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Foreword: Physical, Behavioral, and Cognitive Effects of Prenatal Tobacco and Postnatal Secondhand Smoke Exposure
Physical, Behavioral, and Cognitive Effects of Prenatal Tobacco and Postnatal Secondhand Smoke Exposure Sherry Zhou, David G. Rosenthal, MD, Scott Sherman, MD, MPH, Judith Zelikoff, PhD, Terry Gordon, PhD, Michael Weitzman, MD
Foreword: Physical, Behavioral, and Cognitive Effects of Prenatal Tobacco and Postnatal Secondhand Smoke Exposure found in cigarette smoke. Children were not mentioned. The Report of the Surgeon General in 1996 was the first Surgeon General’s Report to establish a health risk due to tobacco smoke exposure for children and other nonsmokers.3 It concluded the following:
This year marks the 50th anniversary of the 1964 report of the Advisory Committee to Luther L. Terry, M.D., the 9th Surgeon General of the U.S. Public Health Service, on Smoking and Health.1 That seminal report brought the American public’s attention to the health hazards faced by smokers; it made no mention whatsoever of the effects of smoking on children or others in the homes of smokers. It was not until 1972 that the topic of passive exposure of nonsmokers to secondhand smoke was first considered in a Surgeon General’s report.2 That report presented information about public exposure to air pollution from tobacco and the harmful constituents that are
Curr Probl PediatrAdolesc Health Care, September 2014
(1) involuntary smoking is a cause of disease, including lung cancer, in healthy nonsmokers; (2) the children of parents who smoke, compared with the children of nonsmoking parents, have an increased frequency of respiratory infections, increased respiratory symptoms, and slightly smaller rates of increase in lung function as the lung matures; and (3) simple separation of smokers and nonsmokers within the same air space may reduce, but does not eliminate, exposure of nonsmokers to environmental tobacco smoke. Ten years later, the Surgeon General’s report The Health Consequences of Involuntary Exposure to Tobacco Smoke went much further; it asserted that there is no risk-free level of exposure to secondhand smoke.4 It also concluded the following: (1) Secondhand smoke causes premature death and disease in adults and children who do not smoke. (2) Exposure to secondhand smoke has immediate negative effects on the heart and causes heart disease and lung cancer.
217
(3) Secondhand smoke can worsen asthma in children and puts them at risk for sudden infant death syndrome (SIDS), respiratory infections, and ear problems. (4) Millions of American adults and children are still exposed to secondhand smoke at home and in the workplace. (5) Having separate smoking and nonsmoking areas, cleaning the air, and ventilating buildings cannot eliminate secondhand smoke exposure. Prohibiting smoking in indoor spaces does. The 2014 Surgeon General’s Report reviewed the evidence from the previous 31 Surgeons’ General reports and added even more conditions to the long list caused by tobacco.5 It concluded that maternal smoking during early pregnancy is causal for orofacial clefts in infants, and may be associated with certain other birth defects (clubfoot, gastroschisis, and atrial septal heart defects). It also found that smokefree indoor air policies are effective in reducing exposure to secondhand smoke and lead to less smoking around covered individuals. Fifty years ago, there were no smokefree policies in the United States. Healthy People 2020, a comprehensive set of 10-year national goals and objectives for improving the health of all Americans, now has specific goals to establish laws in states, the District of Columbia, territories, and tribes on smokefree indoor air that prohibit smoking in public places and worksites and to increase the proportion of smokefree homes.6 Healthy People 2020 considers the percentage of children exposed to secondhand smoke to be a leading health indicator. As of the most recent update, this indicator had been met; secondhand smoke exposure among children 3–11 years old
218
dropped from 52.2% in 2005–2008 to 41.3% in 2009–2012.6 Our work is far from done, however. We have more to do to extend complete smokefree indoor protections to 100% of U.S. children. In this issue, Zhou et al. have provided a comprehensive review of the health effects of prenatal tobacco and postnatal secondhand smoke exposure. This evidence should compel us to continue the remarkable progress that has been made in the last 50 years.
References 1. U.S. Department of Health, Education and Welfare. Smoking and Health: Report of the Advisory Committee to the Surgeon General of the Public Health Service. PHS Publication No. 1103. Washington, DC: U.S. Department of Health, Education, and Welfare, Public Health Service; 1964. 2. U.S. Department of Health, Education and Welfare. The Health Consequences of Smoking: A Report of the Surgeon General. Washington, DC: U.S. Department of Health, Education and Welfare, Public Health Service; 1972. 3. U.S. Department of Health and Human Services. The Health Consequences of Involuntary Smoking: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, Centers for Disease Control, Center for Health Promotion and Education, Office on Smoking and Health; 1996. 4. U.S. Department of Health and Human Services. The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2006. 5. U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2014. 6. Healthy People 2020 Leading Health Indicators: Progress Update. 〈http://www.healthypeople.gov/2020/LHI/LHI-ProgressReportExecSum.pdf〉; 2014.
