The decision to start smoking is often made during the teenage years. However, cigarette smoking is becoming increasingly common among younger children. Similarly, use of smokeless or chewing tobacco is increasing among children and adolescents. 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.