Secondhand tobacco smoke (SHS) exposure of children and their families causes significant morbidity and mortality. In their personal and professional roles, pediatricians have many opportunities to advocate for elimination of SHS exposure of children, to counsel tobacco users to quit, and to counsel children never to start. This report discusses the harms of tobacco use and SHS exposure, the extent and costs of tobacco use and SHS exposure, and the evidence that supports counseling and other clinical interventions in the cycle of tobacco use. Recommendations for future research, policy, and clinical practice change are discussed. To improve understanding and provide support for these activities, the harms of SHS exposure are discussed, effective ways to eliminate or reduce SHS exposure are presented, and policies that support a smoke-free environment are outlined.

Secondhand tobacco smoke (SHS) is exhaled smoke, the smoke from burning tobacco, and smoke from the filter or mouthpiece end of a cigarette, pipe, or cigar. It contains many poisons, including nicotine (a pesticide), carbon monoxide, ammonia, formaldehyde, hydrogen cyanide, nitrogen oxides, phenol, sulfur dioxide, and others.1  In 1992, the US Environmental Protection Agency classified SHS as a class A known human carcinogen.2 

Tobacco use is a cycle of addiction and exposure that can begin at conception and persist throughout life.3  Most (∼80%) users of tobacco start before 18 years of age, prompted by exposure to parental and peer tobacco use, smoking in movies and media, advertising directed toward children and adolescents, and other factors.411  More than 126 million nonsmokers are exposed to SHS in the United States, and the most common site of SHS exposure is the home.1,12,13  Children, especially preschool-aged children, are more heavily exposed than adults, perhaps because they spend the most time near their parents13,14  (Fig 1). The proportion of nonsmokers with detectable levels of cotinine (the primary metabolite of nicotine in humans) in serum fell from 88% in 1988–1991 to 43% in 2001–2002, corresponding to the decline in the rate of tobacco use.14  The proportion of women who reported smoking during pregnancy has decreased by 50% over the past 15 years (from ∼20% in 198915  to ∼10% in 200416 ), although many experts question the accuracy of self-reported tobacco use because of the social undesirability of smoking during pregnancy.17  Tobacco use and smoking rates are highest among American Indian and Alaska Native individuals.18 

As with many risky health behaviors, the prevalence of tobacco use is greatest among adults who live below the poverty line and those with less than a high school education.18  Correspondingly, children who live in poverty are more likely to be exposed to SHS than others.19  In a study of serum cotinine levels in nonsmokers, black and white children had higher levels than did Hispanic children.14  Differences in metabolism of nicotine may contribute to these higher concentrations.20 

The reports of direct health effects of SHS exposure are numerous and growing in number. The most recent comprehensive reports are the 2006 US Surgeon General's report, The Health Consequences of Involuntary Exposure to Tobacco Smoke,1  and California's Proposed Identification of Environmental Tobacco Smoke as a Toxic Air Contaminant.21  The major conclusions from the Surgeon General's report relevant to children are summarized in Table 1. In addition to confirming the conclusions of the US Surgeon General, the authors of the California report found sufficient evidence to impute a causal association between SHS exposure of girls and an increased incidence of breast cancer, particularly in premenopausal women.21  Many other effects for which the supporting evidence is incomplete or less compelling have been reported (Appendix 1).

One of the significant consequences of prenatal tobacco exposure is sensitization of the fetal brain to nicotine, which results in increased likelihood of addiction when the brain is exposed to nicotine at a later age. Studies of rodents2224  and primates25  that were exposed prenatally to tobacco have demonstrated subtle brain changes that persist into adolescence and are associated with tobacco use and nicotine addiction.26,27  Population-based human studies have demonstrated associations between prenatal tobacco exposure and early tobacco experimentation28  as well as increased likelihood of tobacco use as an adolescent and adult.29,30  Other studies showed associations between parental tobacco use and increased rates of child experimentation with tobacco and smoking uptake.7,3134  Most of these studies did not control for prenatal tobacco or postnatal SHS exposure, which makes it difficult to draw conclusions about the influence of SHS exposure, because the 3 factors are linked. By definition, in households with a smoker, someone presents a role model of smoking, which may further increase the likelihood of initiation of tobacco use by preadolescents and adolescents.7,35 

The evidence supporting the association of SHS exposure of children with respiratory illnesses is strong. Increased rates of lower respiratory illness, middle-ear infections, tonsillectomy and adenoidectomy, cough, asthma and asthma exacerbations, hospitalizations, and sudden infant death syndrome have been reported.1,21  The scope of these illnesses is huge: it has been estimated that SHS exposure causes asthma symptoms in 200 000 to 1 000 000 children and contributes to as many as 8000 to 26 000 new cases of asthma per year.36  SHS exposure exacerbates many chronic diseases. Children with sickle cell disease who are exposed to SHS have a higher risk of crises that require hospitalization than do unexposed children.37 

Another effect of SHS exposure is increased school absenteeism. Analysis of data from the Third National Health and Nutrition Examination Survey showed that SHS-exposed children were twice as likely to miss 6 or more school days per year than were unexposed children (odds ratio: 2.0 [95% confidence interval: 1.4–2.8]).38  A study of California schoolchildren showed that SHS-exposed children had a similar increased risk of absence from school, with risk increasing as the number of household smokers increased (relative risk: 1.29 [95% confidence interval: 1.02–1.63]).39 

Children and the elderly represent a disproportionate share of fire victims, and smoking materials are the most common ignition source of fatal residential fires.4043  It has been estimated that smoking causes approximately 30% of US fire deaths overall, with at least 100 000 fires each year caused by children playing with ignition materials. The rate of fire deaths has decreased as smoking has decreased.44  The technology of “fire-safe” cigarettes has been available for many years, although implementation of the technology was blocked by the tobacco industry for years.45  In 2004, New York implemented a law that requires all cigarettes sold in the state to have “reduced ignition propensity.”46  Since then, many states and Canada have adopted similar laws.

The cost of buying tobacco products is considerable; a family in which 1 member smokes 1 pack per day would spend more than $1600 on cigarettes each year (average price per pack in 2007: $4.49).47  These expenditures can reduce a family's ability to meet essential needs; among low-income families, food insecurity is more likely if a family member uses tobacco.48 

There are other, hidden costs to a family that are attributable to tobacco use. A 1997 analysis of National Longitudinal Survey of Youth data showed that tobacco users' wages were reduced by 4% to 8%, even after controlling for differences in education and other characteristics. The authors hypothesized that these differences were attributable to a combination of discrimination against tobacco users, increased absenteeism, poor health, and self-selection of jobs that include employer-provided health insurance at the expense of lower wages.49  An additional effect may be decreased ability of SHS-exposed adults to care for children, because SHS exposure causes premature death and disease in nonsmokers, including coronary heart disease and lung cancer.1 

Estimates of the high medical costs of children's exposure to SHS and tobacco use in general have been made, several of which are summarized in Table 2. The health care cost of tobacco use, in both dollars and disease, is tremendous and is estimated to be more than $260 million each day in the United States.50  Smoking by parents alone contributed estimated direct medical expenditures of $4.6 billion and loss-of-life costs of $8.2 billion in 1993.51,52  A study that used National Medical Expenditure Survey data showed that health care costs for respiratory illnesses alone were increased by $120 per year for children 5 years or younger and by $175 per year for children 2 years or younger who were exposed to SHS by maternal smoking (1995 dollars).52  Tobacco users are more likely to be absent from work, to be disabled, and to die prematurely. The corresponding loss of productivity was estimated to be $92 billion for the period 1997–2001.53 

Although household smoking bans reduce children's SHS exposure, even a strict ban does not eliminate exposure.52,54  SHS can enter the home in the air, on dust, in or on clothing, or via the smoker's exhaled breath.55  Nearly 90% of households of nonsmokers have an indoor smoking ban; households that include smokers have a much lower rate of smoking bans.5658  Individuals who consider SHS exposure to be harmful are most likely to report having an indoor home smoking ban.57,5962  Fewer parents ban smoking in the car than in the home,56,59,61,63  although recent state legislative efforts to outlaw smoking in a car carrying a child may increase the rate of car bans.

There is strong evidence that adult tobacco users can successfully quit and that counseling and pharmacotherapies help them succeed. Each year, 4% to 9% of tobacco users quit without support64 ; tobacco users who receive counseling and use pharmacotherapies significantly increase their likelihood of quitting.65 

The 2008 update of the US Public Health Service clinical practice guideline, Treating Tobacco Use and Dependence,65  provides guidelines for clinical practice and presents meta-analyses of approximately 8700 scientific articles on cessation of tobacco use. The review covers assessment of tobacco use; brief, intensive clinical interventions; systems interventions; pharmacotherapies; special populations such as pregnant women, children, and teenagers; and other topics such as weight gain and cost-effectiveness.

The US Public Health Service guideline recommends that all clinicians strongly advise patients who use tobacco to quit and states: “Clinicians in a pediatric setting should offer smoking cessation advice and interventions to parents that limit children's exposure to second-hand smoke.”65  Few studies have evaluated ways to protect children from SHS exposures through promotion of smoking bans or tobacco-cessation interventions delivered to family members through pediatric practices. Interventions that have been successful in decreasing the SHS exposure of children generally provide intensive, home-based counseling66,67 ; these interventions have not been translated effectively from academic to community settings.68,69  In a randomized trial of practice-based counseling and reminders to promote tobacco cessation by mothers, Groner et al70  reported no significant effect of the intervention on cessation, although mothers in the intervention group reported smoking outside more often than did mothers in the control group. A Cochrane collaboration review of programs to reduce exposure of children to SHS concluded that “brief counseling interventions, successful in the adult health setting when coming from physicians, cannot be extrapolated to adults in the setting of child health.”71 

Despite the paucity of evidence supporting the effectiveness of counseling delivered in the pediatric setting, the arguments for asking about tobacco use and SHS exposure, advising all families to make their home and cars smoke free, counseling users to quit, and referring users to cessation programs are compelling. The pediatric visit provides many opportunities to deliver tobacco use-cessation counseling to parents. Because parents of younger children are themselves typically young and healthy, many see their child's pediatrician more often than they see their own primary care clinician. Pediatric visits offer many “teachable moments”72  to discuss tobacco use, from both the prevention and cessation perspectives, and parents may be motivated to change their behavior for the benefit of their child's health. Another important counseling opportunity is the new parent who quit using tobacco during pregnancy: 48% to 70% of mothers who quit smoking during pregnancy relapse after delivery.7376 

Because it is an accepted role of the pediatrician to counsel parents in behavior changes that will improve the life and health of their child, including changes in sensitive areas such as diet and discipline, one might expect that counseling parents to make their homes and cars smoke free or to quit using tobacco would be included routinely in the pediatric visit. However, many opportunities to counsel parents are missed. Tanski et al77  reported that during the period 1997–1999, only 1.5% of ambulatory care visits, 4.1% of well-child visits, 4.4% of acute illness visits for asthma, and 0.3% of acute illness visits for otitis media included delivery of tobacco counseling. One possible reason for these low rates of counseling may be concerns about alienation of the parent.78,79  However, many parents who smoke welcome advice to quit; in a sample of Vermont parents who smoked, 52% said they would welcome a pediatrician's advice to quit using.80  Other studies of parents have concurred.8083 

Other challenges to counseling parents in the pediatric setting are writing prescriptions for cessation medications and the lack of a charting system for parents. Prescription of medications used to support cessation attempts by their child's pediatrician is accepted by parents; in a 2003 telephone survey of parents who smoked, 85% of respondents reported that it was acceptable for their child's doctor to prescribe a smoking-cessation medication for them.84  Only 8% had received such a prescription; in a different survey of pediatricians,78  only 13% said they would prescribe or recommend nicotine-replacement therapy (NRT) to parents who smoke and have children 5 years or younger.

Although writing prescriptions for people who are not patients raises concerns about propriety, malpractice, and ethics, writing prescriptions for family members of a patient has precedent. For instance, prophylactic therapy or immunization for household members of a person exposed to invasive Haemophilus influenzae type b disease, hepatitis A, meningococcal disease, head lice, pertussis, plague, scabies, or varicella is recommended by the AAP Committee on Infectious Diseases.85  Many of the antibiotic agents used for these treatments are associated with significant adverse effects and a prescription is required, whereas several NRT products are available without a prescription. However, the need for good record-keeping persists, and some clinicians may decide to set up a separate chart for their patients' household members.

Practices may adopt strategies to encourage parents to seek care from their own clinicians or seek help from other cessation resources, including local or state health departments. A key aspect of this counseling is to convey the importance of seeking help and the benefits of cessation programs that fit the needs of the parent, including both appropriate counseling and pharmacotherapy.

Other concerns include lack of time and reimbursement for services. As of 2006, 76.5% of states (including the District of Columbia) provided Medicaid coverage for some component of tobacco use treatment,86  and of those, only 1 (New Mexico) offered coverage for all of the treatments recommended in the US Public Health Service guideline.65  Coverage provided by private insurance plans varies widely, and few plans cover over-the-counter NRTs or individual face-to-face counseling.87  The lack of coverage for tobacco-dependence treatments that have been shown to be both efficacious and cost-effective is an important issue in healthy policy.

To further develop the evidence supporting the benefits of tobacco-dependence treatment in the pediatric setting, coding for diagnosis and treatment is important. Two codes may be particularly useful88 :

  • 989.84 (toxic effects of tobacco); and

  • V15.89 (other specified personal history presenting hazards to health [list SHS exposure as the hazard]).

Similarly, naming SHS as a factor in insurance claims, death certificates, and other documents can aid in assessing the effects of SHS exposure on health and the need for reimbursement for treatment of SHS exposure.

There is strong evidence that adult tobacco users can successfully quit and that counseling and pharmacotherapy help them succeed.65  Each attempt to quit increases the likelihood of success. Without counseling, 4% to 9% of tobacco users quit each year64 ; with counseling and pharmacotherapies, 17% to 44% of attempts are successful.89 

In adult medical care settings, simply asking about tobacco use and SHS exposure and recommending that users quit has been shown to increase the number of quit attempts and the success rates of those attempts.65  Counseling does not need to be extensive and is additive, resulting in an increase in quit attempts, and the success rates of quit attempts as the amount of counseling delivered increases even if the counseling is delivered over the course of several visits.

