Tobacco in the 21st Century

On the basis of biological samples of population data, more than half of US children continue to have exposure to secondhand smoke. (1) On the basis of overwhelming evidence from epidemiologic and basic science research, exposure to tobacco smoke prenatally, and in childhood, causes respiratory illness in children. (2) On the basis of overwhelming evidence from epidemiologic and basic science research, smoking tobacco causes cancer and heart disease. (2) On the basis of observational studies, children's exposure to tobacco smoke is also associated with nonrespiratory illnesses, such as sudden infant death syndrome, attention-deficit/hyperactivity disorder, and decreased cognitive scores. (2) On the basis of randomized controlled trials in adults, US Public Health Service guidelines, and results of the Clinical Effort Against Secondhand Smoke Exposure study, parents should be asked about their children's exposure to secondhand smoke at each visit and offered assistance with quitting or referral to the quitline if they smoke. (3)(4)