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Cars Should Be Smoke-Free for Children


Children are held captive and exposed to harmful toxins when parents allow smoking in the car, according to a study reported at the Pediatric Academic Societies annual meeting in Denver. The authors noted few parents are advised by pediatric healthcare providers to maintain a smoke-free car.

Smoking in cars is hazardous to children

The health dangers of secondhand smoke in children have been reported much in the last few years. Respiratory problems are the main health issue associated with exposure to secondhand smoke. In a recent study published in Lancet, a retrospective analysis of data from 192 countries found that the greatest disease burdens were from lower respiratory infections in children younger than 5 years of age, ischemic heart disease in adults, and asthma in adults and children.

Another recent study, published in the Archives of Pediatrics & Adolescent Medicine, looked at children ages 8 to 15. Investigators reported on an association between exposure to secondhand smoke and symptoms of major depressive disorder, generalized anxiety disorder, attention-deficit/hyperactivity disorder, and conduct disorder.

In the new study, parents were surveyed after they had brought in their children for a well or sick visit at a pediatric practice. Seven centers in six states were involved in the study. Parents who smoked were questioned about smoking in their car, the age of their children, and if their pediatrician had advised them to maintain a smoke-free car.

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Investigators found that 146 of 528 parents who smoked (28%) said they had a smoke-free car rule, while 114 (22%) reported having a strictly enforced ban on smoking in the car. Among parents who said they smoked in their car, 52 percent said they smoked while their children were in the car. Only 14 percent of parents said they had been advised by their pediatrician to keep a smoke-free car.

According to Jonathan P. Winickoff, MD, MPH, FAAP, associate professor of pediatrics at MassGeneral Hospital for Children, infants in car seats are “involuntarily and intensely exposed to more than 400 toxic chemicals in tobacco smoke. They have no voice and no choice in whether their parents smoke in the car.”

Infants and children are more susceptible to respiratory problems because their air passages are smaller than those of adults, which means they are more likely to experience severe respiratory infections and asthma attacks. According to the Centers for Disease Control and Prevention, about 7.1 million children in the United States have asthma.

Winickoff notes that their findings “highlight the need for improved pediatric interventions, public health campaigns and health policy regarding smoke-free car laws to protect children from tobacco smoke toxins.”

Bandiera FC et al. Archives of Pediatrics & Adolescent Medicine 2011 Apr; 165(4): 332-38
Centers for Disease Control and Prevention
Nabi E et al. Parents smoking in their cars with children. Abstract
Oberg M et al. Lancet 2011 Jan 8; 377(9760): 139-46