Tailoring the message to the needs of the individual increases the likelihood of success. Although tobacco-cessation counseling is equally effective with women as with men, women may more often have concerns about weight gain or be using nicotine to alleviate depression. Studies of counseling tailored to women have suggested that addressing these gender-specific issues may increase success.65  Counseling of pregnant women has been also shown to be effective; the US Public Health Service guideline65  recommends more intensive counseling, particularly person-to-person psychosocial interventions that exceed the minimal advice to quit. Counseling techniques and resources tailored to pregnant women are available (www.ahrq.gov/path/tobacco.htm#Pregnant).

The most successful counseling and behavioral therapies to promote cessation include problem-solving/skills training and social supports. Most structured counseling is based on the “stages-of-change” theory, which explains how individuals change personal behaviors.90  When used in the context of tobacco-use cessation, the goal is to help a user progress through 6 stages in a stepwise manner (Table 3). Specific counseling methods, such as motivational interviewing, may help identify and overcome barriers to cessation. Motivational interviewing is a client-centered, directive counseling method to enhance readiness for change by helping clients explore and resolve ambivalence toward change91  (Table 4). Both stages-of-change theory and motivational interviewing techniques can be used to understand and address health behaviors other than tobacco use.

The process of effective tobacco-use cessation counseling can be broken into 5 steps, called the 5 A's: ask, advise, assess, assist, and arrange follow-up (Table 5). 65  Identifying the benefits to the child of parental smoking cessation may be an important motivation to parents. Not every parent will be ready to consider quitting. Using the 5 R's (Table 6) to help overcome barriers to cessation can provide a framework for counseling.65 

Correctly used pharmacotherapy significantly increases the odds of success.65  NRT products are available without prescription in patch, gum, and lozenge forms. NRT nasal spray and inhalers require prescriptions. Most NRT products are priced comparably to the cost of smoking a pack of cigarettes each day. Because these products are not available as single units, this cost can be prohibitive for many patients (ie, $50 or more for 1 package). NRTs are relatively easy to use, and some forms can provide rapid relief for difficult moments. However, NRT products have not been as successful in improving long-term cessation rates during pregnancy92  or when used by adolescents93  as they have been in the general population. Bupropion and varenicline are available only by prescription; both reduce the number and severity of urges to smoke, with results for varenicline somewhat better than for bupropion.94  Clinicians should be familiar with NRTs and other pharmacotherapies used to treat tobacco dependence and promote their use for adolescent and young adult patients and parents. The American Academy of Family Physicians has an excellent guide (see “Prescribing Guidelines” at www.aafp.org/online/en/home/clinical/publichealth/tobacco/nrt.html for quick access to information on dosing, precautions, and adverse effects of tobacco-cessation medications that have been approved by the US Food and Drug Administration).

Many users make multiple attempts to quit before succeeding, and although most relapses occur early in the quitting process, some occur months or even years later.65  Because of the chronic relapsing nature of tobacco dependence, pediatricians should continue to deliver the “stay-quit” message whenever possible. Relapse-prevention counseling is especially important right after the quit date and can be delivered during scheduled office visits, during telephone calls, on postcards, or by using other methods.65 

If a “lapse” occurs, discuss the cues that promoted the lapse and what the parent learned about cues and quitting. It is important to remind the parent that the urge to smoke lasts only a few minutes, so distraction techniques can be helpful during “craving attacks.”65  Other topics to address include the parent's success to date and anticipatory guidance regarding weight gain, cravings, environmental cues, and other tobacco users in the household or family.

A variety of resources are available to clinicians to guide care. The US Public Health Service clinical practice guideline65  presents information on how to assess tobacco use; brief and intensive clinical interventions; systems interventions; pharmacotherapy; special populations such as pregnant women, children, and teenagers; and special topics such as weight gain and cost-effectiveness. The national Quit Line, 1-800-QUIT NOW, provides evidence-based, effective telephone counseling and is available throughout the United States. In many states, “fax-back” forms can be used to refer a tobacco user to the Quit Line directly, rather than instructing the patient or parent to call the Quit Line. The use of fax-back referrals has been shown to significantly increase the number of tobacco users who use the Quit Line.95  The American Cancer Society, the American Lung Association, and many hospitals provide group counseling and other cessation resources. Appendix 2 describes many resources for clinicians and tobacco users.

Tobacco-use counseling, NRT products, and other tobacco-addiction treatments have been shown to be both cost-effective and efficacious when used in the internal medicine or family practice setting to treat adult smokers.65,76,96,97  The benefits of insurance coverage of cessation interventions, whether intensive or minimal, accrue to both insurers and employers.98  Brief physician-delivered smoking-cessation counseling is more cost-effective than many other widely recommended screening tests and interventions.99 

Tobacco is a product that, when used as intended, causes significant morbidity and mortality. Accepting funds from the tobacco industry for support of activities, regardless of whether it is related to tobacco control, is contradictory to the mission of health promotion for children and their families.

The tobacco industry has demonstrated their intent to manipulate public opinion,100  scientific research,101107  regulation,108  and education109111  to promote tobacco products throughout the world. Furthermore, by funding prestigious researchers at respected institutions, the tobacco industry gains credibility. Many articles demonstrating the intent of the tobacco industry to promote smoking and tobacco use, as demonstrated by documents internal to the industry, have been published. The American Legacy Foundation maintains the Legacy Tobacco Documents Library at the University of California, San Francisco (http://legacy.library.ucsf.edu); much of the literature on the tobacco industry is based on the documents in the library. One additional example of the influence of the tobacco industry on the practice of medicine is a successful effort to invalidate and remove the ICD (International Classification of Diseases) e-code for SHS exposure on Medicare billing form 1500. The code became available in 1994 and remained invalid until at least 2004. This apparently minor step has had a significant effect on our understanding of SHS exposure.112 

A growing number of communities and states have implemented statewide bans on smoking in public places.§ Bans on smoking at workplaces, restaurants, child care settings, public parks, and beaches and in other public venues have been extremely successful in decreasing and, in some cases, eliminating SHS exposure.113  Other positive effects of bans are increases in quitting attempts and successes,96,114117  increased prevalence of smoke-free homes and cars in the surrounding community,61,118,119  improved air quality and health outcomes for employees120122  and children,123  and decreased social acceptability of tobacco use.58,124,125  Studies of restaurants and bars that compared income before and after a ban have shown no adverse effect on the economics of the hospitality industry.126  Enforcement of smoke-free policies in public space typically is not an issue after a break-in period.1 

Mass-media campaigns and comprehensive community interventions contribute to the overall social unacceptability of SHS exposure of children.113,127,128 

Other areas of public policy in which tobacco use should be addressed include housing, child care settings, and foster care. Several groups are leading efforts to make multiunit housing smoke free, and many cooperative apartment buildings and condominiums already have done so. Appendix 3 lists several resources on this issue. Most states regulate smoking in child care settings, although many allow smoking on the premises when children are not present, resulting in exposure of children to “thirdhand” smoke. The National Resource Center for Health and Safety in Child Care and Early Education provides a list of state regulations applicable to child care settings (http://nrc.uchsc.edu/STATES/states.htm). Exposure of foster children to SHS has been prohibited by several states and counties.129  The National Voice of Foster Parents, an organization of and for foster parents, supports legislation and rules that prohibit the use of tobacco in foster homes and vehicles used to transport foster children.130  It is important to provide treatment for tobacco dependence when implementing and enforcing these restrictions.

Although there have been many successes in efforts to reduce the prevalence and harms of smoking, the pediatric community lags behind the internal medicine, family medicine, and obstetric/gynecology communities in tobacco-control and education efforts.131133  Using provider education and having providers implement self-reminder systems to ensure that tobacco cessation is raised during the clinical examination has been shown to be effective, especially when used as part of a multicomponent clinical program.65  Training in best practices in smoking-cessation counseling is not required in medical schools, pediatric clerkships, or pediatric residency programs, with the sole exception of such training listed in the program requirements for residency and fellowship education in adolescent medicine.134,135  This absence of educational requirements in these key training periods is critical, because clinical practices may become established during training and difficult to change after completion of training.131133  All clinicians should be skilled in counseling to prevent tobacco use and SHS exposure and for tobacco-use cessation.

There are significant gaps in the body of evidence related to pediatric tobacco control. Study of prevention approaches and interventions to limit SHS exposures in primary care settings are particularly needed. Other areas that require further study include pharmacologic effects of nicotine; use and efficacy of NRT products and other pharmacotherapy used to treat nicotine addiction of children, pregnant women, and families; effects of SHS exposure of children; and the effect of indoor air-quality laws and price/tax controls.

SHS exposure of children and their families causes significant morbidity and mortality. Pediatricians have many opportunities to advocate for elimination of SHS exposure of children in their personal and professional roles.

Helen J. Binns, MD, MPH, Chairperson

Joel A. Forman, MD

Catherine J. Karr, MD, PhD

Jerome A. Paulson, MD

Kevin C. Osterhoudt, MD, MSCE

James R. Roberts, MD, MPH

Megan T. Sandel, MD

James M. Seltzer, MD

Robert O. Wright, MD, MPH

Elizabeth Blackburn, RN

US Environmental Protection Agency

Mark Anderson, MD

Centers for Disease Control and Prevention/National Center for Environmental Health

Sharon Savage, MD

National Cancer Institute

Walter J. Rogan, MD

National Institute of Environmental Health Sciences

Dana Best, MD, MPH

Paul Spire

Janet F. Williams, MD, Chairperson

Marylou Behnke, MD

Patricia K. Kokotailo, MD, MPH

Sharon J. Levy, MD

Tammy H. Sims, MD, MS

Martha J. Wunsch, MD

Deborah Simkin, MD

American Academy of Child and Adolescent Psychiatry

Karen S. Smith

Margaret J. Blythe, MD, Chairperson

Michelle S. Barratt, MD, MPH

Paula K. Braverman, MD

Pamela J. Murray, MD, MPH

David S. Rosen, MD, MPH

Warren M. Seigel, MD

Charles J. Wibbelsman, MD

Lesley L. Breech, MD

American College of Obstetricians and Gynecologists

Jorge L. Pinzon, MD

Canadian Paediatric Society

Benjamin Shain, MD, PhD

American Academy of Child and Adolescent Psychiatry

Karen S. Smith

Kelly R. Moore, MD, Chairperson

Joseph T. Bell, MD

Ruth A. Etzel, MD, PhD

Benjamin D. Hoffman, MD

Stephen W. Ponder, MD

Mark M. Redding, MD

Debra Waldron, MD, MPH

Kansas L. Dubray, MD

Association of American Indian Physicians

Kirsten J. Lund, MD

American College of Obstetricians and Gynecologists

Kent Saylor, MD

Canadian Paediatric Society

Michael G. Storck, MD

American Academy of Child and Adolescent Psychiatry

Stephen A. Holve, MD

Capt Judith K. Thierry, DO

Sunnah Kim, MS, RN

Note that these studies have not been critically evaluated. The reader is advised to perform his or her own evaluation before drawing conclusions. See www.aap.org/richmondcenter/AAP_Tobacco_Policy.html for updates.

Increased risk of:

  • Growth abnormalities, including

    • low birth weight115  and amplification of risk of low birth weight in fetus' with cystic fibrosis16  and

    • intrauterine growth retardation/small for gestational age1,5,12,17 

  • Delivery complications, including

    • premature rupture of membranes,17 

    • placenta previa and abruption,1720 

    • preterm delivery, stillbirth, spontaneous abortion,1,3,5,11,15,1722  and

    • admission to NICUs3 

  • Orofacial clefts2331  (recent studies have been less supportive, although Honein et al32  found fairly strong evidence for specific types of clefts)

  • Septal and right-sided obstructive cardiac defects33 

  • Increased systolic blood pressure at 2 months of age34 

Increased risk of:

  • Decreased birth weight,3539 

  • Fetal mortality,36,40  and

  • Preterm delivery36  and spontaneous abortion40 

Increased risk of:

  • Nicotine-withdrawal symptoms during the neonatal period41 

  • Infant death

  • Persistent pulmonary hypertension of the newborn46 

  • Poor sleep47 

  • Infection, including neonatal infection18,48 

  • Hypoparathyroidism49 

  • Respiratory effects, including

    • reduced lung function in infants and children,5053 

    • lower respiratory tract illnesses (such as pneumonia and bronchiolitis),54 

    • increased diagnosis of asthma55  and use of bronchodilating drugs,47  and

    • otitis media56,57 

  • Poor growth58 

  • Behavioral and neurocognitive effects, including

    • abnormal neonatal neurobehavior, developmental delay, attention- deficit/hyperactivity disorder, con- duct disorder and other aggressive behaviors,5961  and psychiatric disorders,6287  and

    • speech-processing ability88 

  • Febrile seizures89 

  • Experimentation with tobacco and addiction to tobacco as an older child or adult76,9092 

  • Gastrointestinal disease, including

    • colic,9396 

    • pyloric stenosis,97  and

    • diabetes98 

  • Legg-Calvé-Perthes disease99 

  • Some cancers100103 

  • Development of allergies104,105 

  • Hospitalization for any illness106113 

  • Office visits for any illness106110 

  • Hyperopia114 

  • Significant reductions in cortical gray matter and total parenchymal volumes and head circumference115 

  • Altered development of white matter microstructure116 

  • Craniosynostosis117  (rather weak evidence)

Increased risk of:

  • Reduced cognitive development118 

  • Conduct disorder59 

Increased risk of:

  • Decreased initiation and duration of breastfeeding119125 

  • Decreased iodine levels in human milk126 

Increased risk of:

  • Allergic sensitization111,127152 

  • Poor sleep, in breastfed infants153 

  • Lower respiratory disease, including

    • persistent decreased lung function,106109,137,139,149,154  amplified in children with cystic fibrosis,16 

    • infections,137,139,151,154157 

    • bronchiolitis,158  wheezing,47  and use of bronchodilating drugs,47 

    • asthma prevalence,159  and

    • frequency and severity of asthma exacerbations

  • Upper respiratory infections, including

    • otitis media,

    • cough106,110,111,189,190  and use of cough medicines,47 

    • rhinitis47  and nasal obstruction,192 

    • tonsillectomy, adenoidectomy, and placement of pressure-equalizing tubes,168,179,180,193,194  and

    • respiratory complications associated with anesthesia195199 

  • Infections, including

    • invasive meningitis,200,201 

    • infection with Mycobacterium tuberculosis in children who live in a household with a patient with tuberculosis,202  and

    • infection with Helicobacter pylori203,204 

  • Hospitalization for

  • Gastrointestinal disease, including

  • Increased complications of type 1 diabetes mellitus212  (study was small, included active smokers)

  • Behavioral and neurocognitive effects69,70,8587,213,214 

  • Dental disease215,216 

  • School absences106,110,112,139,217,218 

  • Molecular, genetic, and cellular changes219222 

  • Experimentation with tobacco and addiction to tobacco as an older child or adult110,223226 

  • Injury and death attributable to fires110,227231 

  • Hyperopia114 

Increased risk of:

  • Asthma232 

  • Elevated cholesterol levels in young adults233 

  • Hypertension234 

  • Younger age at menopause235  (suggestive)

Increased risk of:

  • Altered lipid profiles and endothelium effects in adolescents and young adults236238 

  • Asthma232,239 

  • Chronic dry cough and phlegm240 

  • Lung cancer, leukemia, and lymphoma, as an adult220,221,241,242 

  • Increased risk of spontaneous abortion in women exposed as children to SHS by both parents243,244 

1-800-QUIT-NOW

  • http://1800quitnow.cancer.gov: 1-800-QUIT-NOW is the toll-free national telephone counseling service to help people stop smoking or quit other forms of tobacco use.

