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ELECTRONIC ARTICLE: Elisa K. Tong, Lucinda England, and Stanton A. Glantz Changing Conclusions on Secondhand Smoke in a Sudden Infant Death Syndrome Review Funded by the Tobacco Industry Pediatrics 2005; 115: e356-e366 [Abstract] [Full text] [PDF]

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competing interests not limited to tobacco companies

Linda J. Smith   (9 March 2005)

Second hand smoke (SHS) and child health

Ediriweera B.R., Desapriya, Ian Pike, Assistant Professor,Department of Pediatrics   (7 April 2005)

competing interests not limited to tobacco companies 9 March 2005
Linda J. Smith, lactation consultant, author Bright Future Lactation Resource Centre Ltd Send letter to journal: Re: competing interests not limited to tobacco companies lindaj{at}bflrc.com Linda J. Smith	Competing interests regarding infant sleep are not limited to tobacco companies. Documented SIDS risk factors include non-breastfeeding (formula feeding). (Mitchell et al, NZ Med J 104: 71-76, 1991). Funding from competing interests has been identified as problematic in other areas of medicine, and pediatrics is clearly not excluded. I call on researchers to document infant feeding method in all infant death investigations, and to support research funded by sources free from competing interests.
Second hand smoke (SHS) and child health 7 April 2005
Ediriweera B.R., Desapriya, Research Associate Department of Pediatrics, University of British Columbia-V6H 3V4, Ian Pike, Assistant Professor,Department of Pediatrics Send letter to journal: Re: Second hand smoke (SHS) and child health edesap{at}cw.bc.ca Ediriweera B.R., Desapriya, et al.	Environmental tobacco smoke and child health The recent study by Tong, England and Glantz (1) adds to the very substantive existing scientific evidence around the hazard posed by second -hand smoke (SHS) to child health. The public health case for widespread government action to enact restrictions against pregnant women smoking in general and children’s exposure to second-hand smoke is now extremely strong. Using National Household Survey on Drug Abuse (NHSDA) estimates of substance use during pregnancy, the approximate numbers of births in 1999 complicated by maternal use of illicit drugs, tobacco, and alcohol were 134,110; 694,220; and 544,330, respectively. (2) Thus, from the public health perspective, the impact of substance use during pregnancy extends far beyond maternal health to that of a large number of the unborn population. SHS is a real and substantial threat to child health; causing death and suffering throughout the world. (3)The vast majority of children exposed to tobacco smoke do not choose to be exposed. This involuntary and harmful exposure can be seen as a human rights violation, given the provisions of Article 6 and 24 of the 1989 United Nations Convention on the rights of the Child. (3) Preventing children’s exposure to tobacco smoke will lead to improved child, adolescent, and ultimately adult health, resulting in reduced mortality and substantial savings in long term/short term health care and other direct costs. Maternal smoking during pregnancy is a major cause of sudden infant death syndrome (SIDS) and other well-documented health effects, including reduced birth weight and decreased lung function. (1) SHS exposure among nonsmoking pregnant women can cause a decrease in birth weight and that infant exposure to SHS may contribute to the risk of SIDS. The risk of SIDS is higher amongst babies whose mothers smoke (RR= 4.7) but also amongst babies living in a house where only the father smokes (RR =1.4). (4) The published literature reports a 20% to 30% smoking rate among pregnant women. (5)Smoking during pregnancy is a significant public health problem worldwide. Strong public health and legal interventions must be adopted for the women to stop smoking before pregnancy. A major, preventable exposure remains for infants throughout the world and health care providers should redouble counseling efforts toward reducing this exposure. As Tong, England and Glantz have suggested clinicians and public health officials should intensify their efforts to promote reducing infant exposure to second hand smoking as an effective strategy for reducing SIDS. (1) Any contact with a woman in the childbearing years must be viewed as an opportunity for health promotion, health education, positive behavior reinforcement, and an opportunity to reiterate and follow up on and reinforce a smoke free message. Despite support from professional organizations and federal government groups, many pediatricians and family physicians do not routinely engage in intensive efforts to reduce children's SHS exposure. Training in techniques for reducing tobacco dependence should be included in professional education programs. (6)Effective intervention by pediatrics and family physicians in Sweden; maternal smoking during pregnancy has decreased from 24% to 10% during 1994-2004. (7) References: (1). Tong, E.K., England, L., Glantz, S.A., Changing Conclusions on Secondhand Smoke in a Sudden Infant Death Syndrome Review Funded by the Tobacco Industry, PEDIATRICS 2005:115;e356-e366 (2). Substance Abuse and Mental Health Services Administration (SAMHSA): National Household Survey on Drug Abuse (NHSDA) National Institute of Drug Abuse. 1999. (3). Desapriya, E.B.R and Nobutada I., Shimizu, S., Political economy of tobacco control policy on public health in Japan. Japanese Journal of Alcohol Studies & Drug Dependence 2003:38(1);15-33 (4). Peter B., et al; Smoking and the sudden infant death syndrome: results from 1993-5 case-control study for confidential inquiry in to stillbirths and deaths in infancy. BMJ 1996: 313; 195-198 (5). DiFranza JR, Lew RA: Effect of Maternal Cigarette Smoking on Pregnancy Complications and Sudden Infant Death Syndrome. J Family Practice 1995:40(4):385-394 (6). Klerman L., Protecting children: reducing their environmental tobacco smoke exposure. Nicotine Tobacco Res. 2004: 2; 239-253. (7). Alm B, Wennergren G, Erdes L., et al; [Parents have accepted the advice on how to prevent sudden infant death] Lakartidningen. 2004:101(14); 1268-70. (Article in Swedish)