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PEDIATRICS Vol. 113 No. 4 April 2004, pp. 1007-1015

SUPPLEMENT ARTICLE

Prenatal and Postnatal Environmental Tobacco Smoke Exposure and Children’s Health

Joseph R. DiFranza, MD*, C. Andrew Aligne, MD, MPH{ddagger} and Michael Weitzman, MD{ddagger},§

* Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, Massachusetts
{ddagger} Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York
§ American Academy of Pediatrics, Center for Child Health Research, Rochester, New York

Children’s exposure to tobacco constituents during fetal development and via environmental tobacco smoke (ETS) exposure is perhaps the most ubiquitous and hazardous of children’s environmental exposures. A large literature links both prenatal maternal smoking and children’s ETS exposure to decreased lung growth and increased rates of respiratory tract infections, otitis media, and childhood asthma, with the severity of these problems increasing with increased exposure. Sudden infant death syndrome, behavioral problems, neurocognitive decrements, and increased rates of adolescent smoking also are associated with such exposures. Studies of each of these problems suggest independent effects of both pre- and postnatal exposure for each, with the respiratory risk associated with parental smoking seeming to be greatest during fetal development and the first several years of life.

Key Words: environmental tobacco smoke • children • prenatal • otitis media • asthma • SIDS

Abbreviations: ETS, environmental tobacco smoke • SIDS, sudden infant death syndrome • OM, otitis media • EPA, Environmental Protection Agency • NCI, National Cancer Institute

Received for publication Oct 7, 2003; Accepted Oct 20, 2003.




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