Addressing Tobacco in Healthcare

  • www.atmc.wisc.edu: The Addressing Tobacco in Healthcare Research Network, supported by the Robert Wood Johnson Foundation, connects researchers, health care providers, and other partners interested in developing and implementing changes to health care systems that will improve the delivery of evidence-based tobacco-dependence treatment.

Agency for Healthcare Research and Quality

  • www.ahrq.gov

  • www.ahrq.gov/clinic/tobacco/tobaqrg.pdf—clinical practice guideline Treating Tobacco Use and Dependence: This Public Health Service guideline contains strategies and recommendations designed to assist clinicians, tobacco-dependence treatment specialists, and health care administrators, insurers, and purchasers in delivering and supporting effective treatments for tobacco use and dependence.

  • www.ahrq.gov/clinic/tobacco/tobaqrg.htmTreating Tobacco Use and Dependence, quick reference guide for clinicians: This is a quick how-to guide to assist clinicians in implementing the clinical practice guidelines.

  • www.ahrq.gov/clinic/tobacco/clinhlpsmksqt.htm—Helping Smokers Quit: A Guide for Clinicians: This guide gives clinicians easy access to information to help their patients quit smoking. The tool is based on the 5 A's approach to cessation intervention (ask, advise, assess, assist, and arrange) and offers other helpful resources.

Alliance for the Prevention and Treatment of Nicotine Addiction

  • www.aptna.org: The mission of the Alliance for the Prevention and Treatment of Nicotine Addiction is to work toward reduction in tobacco-caused morbidity and mortality by providing services that promote effective treatment and prevention of nicotine addiction. Services are targeted to health care providers, clinicians, administrators, organizations, and educational institutions to promote policies that lead to an increase in implementing effective smoking-cessation strategies among high-risk tobacco users.

American Academy of Allergy Asthma & Immunology

  • www.aaaai.org: The American Academy of Allergy Asthma & Immunology is the largest professional medical specialty organization in the United States, representing allergists, asthma specialists, clinical immunologists, allied health professionals, and others with a special interest in the research and treatment of allergic disease.

American Academy of Family Physicians

American Academy of Pediatrics

American Cancer Society

  • www.cancer.org: The American Cancer Society is the nationwide community-based voluntary health organization dedicated to eliminating cancer as a major health problem.

American College of Obstetricians and Gynecologists

American Legacy Foundation

  • www.americanlegacy.org: The American Legacy Foundation concentrates on tobacco prevention and cessation, because smoking is the largest preventable cause of death in America. Its programs are working to engage all Americans in the dialogue about tobacco and to foster an understanding about its harmful effects.

American Lung Association

  • www.lungusa.org: Founded in 1904 to fight tuberculosis, the American Lung Association fights lung disease in all its forms, with special emphasis on asthma, tobacco control, and environmental health.

Ask and Act

Centers for Disease Control and Prevention

  • www.cdc.gov

  • www.cdc.gov/tobacco—Office on Smoking and Health: The Office on Smoking and Health offers information on all aspects of tobacco control and prevention.

  • www.cdc.gov/tobacco/quit_smoking/cessation/practical_guide—A Practical Guide to Working with Health-Care Systems on Tobacco-Use Treatment: This guide was designed to increase public health professionals' comfort with and skill in establishing collaborative relationships with leaders of health care systems and to facilitate the creation of long-term partnerships that promote effective system-wide tobacco-use treatment.

  • www.cdc.gov/tobacco/media_communications/countermarketing/mcrc/index.htm—Media Campaign Resource Center for Tobacco Prevention and Control: The Media Campaign Resource Center provides access to effective media campaign materials for tobacco-use prevention.

The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General

The Health Consequences of Smoking: A Report of the Surgeon General

Motivational Interviewing

  • www.motivationalinterview.org: Moti- vational interviewing is a client-centered, directive method for enhancing intrinsic motivation to change by exploring and resolving ambivalence. This Web site is intended to provide resources for those seeking information on motivational interviewing. It includes general information about the approach as well as links, training resources, and information on reprints and recent research.

National Tobacco Technical Assistance Consortium

  • www.ttac.org: The National Tobacco Technical Assistance Consortium: is dedicated to assisting organizations in building and developing highly effective tobacco-control programs.

Professional Assisted Cessation Therapy

  • www.endsmoking.org: Professional Assisted Cessation Therapy is an independent consortium of leaders in the treatment of tobacco dependence whose mission is to lower barriers to broader use of cessation therapy through education and advocacy.

Smoke Free Homes

  • www.kidslivesmokefree.org: Smoke Free Homes’ mission is to reduce secondhand smoke exposure of children by increasing the awareness and understanding of the health benefits of creating smoke-free environments for children among members of the pediatric community.

Smokefree.gov

  • www.smokefree.gov: This National Institutes of Health Web site was developed by using evidenced-based research. The site features “LiveHelp,” which connects smokers with a cessation counselor via instant messaging, and an interactive Web-based cessation guide based on the National Cancers Institute's “Clearing the Air” booklet.

US Environmental Protection Agency Smoke-Free Homes

  • www.epa.gov/smokefree: This site offers a wealth of information on the health effects of SHS on children and helps families establish a smoke-free home.

Smoking Cessation: Effective Intervention Strategies

  • http://nosmoking.msm.edu: This course is a collaborative effort of the Morehouse School of Medicine and the Mercer School of Medicine. It is intended primarily for medical students, who can register to receive academic curriculum credit.

Prevention and Cessation Education for Medical Students

  • www.teachtobacco.org: Prevention and Cessation Education for Medical Students (PACE) is a consortium of 12 US medical schools funded by the National Cancer Institute to assess and improve tobacco teaching. PACE aims to successfully incorporate tobacco education modules into a number of US medical schools to ensure that graduating students at these schools will be able to skillfully perform tobacco use-prevention and -cessation counseling for children, adolescents, and adults.

Helping People Quit Smoking: Nursing Best Practice Guidelines

  • www.rnao.org/smokingcessation: This training Web site developed by the Registered Nurses Association of Ontario comprises a minicourse and 4 modules focusing on how nurses can provide brief interventions for smoking cessation.

Tobacco-Free Nurses

Mom's Quit Connection

  • www.snjpc.org/mqc: Mom's Quit Connection is a free program of the Southern New Jersey Perinatal Cooperative that provides cessation counseling to pregnant and parenting women and teenagers who want to stop smoking. Perinatal smoking-cessation community and professional education programs are offered to health care providers, schools, and service agencies, including a practice-based, on-site American College of Obstetricians and Gynecologists 5 A's brief intervention training for clinicians.

The National Partnership for Smoke-Free Families

  • www.helppregnantsmokersquit.org: Smoke-Free Families is a national program supported by the Robert Wood Johnson Foundation working to discover the best ways to help pregnant smokers quit before, during, and after pregnancy. This Web site provides information about effective, evidence-based smoking-cessation treatments to care professionals and consumers.

CEASE: Clinical Effort Against SHS Exposure

Clean Air for Healthy Children & Families

  • www.cleanairforhealthychildren.org: The Clean Air for Healthy Children & Families program is a smoking-cessation counseling training program primarily targeted to health care professionals who care for pregnant women, mothers, and caregivers of young children and teenagers.

Mayo Clinic Nicotine Dependence Center

  • www.mayoclinic.org/ndc-rst: The Nicotine Dependence Center offers educational activities to health care professionals who are interested in incorporating nicotine-dependence treatment into their practice and/or developing a service to meet the needs of tobacco-dependent patients.

Quitters Win, No Ifs, Ands or Butts

  • www.mdhelpquit.org: This Web-based continuing education activity examines smoking cessation in primary care, with the goal of affecting physicians' clinical practices regarding smoking-cessation counseling and use of valuable resources such as “quitlines.”

Rx for Change

  • http://rxforchange.ucsf.edu: Rx for Change: Clinician-Assisted Tobacco Cessation is a comprehensive, turn-key, tobacco use-cessation training program that equips health professional students and licensed clinicians with state-of-the-art knowledge and skills for assisting patients with quitting.

Smoking Cessation in the Pediatric Office

  • www-cme.erep.uab.edu/scpo/index.html: Sponsored by the University of Alabama, among others, this program assists pediatric health care providers in determining the smoking status of the parents of pediatric patients and influencing those who smoke to quit.

TobaccoCME.com

  • www.tobaccocme.com: TobaccoCME. com is a Web-based program that provides training in tobacco treatment that prepares physicians to provide clinical tobacco interventions for prevention and cessation.

Treating Tobacco Use and Dependence

  • www.medscape.com/viewprogram/3607: A continuing medical education credit course for physicians, nurses, and pharmacists developed by the University of Wisconsin Center for Tobacco Research and Intervention and offered through Medscape.

University of Massachusetts Center for Tobacco Prevention and Control Tobacco Treatment Specialist: Training and Certification Program

University of Medicine and Dentistry of New Jersey School of Public Health's Tobacco Dependence Program

  • www.tobaccoprogram.org: The Tobacco Dependence Program has developed certified trainings to prepare professionals to provide intensive specialist treatment for tobacco dependence.

Helping Young Smokers Quit

  • www.helpingyoungsmokersquit.org: The Helping Young Smokers Quit initiative works to fill a gap in knowledge about the numbers and distribution of youth cessation programs, as well as the types of treatment approaches and program components that are currently offered across the United States.

Youth Tobacco Cessation Collaborative

  • www.youthtobaccocessation.org: The Youth Tobacco Cessation Collaborative was created to address the gaps in knowledge about what cessation strategies are most effective in assisting youth to quit smoking.

1-800-QUIT-NOW

  • http://1800quitnow.cancer.gov: 1-800- QUIT-NOW is the toll-free national telephone counseling service to help people stop smoking or quit other forms of tobacco use. Spanish-speaking counselors are available.

Become an EX

  • www.becomeanex.org: This free quit plan sponsored by the American Legacy Foundation uses a systematic program to help prepare a customized quitting plan for each person.

Freedom From Smoking Online

  • www.ffsonline.org: This online smoking-cessation program sponsored by the American Lung Association is an interactive course designed to educate and modify the behavior patterns of a smoker. Freedom From Smoking Online can be accessed day or night, 7 days per week, on any schedule the smoker chooses. It is ready whenever a smoker wants to start the process of quitting and is free of charge (registration is required).

Nicotine Anonymous

  • www.nicotine-anonymous.org: Nicotine Anonymous welcomes all those seeking freedom from nicotine addiction, including those using cessation programs and nicotine-withdrawal aids. The organization offers group support and recovery using the “12 steps,” as adapted from Alcoholics Anonymous, to achieve abstinence from nicotine.

QuitNet

  • www.quitnet.com: This Web site includes a quitting guide, a national directory, pharmaceutical product overview, and Web resource directory with links to other online resources, programs, and self-help materials. Registered users can access customized advice, peer support, quitting tools and tips, and referrals to counselors.

Smokefree.gov

  • www.smokefree.gov: This National Institutes of Health Web site was developed by using evidence-based research. The site features “LiveHelp,” which connects smokers with a cessation counselor via instant messaging, and an interactive Web-based cessation guide based on the National Cancer Institute's “Clearing the Air” booklet.

California EPA Office of Environmental Health Hazard Assessment

  • www.oehha.ca.gov: This office's overall mission is to protect and enhance public health and the environment by scientific evaluation of risks posed by hazardous substances.

US Environmental Protection Agency Smoke-Free Homes

  • www.epa.gov/smokefree: This site offers a wealth of information on the health effects of SHS on children and helps families establish a smoke-free home. Materials are available in Spanish.

Addressing Tobacco in Health Care

  • www.atmc.wisc.edu: The Addressing Tobacco in Healthcare Network, supported by the Robert Wood Johnson Foundation, connects researchers, health care providers, and other partners interested in developing and implementing changes to health care systems that will improve the delivery of evidence-based tobacco-dependence treatment.

Allergy & Asthma Network Mothers of Asthmatics

  • www.aanma.org: AANMA is a national nonprofit network of families whose desire is to overcome, not cope with, allergies and asthma.