Ruth A. Etzel, MD, PhD Associate Editor
Curr Probl Pediatr Adolesc Health Care, September 2014
Foreword: Physical, Behavioral, and Cognitive Effects of Prenatal Tobacco and Postnatal Secondhand Smoke Exposure found in cigarette smoke. Children were not mentioned. The Report of the Surgeon General in 1996 was the first Surgeon General’s Report to establish a health risk due to tobacco smoke exposure for children and other nonsmokers.3 It concluded the following:
This year marks the 50th anniversary of the 1964 report of the Advisory Committee to Luther L. Terry, M.D., the 9th Surgeon General of the U.S. Public Health Service, on Smoking and Health.1 That seminal report brought the American public’s attention to the health hazards faced by smokers; it made no mention whatsoever of the effects of smoking on children or others in the homes of smokers. It was not until 1972 that the topic of passive exposure of nonsmokers to secondhand smoke was first considered in a Surgeon General’s report.2 That report presented information about public exposure to air pollution from tobacco and the harmful constituents that are
Curr Probl PediatrAdolesc Health Care, September 2014
(1) involuntary smoking is a cause of disease, including lung cancer, in healthy nonsmokers; (2) the children of parents who smoke, compared with the children of nonsmoking parents, have an increased frequency of respiratory infections, increased respiratory symptoms, and slightly smaller rates of increase in lung function as the lung matures; and (3) simple separation of smokers and nonsmokers within the same air space may reduce, but does not eliminate, exposure of nonsmokers to environmental tobacco smoke. Ten years later, the Surgeon General’s report The Health Consequences of Involuntary Exposure to Tobacco Smoke went much further; it asserted that there is no risk-free level of exposure to secondhand smoke.4 It also concluded the following: (1) Secondhand smoke causes premature death and disease in adults and children who do not smoke. (2) Exposure to secondhand smoke has immediate negative effects on the heart and causes heart disease and lung cancer.
217
(3) Secondhand smoke can worsen asthma in children and puts them at risk for sudden infant death syndrome (SIDS), respiratory infections, and ear problems. (4) Millions of American adults and children are still exposed to secondhand smoke at home and in the workplace. (5) Having separate smoking and nonsmoking areas, cleaning the air, and ventilating buildings cannot eliminate secondhand smoke exposure. Prohibiting smoking in indoor spaces does. The 2014 Surgeon General’s Report reviewed the evidence from the previous 31 Surgeons’ General reports and added even more conditions to the long list caused by tobacco.5 It concluded that maternal smoking during early pregnancy is causal for orofacial clefts in infants, and may be associated with certain other birth defects (clubfoot, gastroschisis, and atrial septal heart defects). It also found that smokefree indoor air policies are effective in reducing exposure to secondhand smoke and lead to less smoking around covered individuals. Fifty years ago, there were no smokefree policies in the United States. Healthy People 2020, a comprehensive set of 10-year national goals and objectives for improving the health of all Americans, now has specific goals to establish laws in states, the District of Columbia, territories, and tribes on smokefree indoor air that prohibit smoking in public places and worksites and to increase the proportion of smokefree homes.6 Healthy People 2020 considers the percentage of children exposed to secondhand smoke to be a leading health indicator. As of the most recent update, this indicator had been met; secondhand smoke exposure among children 3–11 years old
218
dropped from 52.2% in 2005–2008 to 41.3% in 2009–2012.6 Our work is far from done, however. We have more to do to extend complete smokefree indoor protections to 100% of U.S. children. In this issue, Zhou et al. have provided a comprehensive review of the health effects of prenatal tobacco and postnatal secondhand smoke exposure. This evidence should compel us to continue the remarkable progress that has been made in the last 50 years.
References 1. U.S. Department of Health, Education and Welfare. Smoking and Health: Report of the Advisory Committee to the Surgeon General of the Public Health Service. PHS Publication No. 1103. Washington, DC: U.S. Department of Health, Education, and Welfare, Public Health Service; 1964. 2. U.S. Department of Health, Education and Welfare. The Health Consequences of Smoking: A Report of the Surgeon General. Washington, DC: U.S. Department of Health, Education and Welfare, Public Health Service; 1972. 3. U.S. Department of Health and Human Services. The Health Consequences of Involuntary Smoking: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, Centers for Disease Control, Center for Health Promotion and Education, Office on Smoking and Health; 1996. 4. U.S. Department of Health and Human Services. The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2006. 5. U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2014. 6. Healthy People 2020 Leading Health Indicators: Progress Update. 〈http://www.healthypeople.gov/2020/LHI/LHI-ProgressReportExecSum.pdf〉; 2014.
Ruth A. Etzel, MD, PhD Associate Editor
Curr Probl Pediatr Adolesc Health Care, September 2014