The impact of smoking on children's health: new initiatives.

THE PREVIOUS ARTICLES presented in the 2000 Child Health Policy column have examined the state of children’s health within the context of the Healthy People 2000 and 2010 objectives. For example, columns thus far have discussed mental health objectives and physical fitness objectives that are geared towards improving children’s health and eliminating disparities by 2010. This column focuses on the latest findings and initiatives related to children and tobacco use. Information regarding programs and federal initiatives that can be replicated at the local level are presented in this column to help pediatric nurses and other health care providers become more aware about new programs that they can implement in their practices and communities to assist children and their families to abstain from or stop smoking. More than 430,000 deaths per year among adults can be attributable to tobacco use (Centers for Disease Control and Prevention, 1997). Unfortunately, many of these adults started smoking during their teenage years. To date, 646,950 children have become regular smokers in 2000, and 207,024 of them will eventually die from their addiction (Campaign for Tobacco Free Kids, 2000). Each day more than 3,000 kids become smokers (Centers for Disease Control and Prevention, 1998) and the ages range from 12 to 17 years. There are several adverse effects of smoking. Over the past several decades, cigarette smoking during pregnancy has been associated with hazardous pregnancy outcomes, including increased incidences of low birth weight (U.S. Department of Health and Human Services, 1990), reduced forced expiratory flows for infants, and miscarriages (Hanrahan et al., 1992; Zuckerman, 1998). Researchers report that children aged 0 to 5 years who are exposed to maternal smoking are 2.1 times more likely to develop asthma compared with those free from exposure (Weitzman, Gortmaker, Walker, & Sobol, 1990). In addition to infants and children experiencing lifelong effects of maternal smoking during pregnancy, exposure to secondhand smoke is also detrimental. Studies indicate that primary source of children’s exposure to environmental tobacco smoke is in the home. (U.S. Department of Health and Human Services, 1991). As a result of secondhand smoke, 150,000 to 300,000 infants and children under 18 months experience lower respiratory track infections (California Environmental Protection Agency, 1997). Exposure to secondhand smoke is reported to cause lung cancer in approximately 3,000 nonsmokers each year (U.S. Environmental Protection Agency, 1992). Because of the direct and indirect impact of smoking on our children, smoking prevention among all populations must be addressed. On January 24, 2000, the United States Surgeon General released Healthy People 2010, the prevention agenda for the Nation (U.S. Department of Health and Human Services, 2000c). Of the 28 health focus areas, several of the objectives address From Oak Tree Solutions, Inc., Reston, VA and the Center for Health Policy, Research & Ethics, George Mason University, Sterling, VA. Address reprint requests to Stephanie L. Ferguson, PhD, RN, FAAN, Associate Professor, Center for Health Policy, Research & Ethics, George Mason University, 46809 Trailwood Place, Sterling, VA 20165-7544. E-mail: drslferg@aol.com Copyright r 2000 by W.B. Saunders Company 0882-5963/00/1506-0009$10.00/0 doi: 10.1053/jpdn.2000.18220