American Legacy Foundation

  • www.americanlegacy.org: The American Legacy Foundation was established in March 1999 as a result of the Master Settlement Agreement between a coalition of attorneys general in 46 states and 5 US territories and the tobacco industry. The foundation is dedicated to promoting tobacco-free generations.

Americans for Nonsmokers' Rights

  • www.no-smoke.org: Americans for Nonsmokers' Rights is the leading national lobbying organization dedicated to nonsmokers' rights, taking on the tobacco industry at all levels of government to protect nonsmokers from SHS and youth from tobacco addiction.

Campaign for Tobacco-Free Kids

  • http://tobaccofreekids.org: The campaign is dedicated to protecting children from tobacco addiction by raising awareness of its use.

Global Tobacco Research Network

  • http://tobaccoresearch.net: The Global Tobacco Research Network's mission is to enhance research by promoting collaboration and partnerships, providing information, facilitating training, and sharing research tools with the goal of reducing the burden of disease and death caused by tobacco.

Institute for Global Tobacco Control

  • www.jhsph.edu/global_tobacco: Established in 1998 in the Department of Epidemiology at the Johns Hopkins Bloomberg School of Public Health, the Institute for Global Tobacco Control works to prevent death and disease from tobacco use through research, education, and policy development.

National Action Plan for Tobacco Cessation

  • www.ctri.wisc.edu/Researchers/NatActionPlan%2002–04.pdf: This report, prepared by the Interagency Committee on Smoking and Health's Subcommittee on Cessation, outlines a series of feasible, science-based action steps to promote smoking cessation, reduce smoking prevalence, and prevent millions from starting to smoke.

National African American Tobacco Education Network

  • www.naaten.org: The National African American Tobacco Education Network is a collaborative of national African American stakeholders that have an interest in establishing or augmenting tobacco prevention and control activities within their organizations as well as the African American community.

National African American Tobacco Prevention Network

  • www.naatpn.org: The National African American Tobacco Prevention Network is a national organization dedicated to facilitating the development and implementation of comprehensive and community-competent tobacco-control programs to benefit communities and people of African descent.

National Latino Council on Alcohol and Tobacco Prevention

  • www.nlcatp.org: The National Latino Council on Alcohol and Tobacco Prevention is the only Latino national organization dedicated solely to reducing the harm caused by alcohol and tobacco in the Latino community through research, advocacy, policy analysis, community education, training, and information dissemination.

North American Quitline Consortium

  • www.naquitline.org: The North American Quitline Consortium seeks to unite quitline professionals in the United States and Canada to enable them to work together to increase access to and the effectiveness of quitline services that help people in their quitting attempts.

Policy Advocacy on Tobacco and Health

  • www.thepraxisproject.org: Policy Advocacy on Tobacco and Health is an initiative of the Praxis Project Inc, designed to simultaneously build bridges between tobacco-control policy initiatives and strengthen the voice and capacity of communities of color in the tobacco-control movement.

Smoke Free Movies

  • www.smokefreemovies.ucsf.edu: This project aims to sharply reduce the US film industry's usefulness to the tobacco industry's domestic and global marketing.

Smoking Cessation Leadership Center

  • http://smokingcessationleadership.ucsf.edu: The Smoking Cessation Leadership Center is a national program office of the Robert Wood Johnson Foundation that aims to increase smoking-cessation rates and increase the number of health professionals who help smokers quit.

Tar Wars

  • www.tarwars.org: Tar Wars is a prohealth, tobacco-free education program and poster contest of the American Academy of Family Physicians designed to discourage tobacco use among fourth- and fifth-grade students.

Tobacco.org

Tobacco Policy Change

  • www.tobaccopolicychange.org: This national initiative of the Robert Wood Johnson Foundation was created to provide resources and technical assistance for community, regional, and national organizations and tribal groups interested in advocating for effective tobacco use-prevention and -cessation policy initiatives.

UAMS Smoke-Free Hospital Toolkit

UMICH Implementing a Smoke-Free Environment CD and Toolkits

  • www.med.umich.edu/mfit/tobacco/freeenvironment.htm: The University of Michigan Health System's Tobacco Consultation Service has developed a CD and toolkits to guide hospitals and other health care facilities on the steps to creating a smoke-free workplace.

Academic Pediatric Association: Pediatric Tobacco Issues Special Interest Group (The “Cig SIG”)

  • www.ambpeds.org/specialInterestGroups/sig_ped_tobacco.cfm: The “Cig SIG's” mission is to bring members and friends of the Academic Pediatric Association together for networking, dissemination of information, and discussion of research and funding opportunities, education, health care delivery, public policy, and advocacy related to pediatric tobacco control.

Global Tobacco Research Network

  • http://tobaccoresearch.net: The Global Tobacco Research Network's mission is to enhance research by promoting collaboration and partnerships, providing information, facilitating training, and sharing research tools with the goal of reducing the burden of disease and death caused by tobacco.

Society for Research on Nicotine and Tobacco

  • www.srnt.org: This Web site provides information on the latest research, abstracts, publications, and events related to nicotine and tobacco.

University of Wisconsin Center for Tobacco Research and Intervention

  • www.ctri.wisc.edu: The University of Wisconsin Center for Tobacco Research and Intervention was founded and is directed by Michael Fiore, MD, MPH, and is recognized internationally as a leading authority on tobacco-use treatment.

California

  • www.smokefreehousing.org—California Smoke Free Housing Project: Smokefreehousing.org was created to provide a source for accessing information on smoke-free housing in Northern California.

  • www.smokefreeapartments.org— Southern California Smokefree Apartment House Registry: A free information service for owners and managers of smoke-free apartment buildings, condominiums, townhouses, and rental houses and for prospective tenants. It is based in southern California and is starting out with names of owners and managers in the Los Angeles area who offer smoke-free housing.

Maine

  • www.smokefreeforme.org/tenant.php—Smoke Free For Maine: A Web site on tenants’ and landlords’ rights in ensuring a smoke- free housing environment. A page on the Web site addresses public housing.

Michigan

  • www.tcsg.org/sfelp/apartment.htm— The Smoke-Free Environments Law Project: Based in Ann Arbor, this Web site includes methods to help create a smoke-free housing environment and addresses issues of public opinion and frequently asked questions about the smoke-free housing market.

Oregon

Utah

Washington

  • www.metrokc.gov/health/tobacco/housing.htm—The Seattle and King County Tobacco Prevention Program: Includes a “how-to” guide and PowerPoint presentation for landlords, tenants, and housing authorities to stop smoking in their housing developments.

West Virginia

  • www.s-fhc.com—Smoke-Free Housing Consultants: This site will help you understand the demand for, advantages of, and legalities of owning or managing smoke-free apartment and condominium buildings. Smoke-Free Housing Consultants is available for consultation in all states that do not currently have a state- or tax-funded smoke-free housing advisory organization. They will refer you to someone in your area that can help you if an agency is working on this problem in your area.

  • www.tcsg.org/sfelp/fha_01.pdf— Federal Fair Housing Act and the Protection of Persons Who Are Disabled by SHS in Most Private and Public Housing:

  • www.no-smoke.org/goingsmokefree.php?dp=d11—How landlords can prohibit smoking in rental housing

FIGURE 1

Prevalence of SHS exposure, indicated by a serum cotinine level of ≥0.05 ng/mL, United States, 2001–2002.1 

FIGURE 1

Prevalence of SHS exposure, indicated by a serum cotinine level of ≥0.05 ng/mL, United States, 2001–2002.1 

TABLE 1

Major Conclusions of the Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General1 

Exposure TypeDiseaseConclusion (Page No.)
Maternal exposure to SHS during pregnancy Preterm delivery The evidence is suggestive but not sufficient to infer a causal relationship (195). 
 Low birth weight The evidence is sufficient to infer a causal relationship (205). 
Maternal exposure to SHS during pregnancy and postnatal SHS exposure Childhood cancer, leukemia, lymphoma, and brain tumors The evidence is suggestive but not sufficient to infer causal relationships (242). 
Postnatal SHS exposure Sudden infant death The evidence is sufficient to infer a causal relationship (194). 
 Lower respiratory illnesses The evidence is sufficient to infer a causal relationship. The increased risk for lower respiratory illnesses is greatest from smoking by the mother (292). 
 Middle-ear disease The evidence is sufficient to infer a causal relationship between parental smoking and middle-ear disease in children, including acute and recurrent otitis media and chronic middle-ear effusion. 
  The evidence is suggestive but not sufficient to infer a causal relationship between parental smoking and the natural history of middle-ear effusion (309). 
 Cough, phlegm, wheeze, breathlessness, asthma The evidence is sufficient to infer a causal relationship between SHS exposure from parental smoking and the onset of wheeze illnesses in early childhood (375). 
  Among school-aged children, the evidence is sufficient to infer a causal relationship (355). 
  The evidence is suggestive but not sufficient to infer a causal relationship between SHS exposure from parental smoking and the onset of childhood asthma (375). 
  Among school-aged children, the evidence is sufficient to infer a causal relationship between parental smoking and ever having asthma (355). 
Maternal smoking during pregnancy and postnatal SHS exposure Lung function The evidence is sufficient to infer a causal relationship between maternal smoking during pregnancy and persistent adverse effects on lung function across childhood (399). 
  The evidence is sufficient to infer a causal relationship between exposure to SHS after birth and a lower level of lung function during childhood (399). 
Exposure TypeDiseaseConclusion (Page No.)
Maternal exposure to SHS during pregnancy Preterm delivery The evidence is suggestive but not sufficient to infer a causal relationship (195). 
 Low birth weight The evidence is sufficient to infer a causal relationship (205). 
Maternal exposure to SHS during pregnancy and postnatal SHS exposure Childhood cancer, leukemia, lymphoma, and brain tumors The evidence is suggestive but not sufficient to infer causal relationships (242). 
Postnatal SHS exposure Sudden infant death The evidence is sufficient to infer a causal relationship (194). 
 Lower respiratory illnesses The evidence is sufficient to infer a causal relationship. The increased risk for lower respiratory illnesses is greatest from smoking by the mother (292). 
 Middle-ear disease The evidence is sufficient to infer a causal relationship between parental smoking and middle-ear disease in children, including acute and recurrent otitis media and chronic middle-ear effusion. 
  The evidence is suggestive but not sufficient to infer a causal relationship between parental smoking and the natural history of middle-ear effusion (309). 
 Cough, phlegm, wheeze, breathlessness, asthma The evidence is sufficient to infer a causal relationship between SHS exposure from parental smoking and the onset of wheeze illnesses in early childhood (375). 
  Among school-aged children, the evidence is sufficient to infer a causal relationship (355). 
  The evidence is suggestive but not sufficient to infer a causal relationship between SHS exposure from parental smoking and the onset of childhood asthma (375). 
  Among school-aged children, the evidence is sufficient to infer a causal relationship between parental smoking and ever having asthma (355). 
Maternal smoking during pregnancy and postnatal SHS exposure Lung function The evidence is sufficient to infer a causal relationship between maternal smoking during pregnancy and persistent adverse effects on lung function across childhood (399). 
  The evidence is sufficient to infer a causal relationship between exposure to SHS after birth and a lower level of lung function during childhood (399). 
TABLE 2

Some Costs of Tobacco Use and SHS Exposure

ItemCostSourceYears Data CollectedCitation
Smoking during pregnancy: neonatal health care Smoking-attributable fraction for neonatal costs: 2.2% (all states); $700/infant born to a mother who smoked during pregnancy Centers for Disease Control and Prevention Pregnancy Risk Assessment Monitoring System (PRAMS) database 1995 Adams et al (2002)136  
SHS exposure of pregnant women: early intervention services delivered to children with developmental delay attributed to maternal SHS exposure during pregnancy $99 million for early-intervention services delivered to 8300 New York City children ($11 900/child) New York City data 2002 Miller et al (2006)137  
SHS exposure of children: health care costs 9% of total direct medical costs in the first year of life Birth cohort study in Hong Kong 1997–1998 Leung et al (2003)51  
SHS exposure of children: respiratory disease, sudden infant death, burns, costs to the family Direct medical expenditures of $4.6 billion; loss-of-life costs of $8.2 billion Literature synthesis 1980–1996 Aligne and Stoddard (1997)3  
SHS exposure of children: medical expenditures for childhood respiratory illness Respiratory-related health care expenditures: 19% of expenditures for childhood respiratory conditions ($120/child aged ≤5 y; $175/child aged ≤2 y) National Medical Expenditure Survey 1987 Stoddard and Gray (1997)52  
Overall smoking in the United States 6%–8% of total annual expenditures for health care, with some estimates up to 14% Literature synthesis Through 1998 Warner et al (1999)138  
ItemCostSourceYears Data CollectedCitation
Smoking during pregnancy: neonatal health care Smoking-attributable fraction for neonatal costs: 2.2% (all states); $700/infant born to a mother who smoked during pregnancy Centers for Disease Control and Prevention Pregnancy Risk Assessment Monitoring System (PRAMS) database 1995 Adams et al (2002)136  
SHS exposure of pregnant women: early intervention services delivered to children with developmental delay attributed to maternal SHS exposure during pregnancy $99 million for early-intervention services delivered to 8300 New York City children ($11 900/child) New York City data 2002 Miller et al (2006)137  
SHS exposure of children: health care costs 9% of total direct medical costs in the first year of life Birth cohort study in Hong Kong 1997–1998 Leung et al (2003)51  
SHS exposure of children: respiratory disease, sudden infant death, burns, costs to the family Direct medical expenditures of $4.6 billion; loss-of-life costs of $8.2 billion Literature synthesis 1980–1996 Aligne and Stoddard (1997)3  
SHS exposure of children: medical expenditures for childhood respiratory illness Respiratory-related health care expenditures: 19% of expenditures for childhood respiratory conditions ($120/child aged ≤5 y; $175/child aged ≤2 y) National Medical Expenditure Survey 1987 Stoddard and Gray (1997)52  
Overall smoking in the United States 6%–8% of total annual expenditures for health care, with some estimates up to 14% Literature synthesis Through 1998 Warner et al (1999)138  
TABLE 3

