, smoke will still be inhaled from parents’ clothing, the car, etc.

I.  Effects on Pregnancy:

• produces SGA babies from small placentas
• increased incidence of SIDS
• increased risk of perinatal mortality

II.  Effects on Long-Term Developmental Outcomes

• produces increased incidence of mild mental retardation: (Pediatrics 1996;87:547-564)
• cognitive and achievement deficits among children of smokers
• more likely to have behavioral problems and auditory deficits

III.  Increased Incidence of Infections

A.  Upper Respiratory Tract Infections

1. Otitis Media: 354,000 to 2.2 million episodes of otitis/year
2. Tympanostomy tubes: 5,200 to 165,000 tubes/year
3. Tonsillectomy and Adenoidectomy: 14,000-21,000 T&As/year

B.  Lower Respiratory Infections and Asthma

1. Asthma: 529,000 office visits/year
2. Coughs: 1.3-2 million visits/year
3. Bronchitis: 260,000-436,000 episodes/year
4. Pneumonia: 115,000-190,000 episodes/year
5. Bronchiolitis: increased, but no specific data for this
6. Hospitalizations from respiratory tract illness: 15% are associated with exposure to smoke.

IV.  Accidental Deaths: 148 children/year die from fires initiated by smoking materials; 359/year had injuries as a result of fires.

Recommendation: Urge new laws for not allowing smoking wherever children are.  This is the only way we will make a difference in the above morbidity and mortality.

Reference: Peds 1996;97:560-568

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Department of Pediatrics  |  Medical College of Georgia
Please email comments, suggestions or questions to:
John T.  Benjamin M.D.,  jbenj@mcg.edu

February 27, 2004