The majority of smokeless tobacco users begin by 13 years of age, and some begin as early as 4 or 5 years of age. Exposure to environmental tobacco smoke is a potential health hazard for infants and children. Passive smoking can exacerbate the symptoms of asthma and allergies and decrease pulmonary function. The rates of lower respiratory tract infection and middle ear effusions are higher in children who are exposed to environmental tobacco smoke. Each year, an estimated 300,000 children suffer from lower respiratory tract infections attributable to environmental tobacco smoke.
Parental smoking is a risk factor for the initiation of smoking by youth.
Children from families in which one or both parents smoke are twice as likely to smoke as are those whose parents do not smoke. See chapter 60 for information about smoking cessation. Parents who smoke while children are in the house should be counseled regarding the harmful effects of smoking on children's health. All tobacco users should be provided with tobacco cessation counseling on a regular basis. Clinicians should discuss nicotine replacement therapy as an adjunct for smoking cessation with patients desiring to quit smoking.