Stages of Change90 

 
 
TABLE 4

Principles of Motivational Interviewing91 

Express Empathy Acceptance Facilitates Change 
 Skillful, reflective listening is fundamental. 
 Ambivalence is normal. 
Develop discrepancy The client, rather than the counselor, should present the arguments for change. 
 Change is motivated by a perceived discrepancy between present behavior and important personal goals or values. 
Roll with resistance Avoid arguing for change. 
 Resistance is not directly opposed. 
 New perspectives are invited but not imposed. 
 The client is a primary resource in finding answers and solutions. 
 Resistance is a signal to respond differently. 
Support self-efficacy A client's belief in the possibility of change is an important motivator. 
 The client, not the counselor, is responsible for choosing and carrying out change. 
 The counselor's own belief in the client's ability to change becomes a self-fulfilling prophecy. 
Express Empathy Acceptance Facilitates Change 
 Skillful, reflective listening is fundamental. 
 Ambivalence is normal. 
Develop discrepancy The client, rather than the counselor, should present the arguments for change. 
 Change is motivated by a perceived discrepancy between present behavior and important personal goals or values. 
Roll with resistance Avoid arguing for change. 
 Resistance is not directly opposed. 
 New perspectives are invited but not imposed. 
 The client is a primary resource in finding answers and solutions. 
 Resistance is a signal to respond differently. 
Support self-efficacy A client's belief in the possibility of change is an important motivator. 
 The client, not the counselor, is responsible for choosing and carrying out change. 
 The counselor's own belief in the client's ability to change becomes a self-fulfilling prophecy. 
TABLE 5

A Systematic Method for Counseling About Tobacco: The 5 A's65 

Ask 
    Obtain a tobacco-use and SHS-exposure history for all patients and their parents/households, including current use or exposure as well as use or exposure before and during pregnancy. 
    Ask about SHS exposures in child care settings and homes visited by the child. 
    Use charting prompts or other cues to increase initiation of history-taking and documentation of family tobacco use and SHS exposures. When selecting or designing electronic health records and paper records, include tobacco-history-documentation prompts in the selection and design criteria. 
    Questions asked should be phrased to limit misunderstanding about whether the query is about smoking “in (inside) the home” or smoking status of household members. When asking about smoking inside the home, say “does anyone smoke inside your home, even in the basement or garage?” rather than “does anyone smoke around the baby?” 
Advise 
    Provide information about elimination of children's SHS exposure to all parents and information about tobacco-use cessation, as indicated. Provide strong messages on harm from SHS exposure. 
    Engage parents in discussions about their tobacco use. Provide a strong quit-using message that is clear. For example, you can say, “As your child's doctor, I think the very best thing you can do for your health and your child's health is to quit smoking.” Personalize the child's health risk by saying, “It is very likely that Alicia's ear infections are worsened by your smoking,” or, “Paul's asthma attacks may improve if he is not exposed to your smoking; it is important that you quit smoking.” 
Assess 
    Determine the parent's readiness to quit. Is the parent a precontemplator or a contemplator? Is he or she ready to quit within the next month? 
Assist 
    Precontemplation stage: Provide a motivational message (the 5 R's [see Table 6]). 
    Contemplation stage: If parents are not ready to set a quit date, ask them to make a list of everything they like and do not like about smoking to help get them thinking about tobacco use in a more specific way. 
    Preparation stage: Help them set a quit date. Address their concerns about quitting, including withdrawal symptoms and perceived barriers to quitting. Perceived barriers to quitting can be addressed by educating the user about the quitting process, including what to expect and how long symptoms will last, weight gain, triggers to smoking, feelings of deprivation, and flagging motivation. Acute nicotine withdrawal can last from several days to weeks after cessation, typically peaking between 1 and 3 wk after the last cigarette is smoked.65  
    Refer to supports such as quit-smoking groups, community quitlines, and other supports, as available. 
Arrange follow-up 
    Plan to follow-up on any behavioral commitments that parents make on follow-up visits for health care maintenance or for ongoing medical problems. 
Ask 
    Obtain a tobacco-use and SHS-exposure history for all patients and their parents/households, including current use or exposure as well as use or exposure before and during pregnancy. 
    Ask about SHS exposures in child care settings and homes visited by the child. 
    Use charting prompts or other cues to increase initiation of history-taking and documentation of family tobacco use and SHS exposures. When selecting or designing electronic health records and paper records, include tobacco-history-documentation prompts in the selection and design criteria. 
    Questions asked should be phrased to limit misunderstanding about whether the query is about smoking “in (inside) the home” or smoking status of household members. When asking about smoking inside the home, say “does anyone smoke inside your home, even in the basement or garage?” rather than “does anyone smoke around the baby?” 
Advise 
    Provide information about elimination of children's SHS exposure to all parents and information about tobacco-use cessation, as indicated. Provide strong messages on harm from SHS exposure. 
    Engage parents in discussions about their tobacco use. Provide a strong quit-using message that is clear. For example, you can say, “As your child's doctor, I think the very best thing you can do for your health and your child's health is to quit smoking.” Personalize the child's health risk by saying, “It is very likely that Alicia's ear infections are worsened by your smoking,” or, “Paul's asthma attacks may improve if he is not exposed to your smoking; it is important that you quit smoking.” 
Assess 
    Determine the parent's readiness to quit. Is the parent a precontemplator or a contemplator? Is he or she ready to quit within the next month? 
Assist 
    Precontemplation stage: Provide a motivational message (the 5 R's [see Table 6]). 
    Contemplation stage: If parents are not ready to set a quit date, ask them to make a list of everything they like and do not like about smoking to help get them thinking about tobacco use in a more specific way. 
    Preparation stage: Help them set a quit date. Address their concerns about quitting, including withdrawal symptoms and perceived barriers to quitting. Perceived barriers to quitting can be addressed by educating the user about the quitting process, including what to expect and how long symptoms will last, weight gain, triggers to smoking, feelings of deprivation, and flagging motivation. Acute nicotine withdrawal can last from several days to weeks after cessation, typically peaking between 1 and 3 wk after the last cigarette is smoked.65  
    Refer to supports such as quit-smoking groups, community quitlines, and other supports, as available. 
Arrange follow-up 
    Plan to follow-up on any behavioral commitments that parents make on follow-up visits for health care maintenance or for ongoing medical problems. 
TABLE 6

Counseling to Overcome Resistance to Quitting Tobacco Use: The 5 R's65 

Relevance 
    Ask parents to consider the personal importance of quitting. 
    Advise parents that (1) their personal health will improve (they will feel better physically and perform better in physical activities, they will have fewer wrinkles and their skin will not age as fast, food will taste better, their sense of smell will improve), (2) the children's health will improve (they will have healthier infants and children, they will set a good example for children), (3) their home, car, clothing, and breath will smell better, (4) they will save money, and (5) they will be able to say they are a “former smoker” and can stop worrying about quitting and about exposing others to smoke. 
    Try to personalize the benefits of quitting to the parents' situation. 
Risks 
    Ask parents to identify the negative consequences of tobacco use. 
    Highlight the consequences that seem most relevant. 
Rewards 
    Ask parents to identify the benefits of quitting. 
    Highlight the benefits that seem most relevant. 
Roadblocks 
    Help parents to identify barriers to quitting. 
    Identify possible solutions such as pharmacotherapy or changes in daily patterns that may alleviate those barriers. 
Repetition 
    Repeat the message every time parents who use tobacco visit the office. 
    Convey to tobacco users that most people make several quit attempts before they are successful. 
Relevance 
    Ask parents to consider the personal importance of quitting. 
    Advise parents that (1) their personal health will improve (they will feel better physically and perform better in physical activities, they will have fewer wrinkles and their skin will not age as fast, food will taste better, their sense of smell will improve), (2) the children's health will improve (they will have healthier infants and children, they will set a good example for children), (3) their home, car, clothing, and breath will smell better, (4) they will save money, and (5) they will be able to say they are a “former smoker” and can stop worrying about quitting and about exposing others to smoke. 
    Try to personalize the benefits of quitting to the parents' situation. 
Risks 
    Ask parents to identify the negative consequences of tobacco use. 
    Highlight the consequences that seem most relevant. 
Rewards 
    Ask parents to identify the benefits of quitting. 
    Highlight the benefits that seem most relevant. 
Roadblocks 
    Help parents to identify barriers to quitting. 
    Identify possible solutions such as pharmacotherapy or changes in daily patterns that may alleviate those barriers. 
Repetition 
    Repeat the message every time parents who use tobacco visit the office. 
    Convey to tobacco users that most people make several quit attempts before they are successful. 

This document is copyrighted and is property of the American Academy of Pediatrics and its Board of Directors. All authors have filed conflict-of-interest statements with the American Academy of Pediatrics. Any conflicts have been resolved through a process approved by the Board of Directors. The American Academy of Pediatrics has neither solicited nor accepted any commercial involvement in the development of the content of this publication.

The guidance in this report does not indicate an exclusive course of treatment or serve as a standard of medical care. Variations, taking into account, individual circumstances may be appropriate.

All technical reports from the American Academy of Pediatrics automatically expire 5 years after publication unless reaffirmed, revised, or retired at or before that time.

For more information on states with bans on smoking in cars that carry children, contact the American Academy of Pediatrics (AAP) Division of State Government Affairs.

Except for people 18 years or younger or if required for reimbursement or insurance coverage.

§

For more information on states with public smoking bans, contact the AAP Division of State Government Affairs.

Refs 106, 110, 111, 128, 134, 140, 149, 156, 157, and 160185.

Refs 106, 110, 111, 160, 165, 177, 178, 182, 183, and 186191.

#

Refs 54, 106, 110, 111, 129, 134, 205, and 208.

