REFERENCE: Wahlgren, D. R., Hovell, M. F., Meltzer, E. O., Meltzer, S. B. (2000). Involuntary smoking and asthma. Current Opinion in Pulmonary Medicine, 6, 31-36.
Involuntary smoking is the third leading preventable cause of death, and among children causes lower respiratory infections, middle ear disease, sudden infant death syndrome, and asthma. Half the world's children may be exposed to environmental tobacco smoke (ETS), exacerbating symptoms in 20% of asthmatic children. Recent studies have reinforced previous conclusions that ETS exposure is causes onset of childhood asthma and exacerbation of symptoms throughout life. The exact mechanisms by which this is accomplished are still unclear, as are the relative contributions of prenatal versus postnatal exposure. Favorable health outcomes can be attained with reduced exposure, however. Among the few studies of ETS exposure reduction interventions, low-intensity (advice) methods have appeared ineffective, and counseling parent smokers appeared successful. Directly counseling school aged children to avoid ETS has yet to be tested. Community norms may need to shift further in favor of protecting children and others from ETS before minimal interventions can be successful. This will require combined and ongoing efforts of the medical and public health establishments, in concert with legislation mandating tobacco-free public places and ETS-related media campaigns.