PEDIATRICS Vol. 44 No. 5 November 1969, pp. 757-759
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SMOKING AND CHILDREN: A PEDIATRIC VIEWPOINT

Paul F. Wehrle M.D., Robert L. Brent M.D., John L. Doyle M.D., Lee E. Farr M.D., Emmett L. Fagan M.D., Laurence Finberg M.D., Andre J. Nahmias M.D., Donald E. Pickering M.D., James N. Yamazaki M.D., and Robert J. M. Horton M.D.

The pediatrician is in an unusually favorable position to reduce the frequency of smoking among young people because of his interest in the prevention of disease and his special experience in dealing with children and teenagers. The hazards of smoking are well-known, and there seems no question but that smoking is etiologically related to carcinoma of the lung and cardiovascular disease. Other conditions, such as pulmonary fibrosis, other malignancies, and emphysema may or may not be etiologically related but do occur more commonly in smokers.

At least three aspects of the smoking problem relate directly to children and teenagers:

1. the short-term effects of smoking by teenagers and children;

2. the effect of tobacco smoke on non-smokers, be they adults or children;

3. suggestions for changes in the anti-smoking advertising campaigns so that they are geared to prevent children from adopting the smoking habit and to recruit the non-smoker into more anti-smoking activities.

There is very little information dealing with the short-term effects of smoking on children and teenagers. There is little doubt that the earlier one starts smoking the greater his chances of developing one of the late effects, but this is not our present concern. Actually, there are data that indicate that smoking teenagers have physical symptoms associated with their habit. Children who smoke have more respiratory symptoms, cough, phlegm, breathlessness, wheezing, and colds, than nonsmokers.

There are other clinical symptoms and personality traits which occur more cornnionly in smoking teenagers. These may have a coincidental relationship or simply reflect personality factors predisposing to smoking. For example, teenage boys have a higher incidence of traumatic injuries and teenage girls have a higher incidence of urinary infections than do their nonsmoking associates.