1
US Department of Health and Human Services.
The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General.
Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health;
2006
2
US Environmental Protection Agency.
Respiratory Health Effects of Passive Smoking: Lung Cancer and Other Disorders.
Washington, DC: US Environmental Protection Agency, Office of Research and Development, Office of Air and Radiation;
1992
3
Aligne CA, Stoddard JJ. Tobacco and children: an economic evaluation of the medical effects of parental smoking.
Arch Pediatr Adolesc Med.
1997
;
151
(7):
648
–653
4
Centers for Disease Control and Prevention.
Preventing Tobacco Use Among Young People: A Report of the Surgeon General.
Atlanta, GA: US Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health;
1994
5
Gidwani PP, Sobol A, DeJong W, Perrin JM, Gortmaker SL. Television viewing and initiation of smoking among youth.
Pediatrics.
2002
;
110
(3):
505
–508
6
Hill KG, Hawkins JD, Catalano RF, Abbott RD, Guo J. Family influences on the risk of daily smoking initiation.
J Adolesc Health.
2005
;
37
(3):
202
–210
7
Komro KA, McCarty MC, Forster JL, Blaine TM, Chen V. Parental, family, and home characteristics associated with cigarette smoking among adolescents.
Am J Health Promot.
2003
;
17
(5):
291
–299
8
Leatherdale ST, Brown KS, Cameron R, McDonald PW. Social modeling in the school environment, student characteristics, and smoking susceptibility: a multi-level analysis.
J Adolesc Health.
2005
;
37
(4):
330
–336
9
Rajan KB, Leroux BG, Peterson AV Jr, et al. Nine-year prospective association between older siblings' smoking and children's daily smoking.
J Adolesc Health.
2003
;
33
(1):
25
–30
10
Sargent JD, Beach ML, Adachi-Mejia AM, et al. Exposure to movie smoking: its relation to smoking initiation among US adolescents.
Pediatrics.
2005
;
116
(5):
1183
–1191
11
Tomeo CA, Field AE, Berkey CS, Colditz GA, Frazier AL. Weight concerns, weight control behaviors, and smoking initiation.
Pediatrics.
1999
;
104
(4 pt 1):
918
–924
12
Gergen PJ, Fowler JA, Maurer KR, Davis WW, Overpeck MD. The burden of environmental tobacco smoke exposure on the respiratory health of children 2 months through 5 years of age in the United States: Third National Health and Nutrition Examination Survey, 1988 to 1994.
Pediatrics.
1998
;
101
(2). Available at: www.pediatrics.org/cgi/content/full/101/2/e8
13
Schwab M, McDermott A, Spengler J. Using longitudinal data to understand children's activity patterns in an exposure context: data from the Kanawha County Health Study.
Environ Int.
1992
;
18
:
173
–189
14
Pirkle JL, Bernert JT, Caudill SP, Sosnoff CS, Pechacek TF. Trends in the exposure of nonsmokers in the U.S. population to secondhand smoke: 1988–2002.
Environ Health Perspect.
2006
;
114
(6):
853
–858
15
US Department of Health and Human Services.
National Pregnancy & Health Survey: Drug Use Among Women Delivering Live Birth—1992.
Washington, DC: National Institute on Drug Abuse; 1996. NIH publication No. 96–3819
16
Martin JA, Hamilton BE, Sutton PD, Ventura SJ, Menacker F, Kirmeyer S. Births: final data for 2004.
Natl Vital Stat Rep.
2006
;
55
(1):
1
–101
17
Russell T, Crawford M, Woodby L. Measurements for active cigarette smoke exposure in prevalence and cessation studies: why simply asking pregnant women isn't enough.
Nicotine Tob Res.
2004
;
6
(suppl 2):
S141
–S151
18
Centers for Disease Control and Prevention. Cigarette smoking among adults: United States, 2006.
MMWR Morb Mortal Wkly Rep.
2007
;
56
(44):
1157
–1161
19
Soliman S, Pollack HA, Warner KE. Decrease in the prevalence of environmental tobacco smoke exposure in the home during the 1990s in families with children.
Am J Public Health.
2004
;
94
(2):
314
–320
20
Knight JM, Eliopoulos C, Klein J, Greenwald M, Koren G. Passive smoking in children: racial differences in systemic exposure to cotinine by hair and urine analysis.
Chest.
1996
;
109
(2):
446
–450
21
California Environmental Protection Agency, Air Resources Board, Office of Environmental Health Hazard Assessment.
Proposed Identification of Environmental Tobacco Smoke as a Toxic Air Contaminant.
Sacramento, CA: California Environmental Protection Agency;
2005
22
Abreu-Villaça Y, Seidler FJ, Tate CA, Cousins MM, Slotkin TA. Prenatal nicotine exposure alters the response to nicotine administration in adolescence: effects on cholinergic systems during exposure and withdrawal.
Neuropsychopharmacology.
2004
;
29
(5):
879
–890
23
Abreu-Villaça Y, Seidler FJ, Slotkin TA. Does prenatal nicotine exposure sensitize the brain to nicotine-induced neurotoxicity in adolescence?
Neuropsychopharmacology.
2004
;
29
(8):
1440
–1450
24
Nordberg A, Zhang XA, Fredriksson A, Eriksson P. Neonatal nicotine exposure induces permanent changes in brain nicotinic receptors and behaviour in adult mice.
Brain Res Dev Brain Res.
1991
;
63
(1–2):
201
–207
25
Slotkin TA, Seidler FJ, Qiao D, et al. Effects of prenatal nicotine exposure on primate brain development and attempted amelioration with supplemental choline or vitamin C: neurotransmitter receptors, cell signaling and cell development biomarkers in fetal brain regions of rhesus monkeys.
Neuropsychopharmacology.
2005
;
30
(1):
129
–144
26
Ernst M, Moolchan ET, Robinson ML. Behavioral and neural consequences of prenatal exposure to nicotine.
J Am Acad Child Adolesc Psychiatry.
2001
;
40
(6):
630
–641
27
Slotkin TA, Tate CA, Cousins MM, Seidler FJ. Prenatal nicotine exposure alters the responses to subsequent nicotine administration and withdrawal in adolescence: serotonin receptors and cell signaling.
Neuropsychopharmacology.
2006
;
31
(11):
2462
–2475
28
Cornelius MD, Leech SL, Goldschmidt L, Day NL. Prenatal tobacco exposure: is it a risk factor for early tobacco experimentation?
Nicotine Tob Res.
2000
;
2
(1):
45
–52
29
Al Mamun A, O'Callaghan FV, Alati R, et al. Does maternal smoking during pregnancy predict the smoking patterns of young adult offspring? A birth cohort study.
Tob Control.
2006
;
15
(6):
452
–457
30
Roberts KH, Munafo MR, Rodriguez D, et al. Longitudinal analysis of the effect of prenatal nicotine exposure on subsequent smoking behavior of offspring.
Nicotine Tob Res.
2005
;
7
(5):
801
–808
31
Clark PI, Scarisbrick-Hauser A, Gautam SP, Wirk SJ. Anti-tobacco socialization in homes of African-American and white parents, and smoking and nonsmoking parents.
J Adolesc Health.
1999
;
24
(5):
329
–339
32
Osler M, Clausen J, Ibsen KK, Jensen G. Maternal smoking during childhood and increased risk of smoking in young adulthood.
Int J Epidemiol.
1995
;
24
(4):
710
–714
33
Sargent JD, Dalton M. Does parental disapproval of smoking prevent adolescents from becoming established smokers?
Pediatrics.
2001
;
108
(6):
1256
–1262
34
Tilson EC, McBride CM, Lipkus IM, Catalano RF. Testing the interaction between parent-child relationship factors and parent smoking to predict youth smoking.
J Adolesc Health.
2004
;
35
(3):
182
–189
35
Taylor JE, Conard MW, Koetting O'Byrne K, Haddock CK, Poston WS. Saturation of tobacco smoking models and risk of alcohol and tobacco use among adolescents.
J Adolesc Health.
2004
;
35
(3):
190
–196
36
Sandler DP, Everson RB, Wilcox AJ, Browder JP. Cancer risk in adulthood from early life exposure to parents' smoking.
Am J Public Health.
1985
;
75
(5):
487
–492
37
West DC, Romano PS, Azari R, Rudominer A, Holman M, Sandhu S. Impact of environmental tobacco smoke on children with sickle cell disease.
Arch Pediatr Adolesc Med.
2003
;
157
(12):
1197
–1201
38
Mannino DM, Moorman JE, Kingsley B, Rose D, Repace J. Health effects related to environmental tobacco smoke exposure in children in the United States: data from the Third National Health and Nutrition Examination Survey.
Arch Pediatr Adolesc Med.
2001
;
155
(1):
36
–41
39
Gilliland FD, Berhane K, Islam T, et al. Environmental tobacco smoke and absenteeism related to respiratory illness in schoolchildren.
Am J Epidemiol.
2003
;
157
(10):
861
–869
40
Barillo DJ, Goode R. Fire fatality study: demographics of fire victims.
Burns.
1996
;
22
(2):
85
–88
41
Copeland AR. Accidental fire deaths: the 5-year Metropolitan Dade Country experience from 1979 until 1983.
Z Rechtsmed.
1985
;
94
(1):
71
–79
42
Squires T, Busuttil A. Can child fatalities in house fires be prevented?
Inj Prev.
1996
;
2
(2):
109
–113
43
Whidden P. Deaths of children in house fires.
BMJ.
1996
;
312
(7029):
511
44
Leistikow BN, Martin DC, Milano CE. Fire injuries, disasters, and costs from cigarettes and cigarette lights: a global overview.
Prev Med.
2000
;
31
(2 pt 1):
91
–99
45
Gunja M, Wayne GF, Landman A, Connolly G, McGuire A. The case for fire safe cigarettes made through industry documents.
Tob Control.
2002
;
11
(4):
346
–353
46
Connolly GN, Alpert HR, Rees V, et al. Effect of the New York State cigarette fire safety standard on ignition propensity, smoke constituents, and the consumer market.
Tob Control.
2005
;
14
(5):
321
–327
47
Smith H. The high cost of smoking.
MSN Money.
June 5, 2007. Available at: http://articles.moneycentral.msn.com/Insurance/InsureYourHealth/HighCostOfSmoking.aspx. Accessed September 3, 2009
48
Armour B, Pitts M, Lee C.
Cigarette Smoking and Food Insecurity Among Low-Income Families in the United States, 2001.
Atlanta, GA: Federal Reserve Bank of Atlanta; 2007:19
49
Levine P, Gustafson T, Velenchik D. More bad news for smokers? The effects of cigarette smoking on wages.
Ind Labor Relat Rev.
1997
;
50
(3):
493
–509
50
Centers for Disease Control and Prevention.
Sustaining State Programs for Tobacco Control: Data Highlights 2006.
Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health;
2006
51
Leung GM, Ho LM, Lam TH. The economic burden of environmental tobacco smoke in the first year of life.
Arch Dis Child.
2003
;
88
(9):
767
–771
52
Stoddard JJ, Gray B. Maternal smoking and medical expenditures for childhood respiratory illness.
Am J Public Health.
1997
;
87
(2):
205
–209
53
Centers for Disease Control and Prevention. Annual smoking-attributable mortality, years of potential life lost, and productivity losses: United States, 1997–2001.
MMWR Morb Mortal Wkly Rep.
2005
;
54
(25):
625
–628
54
Johansson A, Hermansson G, Ludvigsson J. How should parents protect their children from environmental tobacco-smoke exposure in the home?
Pediatrics.
2004
;
113
(4). Available at: www.pediatrics.org/cgi/content/full/113/4/e291
55
Matt GE, Quintana PJ, Hovell MF, et al. Households contaminated by environmental tobacco smoke: sources of infant exposures.
Tob Control.
2004
;
13
(1):
29
–37
56
Gonzales M, Malcoe LH, Kegler MC, Espinoza J. Prevalence and predictors of home and automobile smoking bans and child environmental tobacco smoke exposure: a cross-sectional study of U.S.- and Mexico-born Hispanic women with young children.
BMC Public Health.
2006
;
6
:
265
57
Martinez-Donate AP, Hovell MF, Hofstetter CR, Gonzalez-Perez GJ, Adams MA, Kotay A. Correlates of home smoking bans among Mexican-Americans.
Am J Health Promot.
2007
;
21
(4):
229
–236
58
McMillen RC, Winickoff JP, Klein JD, Weitzman M. US adult attitudes and practices regarding smoking restrictions and child exposure to environmental tobacco smoke: changes in the social climate from 2000–2001.
Pediatrics.
2003
;
112
(1 pt 1). Available at: www.pediatrics.org/cgi/content/full/112/1/e55
59
Kegler MC, Malcoe LH. Smoking restrictions in the home and car among rural Native American and white families with young children.
Prev Med.
2002
;
35
(4):
334
–342
60
King G, Mallett R, Kozlowski L, Bendel RB, Nahata S. Personal space smoking restrictions among African Americans.
Am J Prev Med.
2005
;
28
(1):
33
–40
61
Norman GJ, Ribisl KM, Howard-Pitney B, Howard KA. Smoking bans in the home and car: do those who really need them have them?
Prev Med.
1999
;
29
(6 pt 1):
581
–589
62
Pizacani BA, Martin DP, Stark MJ, Koepsell TD, Thompson B, Diehr P. Household smoking bans: which households have them and do they work?
Prev Med.
2003
;
36
(1):
99
–107
63
Wakefield M, Banham D, Martin J, Ruffin R, McCaul K, Badcock N. Restrictions on smoking at home and urinary cotinine levels among children with asthma.
Am J Prev Med.
2000
;
19
(3):
188
–192
64
Centers for Disease Control and Prevention.
Reducing Tobacco Use: A Report of the Surgeon General.
Vol 49. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, Office on Smoking and Health; 2000
65
Fiore M, Jaen C, Baker T, et al.
Treating Tobacco Use and Dependence: 2008 Update—Clinical Practice Guideline.
Rockville, MD: US Department of Health and Human Services, Public Health Service;
2008
66
Gehrman CA, Hovell MF. Protecting children from environmental tobacco smoke (ETS) exposure: a critical review.
Nicotine Tob Res.
2003
;
5
(3):
289
–301
67
Kallio K, Jokinen E, Hämäläinen M, et al. Impact of repeated lifestyle counselling in an atherosclerosis prevention trial on parental smoking and children's exposure to tobacco smoke.
Acta Paediatr.
2006
;
95
(3):
283
–290
68
Conway TL, Woodruff SI, Edwards CC, Hovell MF, Klein J. Intervention to reduce environmental tobacco smoke exposure in Latino children: null effects on hair biomarkers and parent reports.
Tob Control.
2004
;
13
(1):
90
–92
69
Zakarian JM, Hovell MF, Sandweiss RD, et al. Behavioral counseling for reducing children's ETS exposure: implementation in community clinics.
Nicotine Tob Res.
2004
;
6
(6):
1061
–1074
70
Groner JA, Ahijevych K, Grossman LK, Rich LN. The impact of a brief intervention on maternal smoking behavior.
