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Freedom to breathe freely

There is no getting around it: Secondhand smoke is dangerous to the health of our nation's youth.

Doctors have known for years that childhood asthma, middle-ear disease, bronchitis, pneumonia, colic and even sudden infant death syndrome (SIDS) are clinically shown to be associated with breathing this environmental pollutant. It turns out this picture is only the tip of a very toxic iceberg.

A recent study indicates that exposure to secondhand smoke also significantly affects cognitive abilities in children and adolescents, aged 6 to 16. Even relatively low exposure levels are associated with lower scores in standard reading, math and reasoning tests.

And we are not talking about just a few youngsters. It is estimated that more than 33.3 million children are at risk for secondhand smoke-related reading deficits.

I think its time this public-health issue receives a full airing. Environmental tobacco smoke (ETS) is the formal name for secondhand smoke. It's the toxic product of the smoke from a lit cigarette coupled with the smoke exhaled by the smoker. Exposure to ETS can be measured by determining the level of cotinine -- a major metabolite of nicotine -- in the blood, saliva, urine and hair.

In research reported in the January 2005 issue of Environmental Health Perspectives, cotinine levels were measured in the blood of 4,399 youths who were non-smokers or who had not smoked in the past five days. The study showed that children with the highest serum cotinine levels performed significantly lower on tests involving math, reading and visio-spatial reasoning, than did children in the lowest cotinine level group.

This is consistent with prior research linking ETS exposure with decreased performance in tests of reasoning ability, language development and intelligence, as well as with students having an increased risk for being held back a grade. Not surprisingly, mean serum cotinine levels were significantly higher among children who had at least one smoker living in their homes.

Study author Dr. Kimberly Yolton of the Cincinnati Children's Hospital Medical Center in Ohio explains how much ETS is needed to produce toxic results: "The impact of ETS on a child's environment depends on many factors such as proximity to the source (i.e., smoker), ventilation and air flow, and intensity of the smoke. But we did find that even in homes where there was only one smoker who smoked less than one pack per day, ETS exposure in the children was at a level where we saw a reduction in reading performance."

I believe that secondhand smoke is both a family and a national issue.

The simple message to parents who still smoke is: Find a way to quit. But such radical action is not always possible. For this group, reducing harm to family members by not smoking in the house or the family car is a beginning.

"Parents should do their best to protect their children from exposure to ETS," said Dr. Yolton. "If they are smokers and unable to quit (we know this is extremely difficult), they should do their best to smoke far away from their children and provide their children with fresh air."

But what about ETS outside the home?

I asked Dr. Yolton about the implication of her team's research on national policy with regard to secondhand smoke. She spoke quite candidly: "Since a large portion of our sample was exposed to ETS outside the home, I think this research could potentially have large policy implications. Parents are able to protect their children from harmful things when they are safe at home, but when (they) take (their) children into public spaces, they have less control.

"We need to find more effective ways to guarantee that all our children have fresh, clean air to breathe so they can grow and develop to their optimal potential."

I couldn't agree more.

It's time to sit with our neighbors to draw up and implement blueprints for an ETS-free community. Each small success will serve as a model for change on a national level. Let's also encourage adults who are not ready to stop smoking to explore harm-reduction methods that will lessen exposure to secondhand smoke within their homes. This can be accomplished by public-service announcements in the media and educational programs in schools and in the community.

Before long, we all will be able to breathe freely.

Judy Shepps Battle is a New Jersey resident, addictions specialist, consultant and freelance writer. She can be reached by e-mail at Additional information on this and other topics can be found at her website at

Web posted on Thursday, January 27, 2005


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Updated: 04-Nov-2010 10:01

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