Pediatrics.
2000
;
105
(1 pt 3):
267
–271
71
Roseby R, Waters E, Polnay A, Campbell R, Webster P, Spencer N. Family and carer smoking control programmes for reducing children's exposure to environmental tobacco smoke.
Cochrane Database Syst Rev.
2007
;(3):CD001746
72
McBride CM, Emmons KM, Lipkus IM. Understanding the potential of teachable moments: the case of smoking cessation.
Health Educ Res.
2003
;
18
(2):
156
–170
73
Colman GJ, Joyce T. Trends in smoking before, during, and after pregnancy in ten states.
Am J Prev Med.
2003
;
24
(1):
29
–35
74
Ma Y, Goins KV, Pbert L, Ockene JK. Predictors of smoking cessation in pregnancy and maintenance postpartum in low-income women.
Matern Child Health J.
2005
;
9
(4):
393
–402
75
Solomon LJ, Higgins ST, Heil SH, Badger GJ, Thomas CS, Bernstein IM. Predictors of postpartum relapse to smoking.
Drug Alcohol Depend.
2007
;
90
(2–3):
224
–227
76
Substance Abuse and Mental Health Services Administration.
Results From the 2002 National Survey on Drug Use and Health: National Findings.
Rockville, MD: Office of Applied Studies;
2003
77
Tanski SE, Klein JD, Winickoff JP, Auinger P, Weitzman M. Tobacco counseling at well-child and tobacco-influenced illness visits: opportunities for improvement.
Pediatrics.
2003
;
111
(2). Available at: www.pediatrics.org/cgi/content/full/111/2/e162
78
Pérez-Stable EJ, Juarez-Reyes M, Kaplan C, Fuentes-Afflick E, Gildengorin V, Millstein S. Counseling smoking parents of young children: comparison of pediatricians and family physicians.
Arch Pediatr Adolesc Med.
2001
;
155
(1):
25
–31
79
Zapka JG, Pbert L, Stoddard AM, Ockene JK, Goins KV, Bonollo D. Smoking cessation counseling with pregnant and postpartum women: a survey of community health center providers.
Am J Public Health.
2000
;
90
(1):
78
–84
80
Frankowski BL, Weaver SO, Secker-Walker RH. Advising parents to stop smoking: pediatricians' and parents' attitudes.
Pediatrics.
1993
;
91
(2):
296
–300
81
Cluss PA, Moss D. Parent attitudes about pediatricians addressing parental smoking.
Ambul Pediatr.
2002
;
2
(6):
485
–488
82
Frankowski BL, Secker-Walker RH. Advising parents to stop smoking: opportunities and barriers in pediatric practice.
Am J Dis Child.
1989
;
143
(9):
1091
–1094
83
Moss D, Cluss PA, Mesiano M, Kip KE. Accessing adult smokers in the pediatric setting: what do parents think?
Nicotine Tob Res.
2006
;
8
(1):
67
–75
84
Winickoff JP, Tanski SE, McMillen RC, Klein JD, Rigotti NA, Weitzman M. Child health care clinicians' use of medications to help parents quit smoking: a national parent survey.
Pediatrics.
2005
;
115
(4):
1013
–1017
85
American Academy of Pediatrics.
Red Book: 2006 Report of the Committee on Infectious Diseases.
Pickering LK, Baker CJ, Long SS, McMillan JA, eds. 27th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2006
86
Centers for Disease Control and Prevention. State Medicaid coverage for tobacco-dependence treatments: United States, 2006.
MMWR Morb Mortal Wkly Rep.
2008
;
57
(5):
117
–122
87
McPhillips-Tangum C, Rehm B, Carreon R, Erceg CM, Bocchino C. Addressing tobacco in managed care: results of the 2003 survey.
Prev Chronic Dis.
2006
;
3
(3):
A87
88
American Academy of Pediatrics. Coding corner: what diagnosis code should I use for parental smoke exposure?
AAP News.
2003
;
23
(1):
31
89
Potts LA, Garwood CL. Varenicline: the newest agent for smoking cessation.
Am J Health Syst Pharm.
2007
;
64
(13):
1381
–1384
90
Prochaska JO, DiClemente CC, Norcross JC. In search of how people change: applications to addictive behaviors.
Am Psychol.
1992
;
47
(9):
1102
–1114
91
Miller W, Rollnick S, Conforti K.
Motivational Interviewing: Preparing People for Change.
2nd ed. New York, NY: Guilford Press;
2002
92
Pollak KI, Oncken CA, Lipkus IM, et al. Nicotine replacement and behavioral therapy for smoking cessation in pregnancy.
Am J Prev Med.
2007
;
33
(4):
297
–305
93
Grimshaw GM, Stanton A. Tobacco cessation interventions for young people.
Cochrane Database Syst Rev.
2006
;(4):CD003289
94
Jorenby DE, Hays JT, Rigotti NA, et al. Efficacy of varenicline, an alpha4beta2 nicotinic acetylcholine receptor partial agonist, vs placebo or sustained-release bupropion for smoking cessation: a randomized controlled trial.
JAMA.
2006
;
296
(1):
56
–63
95
Stead LF, Perera R, Lancaster T. Telephone counselling for smoking cessation.
Cochrane Database Syst Rev.
2006
;(3):CD002850
96
Farrelly MC, Evans WN, Sfekas AE. The impact of workplace smoking bans: results from a national survey.
Tob Control.
1999
;
8
(3):
272
–277
97
Fichtenberg CM, Glantz SA. Effect of smoke-free workplaces on smoking behaviour: systematic review.
BMJ.
2002
;
325
(7357):
188
98
Levy DE. Employer-sponsored insurance coverage of smoking cessation treatments.
Am J Manag Care.
2006
;
12
(9):
553
–562
99
Coffield AB, Maciosek MV, McGinnis JM, et al. Priorities among recommended clinical preventive services.
Am J Prev Med.
2001
;
21
(1):
1
–9
100
Tsoukalas TH, Glantz SA. Development and destruction of the first state funded anti-smoking campaign in the USA.
Tob Control.
2003
;
12
(2):
214
–220
101
Baba A, Cook DM, McGarity TO, Bero LA. Legislating “sound science”: the role of the tobacco industry.
Am J Public Health.
2005
;
95
(suppl 1):
S20
–S27
102
Bero LA. Tobacco industry manipulation of research.
Public Health Rep.
2005
;
120
(2):
200
–208
103
Muggli ME, Hurt RD, Blanke DD. Science for hire: a tobacco industry strategy to influence public opinion on secondhand smoke.
Nicotine Tob Res.
2003
;
5
(3):
303
–314
104
Ong EK, Glantz SA. Tobacco industry efforts subverting International Agency for Research on Cancer's second-hand smoke study.
Lancet.
2000
;
355
(9211):
1253
–1259
105
Ong EK, Glantz SA. Constructing “sound science” and “good epidemiology”: tobacco, lawyers, and public relations firms.
Am J Public Health.
2001
;
91
(11):
1749
–1757
106
Tong EK, England L, Glantz SA. Changing conclusions on secondhand smoke in a sudden infant death syndrome review funded by the tobacco industry.
Pediatrics.
2005
;
115
(3). Available at: www.pediatrics.org/cgi/content/full/115/3/e356
107
Tong EK, Glantz SA. Tobacco industry efforts undermining evidence linking secondhand smoke with cardiovascular disease.
Circulation.
2007
;
116
(16):
1845
–1854
108
Bryan-Jones K, Bero LA. Tobacco industry efforts to defeat the occupational safety and health administration indoor air quality rule.
Am J Public Health.
2003
;
93
(4):
585
–592
109
Davis KC, Nonnemaker JM, Farrelly MC. Association between national smoking prevention campaigns and perceived smoking prevalence among youth in the United States.
J Adolesc Health.
2007
;
41
(5):
430
–436
110
Landman A, Ling PM, Glantz SA. Tobacco industry youth smoking prevention programs: protecting the industry and hurting tobacco control.
Am J Public Health.
2002
;
92
(6):
917
–930
111
Mandel LL, Bialous SA, Glantz SA. Avoiding “truth”: tobacco industry promotion of life skills training.
J Adolesc Health.
2006
;
39
(6):
868
–879
112
Cook DM, Tong EK, Glantz SA, Bero LA. The power of paperwork: how Philip Morris neutralized the medical code for secondhand smoke.
Health Aff (Millwood).
2005
;
24
(4):
994
–1004
113
Thomson G, Wilson N, Howden-Chapman P. Population level policy options for increasing the prevalence of smokefree homes.
J Epidemiol Community Health.
2006
;
60
(4):
298
–304
114
Bauer JE, Hyland A, Li Q, Steger C, Cummings KM. A longitudinal assessment of the impact of smoke-free worksite policies on tobacco use.
Am J Public Health.
2005
;
95
(6):
1024
–1029
115
McMullen KM, Brownson RC, Luke D, Chriqui J. Strength of clean indoor air laws and smoking related outcomes in the USA.
Tob Control.
2005
;
14
(1):
43
–48
116
Ranson MK, Jha P, Chaloupka FJ, Nguyen SN. Global and regional estimates of the effectiveness and cost-effectiveness of price increases and other tobacco control policies.
Nicotine Tob Res.
2002
;
4
(3):
311
–319
117
Tauras JA. Public policy and smoking cessation among young adults in the United States.
Health Policy.
2004
;
68
(3):
321
–332
118
Ashley MJ, Cohen J, Ferrence R, et al. Smoking in the home: changing attitudes and current practices.
Am J Public Health.
1998
;
88
(5):
797
–800
119
Borland R, Yong HH, Cummings KM, Hyland A, Anderson S, Fong GT. Determinants and consequences of smoke-free homes: findings from the International Tobacco Control (ITC) four country survey.
Tob Control.
2006
;
15
(suppl 3):iii42–iii50
120
Centers for Disease Control and Prevention. Indoor air quality in hospitality venues before and after implementation of a clean indoor air law: Western New York, 2003.
MMWR Morb Mortal Wkly Rep.
2004
;
53
(44):
1038
–1041
121
Centers for Disease Control and Prevention. Reduced secondhand smoke exposure after implementation of a comprehensive statewide smoking ban: New York, June 26, 2003–June 30, 2004.
MMWR Morb Mortal Wkly Rep.
2007
;
56
(28):
705
–708
122
Albers AB, Siegel M, Cheng DM, Rigotti NA, Biener L. Effects of restaurant and bar smoking regulations on exposure to environmental tobacco smoke among Massachusetts adults.
Am J Public Health.
2004
;
94
(11):
1959
–1964
123
Akhtar PC, Currie DB, Currie CE, Haw SJ. Changes in child exposure to environmental tobacco smoke (CHETS) study after implementation of smoke-free legislation in Scotland: national cross sectional survey.
BMJ.
2007
;
335
(7619):
545
124
Centers for Disease Control and Prevention. State-specific prevalence of current cigarette smoking among adults, and policies and attitudes about secondhand smoke: United States, 2000.
MMWR Morb Mortal Wkly Rep.
2001
;
50
(49):
1101
–1106
125
Heloma A, Jaakkola MS. Four-year follow-up of smoke exposure, attitudes and smoking behaviour following enactment of Finland's national smoke-free work-place law.
Addiction.
2003
;
98
(8):
1111
–1117
126
Centers for Disease Control and Prevention. Impact of a smoking ban on restaurant and bar revenues: El Paso, Texas, 2002.
MMWR Morb Mortal Wkly Rep.
2004
;
53
(7):
150
–152
127
Centers for Disease Control and Prevention.
Best Practices for Comprehensive Tobacco Control Programs: 2007.
Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health;
2007
128
Task Force on Community Preventive Services. The guide to community preventive services. Available at: www.thecommunityguide.org/tobacco/default.htm. Accessed March 31, 2008
129
Tobacco Public Policy Center at Capital University Law School. The duty to protect foster children from secondhand smoke. Available at: www.law.capital.edu/tobacco/documents/foster_care.pdf. Accessed October 19, 2007
130
National Voice of Foster Parents. Smoking & secondhand smoke. Available at: www.nfpainc.org/content/?page=Position%20Statements&pg=2#cp_111_337. Accessed July 8, 2008
131
Cabana MD, Rand CS, Powe NR, et al. Why don't physicians follow clinical practice guidelines? A framework for improvement.
JAMA.
1999
;
282
(15):
1458
–1465
132
Greco PJ, Eisenberg JM. Changing physicians' practices.
N Engl J Med.
1993
;
329
(17):
1271
–1273
133
Grimshaw JM, Eccles MP, Walker AE, Thomas RE. Changing physicians' behavior: what works and thoughts on getting more things to work.
J Contin Educ Health Prof.
2002
;
22
(4):
237
–243
134
Accreditation Council for Graduate Medical Education. Program requirements for fellowship education in adolescent medicine. Available at: www.acgme.org/acWebsite/downloads/RRC_progReq/321adolPeds07012007.pdf. Accessed April 25, 2007
135
Accreditation Council for Graduate Medical Education. Program requirements for residency education in adolescent medicine. Available at: www.acgme.org/acWebsite/downloads/RRC_progReq/321pr997.pdf. Accessed April 25, 2007
136
Adams EK, Miller VP, Ernst C, Nishimura BK, Melvin C, Merritt R. Neonatal health care costs related to smoking during pregnancy.
Health Econ.
2002
;
11
(3):
193
–206
137
Miller T, Rauh VA, Glied SA, et al. The economic impact of early life environmental tobacco smoke exposure: early intervention for developmental delay.
Environ Health Perspect.
2006
;
114
(10):
1585
–1588
138
Warner KE, Hodgson TA, Carroll CE. Medical costs of smoking in the United States: estimates, their validity, and their implications.
Tob Control.
1999
;
8
(3):
290
–300 injuries, disasters, and costs from cigarettes and cigarette lights: a global overview. Prev Med. 2000;31(2 pt 1):91–99
1
Ahluwalia IB, Grummer-Strawn L, Scanlon KS. Exposure to environmental tobacco smoke and birth outcome: increased effects on pregnant women aged 30 years or older.
Am J Epidemiol.
1997
;
146
(1):
42
–47
2
Barnett E. Race differences in the proportion of low birth weight attributable to maternal cigarette smoking in a low-income population.
Am J Health Promot.
1995
;
10
(2):
105
–110
3
DiFranza JR, Lew RA. Effect of maternal cigarette smoking on pregnancy complications and sudden infant death syndrome.
J Fam Pract.
1995
;
40
(4):
385
–394
4
Eskenazi B, Prehn AW, Christianson RE. Passive and active maternal smoking as measured by serum cotinine: the effect on birthweight.
Am J Public Health.
1995
;
85
(3):
395
–398
5
Horta BL, Victora CG, Menezes AM, Halpern R, Barros FC. Low birthweight, preterm births and intrauterine growth retardation in relation to maternal smoking.
Paediatr Perinat Epidemiol.
1997
;
11
(2):
140
–151
6
Lightwood JM, Phibbs CS, Glantz SA. Short-term health and economic benefits of smoking cessation: low birth weight.
Pediatrics.
1999
;
104
(6):
1312
–1320
7
Lindley AA, Gray RH, Herman AA, Becker S. Maternal cigarette smoking during pregnancy and infant ponderal index at birth in the Swedish Medical Birth Register, 1991–1992.
Am J Public Health.
2000
;
90
(3):
420
–423
8
Mainous AG, Hueston WJ. Passive smoke and low birth weight: evidence of a threshold effect.
Arch Fam Med.
1994
;
3
(10):
875
–878
9
Martin TR, Bracken MB. Association of low birth weight with passive smoke exposure in pregnancy.
Am J Epidemiol.
1986
;
124
(4):
633
–642
10
Perera FP, Jedrychowski W, Rauh V, Whyatt RM. Molecular epidemiologic research on the effects of environmental pollutants on the fetus.
Environ Health Perspect.
1999
;
107
(suppl 3):
451
–460
11
Pollack H, Lantz PM, Frohna JG. Maternal smoking and adverse birth outcomes among singletons and twins.
Am J Public Health.
2000
;
90
(3):
395
–400
12
Roquer JM, Figueras J, Botet F, Jimenez R. Influence on fetal growth of exposure to tobacco smoke during pregnancy.
Acta Paediatr.
1995
;
84
(2):
118
–121
13
Salihu HM, Aliyu MH, Pierre-Louis BJ, Alexander GR. Levels of excess infant deaths attributable to maternal smoking during pregnancy in the United States.
Matern Child Health J.
2003
;
7
(4):
219
–227
14
Windham GC, Eaton A, Hopkins B. Evidence for an association between environmental tobacco smoke exposure and birthweight: a meta-analysis and new data.
Paediatr Perinat Epidemiol.
1999
;
13
(1):
35
–57
15
Windham GC, Hopkins B, Fenster L, Swan SH. Prenatal active or passive tobacco smoke exposure and the risk of preterm delivery or low birth weight.
Epidemiology.
2000
;
11
(4):
427
–433
16
Collaco JM, Vanscoy L, Bremer L, et al. Interactions between secondhand smoke and genes that affect cystic fibrosis lung disease.
JAMA.
2008
;
299
(4):
417
–424
17
Andres RL, Day MC. Perinatal complications associated with maternal tobacco use.
Semin Neonatol.
2000
;
5
(3):
231
–241
18
Tuthill DP, Stewart JH, Coles EC, Andrews J, Cartlidge PH. Maternal cigarette smoking and pregnancy outcome.
Paediatr Perinat Epidemiol.
1999
;
13
(3):
245
–253
19
Windham GC, Swan SH, Fenster L. Parental cigarette smoking and the risk of spontaneous abortion.
Am J Epidemiol.
1992
;
135
(12):
1394
–1403
20
Windham GC, Von Behren J, Waller K, Fenster L. Exposure to environmental and mainstream tobacco smoke and risk of spontaneous abortion.
Am J Epidemiol.
1999
;
149
(3):
243
–247
21
Frøen JF, Arnestad M, Frey K, Vege A, Saugstad OD, Stray-Pedersen B. Risk factors for sudden intrauterine unexplained death: epidemiologic characteristics of singleton cases in Oslo, Norway, 1986–1995.
Am J Obstet Gynecol.
2001
;
184
(4):
694
–702
22
Salihu HM, Sharma PP, Getahun D, et al. Prenatal tobacco use and risk of stillbirth: a case-control and bidirectional case-crossover study.
Nicotine Tob Res.
2008
;
10
(1):
159
–166
23
Beaty TH, Maestri NE, Hetmanski JB, et al. Testing for interaction between maternal smoking and TGFA genotype among oral cleft cases born in Maryland 1992–1996.
Cleft Palate Craniofac J.
1997
;
34
(5):
447
–454
24
Clark JD, Mossey PA, Sharp L, Little J. Socioeconomic status and orofacial clefts in Scotland, 1989 to 1998.
Cleft Palate Craniofac J.
2003
;
40
(5):
481
–485
25
Lammer EJ, Shaw GM, Lovannisci DM, Van Waes J, Finnell RH. Maternal smoking and the risk of orofacial clefts: susceptibility with NAT1 and NAT2 polymorphisms.
Epidemiology.
2004
;
15
(2):
150
–156
26
Little J, Cardy A, Arslan MT, Gilmour M, Mossey PA. Smoking and orofacial clefts: a United Kingdom-based case-control study.
Cleft Palate Craniofac J.
2004
;
41
(4):
381
–386
27
Little J, Cardy A, Munger RG. Tobacco smoking and oral clefts: a meta-analysis.
Bull World Health Organ.
2004
;
82
(3):
213
–218
28
Lorente C, Cordier S, Goujard J, et al. Tobacco and alcohol use during pregnancy and risk of oral clefts.
Am J Public Health.
2000
;
90
(3):
415
–419
29
van Rooij IA, Groenen PM, van Drongelen M, Te Morsche RH, Peters WH, Steegers-Theunissen RP. Orofacial clefts and spina bifida: N-acetyltransferase phenotype, maternal smoking, and medication use.
Teratology.
2002
;
66
(5):
260
–266
30
Wyszynski DF, Duffy DL, Beaty TH. Maternal cigarette smoking and oral clefts: a meta-analysis.
Cleft Palate Craniofac J.
1997
;
34
(3):
206
–210
31
Wyszynski DF, Wu T. Use of US birth certificate data to estimate the risk of maternal cigarette smoking for oral clefting.
Cleft Palate Craniofac J.
2002
;
39
(2):
188
–192
32
Honein MA, Rasmussen SA, Reefhuis J, et al. Maternal smoking and environmental tobacco smoke exposure and the risk of orofacial clefts.
Epidemiology.
2007
;
18
(2):
226
–233
33
Malik S, Cleves MA, Honein MA, et al; National Birth Defects Prevention Study. Maternal smoking and congenital heart defects.
Pediatrics.
2008
;
121
(4). Available at: www.pediatrics.org/cgi/content/full/121/4/e810
34
Geerts CC, Grobbee DE, van der Ent CK, et al. Tobacco smoke exposure of pregnant mothers and blood pressure in their newborns: results from the wheezing illnesses study Leidsche Rijn birth cohort.
Hypertension.
2007
;
50
(3):
572
–578
35
Rebagliato M, Florey Cdu V, Bolumar F. Exposure to environmental tobacco smoke in nonsmoking pregnant women in relation to birth weight.
Am J Epidemiol.
1995
;
142
(5):
531
–537
36
Kharrazi M, DeLorenze GN, Kaufman FL, et al. Environmental tobacco smoke and pregnancy outcome.
Epidemiology.
2004
;
15
(6):
660
–670
37
Hanke W, Sobala W, Kalinka J. Environmental tobacco smoke exposure among pregnant women: impact on fetal biometry at 20–24 weeks of gestation and newborn child's birth weight.
Int Arch Occup Environ Health.
2004
;
77
(1):
47
–52
38
Hegaard HK, Kjaergaard H, Moller LF, Wachmann H, Ottesen B. The effect of environmental tobacco smoke during pregnancy on birth weight.
Acta Obstet Gynecol Scand.
2006
;
85
(6):
675
–681
39
Leonardi-Bee JA, Smyth AR, Britton J, Coleman T. Environmental tobacco smoke and fetal health: systematic review and meta-analysis.
Arch Dis Child Fetal Neonatal Ed.
2008
;
93
(5):
F351
–F361
40
George L, Granath F, Johansson AL, Anneren G, Cnattingius S. Environmental tobacco smoke and risk of spontaneous abortion.
Epidemiology.
2006
;
17
(5):
500
–505
41
Godding V, Bonnier C, Fiasse L, et al. Does in utero exposure to heavy maternal smoking induce nicotine withdrawal symptoms in neonates?
Pediatr Res.
2004
;
55
(4):
645
–651
42
Blair PS, Fleming PJ, Bensley D, et al. Smoking and the sudden infant death syndrome: results from 1993–5 case-control study for confidential inquiry into stillbirths and deaths in infancy. Confidential Enquiry into Stillbirths and Deaths Regional Coordinators and Researchers.
BMJ.
1996
;
313
(7051):
195
–198
43
Elliot J, Vullermin P, Robinson P. Maternal cigarette smoking is associated with increased inner airway wall thickness in children who die from sudden infant death syndrome.
Am J Respir Crit Care Med.
1998
;
158
(3):
802
–806
44
Franco P, Groswasser J, Hassid S, Lanquart JP, Scaillet S, Kahn A. Prenatal exposure to cigarette smoking is associated with a decrease in arousal in infants.
J Pediatr.
1999
;
135
(1):
34
–38
45
Schoendorf KC, Kiely JL. Relationship of sudden infant death syndrome to maternal smoking during and after pregnancy.
Pediatrics.
1992
;
90
(6):
905
–908
46
Bearer C, Emerson RK, O'Riordan MA, Roitman E, Shackleton C. Maternal tobacco smoke exposure and persistent pulmonary hypertension of the newborn.
Environ Health Perspect.
1997
;
105
(2):
202
–206
47
Johansson A, Ludvigsson J, Hermansson G. Adverse health effects related to tobacco smoke exposure in a cohort of three-year olds.
Acta Paediatr.
2008
;
97
(3):
354
–357
48
Jeppesen DL, Nielsen SD, Ersboll AK, Valerius NH. Maternal smoking during pregnancy increases the risk of postnatal infections in preterm neonates.
Neonatology.
2008
;
94
(2):
75
–78
49
Díaz-Gómez NM, Mendoza C, González-González NL, et al. Maternal smoking and the vitamin D-parathyroid hormone system during the perinatal period.
J Pediatr.
2007
;
151
(6):
618
–623
50
Cunningham J, Dockery DW, Gold DR, Speizer FE. Racial differences in the association between maternal smoking during pregnancy and lung function in children.
Am J Respir Crit Care Med.
1995
;
152
(2):
565
–569
51
Gilliland FD, Berhane K, McConnell R, et al. Maternal smoking during pregnancy, environmental tobacco smoke exposure and childhood lung function.
Thorax.
2000
;
55
(4):
271
–276
52
Hanrahan JP, Tager IB, Segal MR, et al. The effect of maternal smoking during pregnancy on early infant lung function.
Am Rev Respir Dis.
1992
;
145
(5):
1129
–1135
53
Li YF, Gilliand FD, Berhane K, et al. Effect of in utero and environmental tobacco smoke exposure on lung function in boys and girls with and without asthma.
Am J Respir Crit Care Med.
2000
;
162
:
2097
–2104
54
Taylor B, Wadsworth J. Maternal smoking during pregnancy and lower respiratory tract illness in early life.
Arch Dis Child.
1987
;
62
(8):
786
–791
55
Gilliland FD, Li YF, Peters JM. Effects of maternal smoking during pregnancy and environmental tobacco smoke on asthma and wheezing in children.
Am J Respir Crit Care Med.
2001
;
163
(2):
429
–436
56
Lieu JE, Feinstein AR. Effect of gestational and passive smoke exposure on ear infections in children.
Arch Pediatr Adolesc Med.
2002
;
156
(2):
147
–154
57
Stathis SL, O'Callaghan DM, Williams GM, Najman JM, Andersen MJ, Bor W. Maternal cigarette smoking during pregnancy is an independent predictor for symptoms of middle ear disease at five years' postdelivery.
Pediatrics.
1999
;
104
(2). Available at: www.pediatrics.org/cgi/content/full/104/2/e16
58
Fox NL, Sexton M, Hebel JR. Prenatal exposure to tobacco: I. Effects on physical growth at age three.
Int J Epidemiol.
1990
;
19
(1):
66
–71
59
Gatzke-Kopp LM, Beauchaine TP. Direct and passive prenatal nicotine exposure and the development of externalizing psychopathology.
Child Psychiatry Hum Dev.
2007
;
38
(4):
255
–269
60
Höök B, Cederblad M, Berg R. Prenatal and postnatal maternal smoking as risk factors for preschool children's mental health.
Acta Paediatr.
2006
;
95
(6):
671
–677
61
Markussen Linnet K, Obel C, Bonde E, et al. Cigarette smoking during pregnancy and hyperactive-distractible preschooler's: a follow-up study.
Acta Paediatr.
2006
;
95
(6):
694
–700
62
Batstra L, Hadders-Algra M, Neeleman J. Effect of antenatal exposure to maternal smoking on behavioral problems and academic achievement in childhood: prospective evidence from a Dutch birth cohort.
Early Hum Dev.
2003
;
75
(1–2):
21
–33
63
Brennan PA, Grekin ER, Mednick SA. Maternal smoking during pregnancy and adult male criminal outcomes.
Arch Gen Psychiatry.
1999
;
56
(3):
215
–219
64
Brennan PA, Grekin ER, Mortensen EL, Mednick SA. Relationship of maternal smoking during pregnancy with criminal arrest and hospitalization for substance abuse in male and female adult offspring.
Am J Psychiatry.
2002
;
159
(1):
48
–54
65
Brook JS, Brook DW, Whiteman M. The influence of maternal smoking during pregnancy on the toddler's negativity.
Arch Pediatr Adolesc Med.
2000
;
154
(4):
381
–385
66
Cornelius MD, Ryan CM, Day NL, Goldschmidt L, Willford JA. Prenatal tobacco effects on neuropsychological outcomes among preadolescents.
J Dev Behav Pediatr.
2001
;
22
(4):
217
–225
67
Day NL, Richardson GA, Goldschmidt L, Cornelius MD. Effects of prenatal tobacco exposure on preschoolers' behavior.
J Dev Behav Pediatr.
2000
;
21
(3):
180
–188
68
Ernst M, Moolchan ET, Robinson ML. Behavioral and neural consequences of prenatal exposure to nicotine.
J Am Acad Child Adolesc Psychiatry.
2001
;
40
(6):
630
–641
69
Eskenazi B, Castorina R. Association of prenatal maternal or postnatal child environmental tobacco smoke exposure and neurodevelopmental and behavioral problems in children.
Environ Health Perspect.
1999
;
107
(12):
991
–1000
70
Fergusson DM, Horwood LJ, Lynskey MT. Maternal smoking before and after pregnancy: effects on behavioral outcomes in middle childhood.
Pediatrics.
1993
;
92
(6):
815
–822
71
Fergusson DM, Woodward LJ, Horwood LJ. Maternal smoking during pregnancy and psychiatric adjustment in late adolescence.
Arch Gen Psychiatry.
1998
;
55
(8):
721
–727
72
Kahn RS, Khoury J, Nichols WC, Lanphear BP. Role of dopamine transporter genotype and maternal prenatal smoking in childhood hyperactive-impulsive, inattentive, and oppositional behaviors.
J Pediatr.
2003
;
143
(1):
104
–110
73
Kotimaa AJ, Moilanen I, Taanila A, et al. Maternal smoking and hyperactivity in 8-year-old children.
J Am Acad Child Adolesc Psychiatry.
2003
;
42
(7):
826
–833
74
Law KL, Stroud LR, LaGasse LL, Niaura R, Liu J, Lester BM. Smoking during pregnancy and newborn neurobehavior.
Pediatrics.
2003
;
111
(6 pt 1):
1318
–1323
75
Milberger S, Biederman J, Faraone SV, Chen L, Jones J. Is maternal smoking during pregnancy a risk factor for attention deficit hyperactivity disorder in children?
Am J Psychiatry.
1996
;
153
(9):
1138
–1142
76
Niaura R, Bock B, Lloyd EE, Brown R, Lipsitt LP, Buka S. Maternal transmission of nicotine dependence: psychiatric, neurocognitive and prenatal factors.
Am J Addict.
2001
;
10
(1):
16
–29
77
Räsänen P, Hakko H, Isohanni M, Hodgins S, Järvelin MR, Tiihonen J. Maternal smoking during pregnancy and risk of criminal behavior among adult male offspring in the Northern Finland 1966 Birth Cohort.
Am J Psychiatry.
1999
;
156
(6):
857
–862
78
Rauh VA, Whyatt RM, Garfinkel R, et al. Developmental effects of exposure to environmental tobacco smoke and material hardship among inner-city children.
Neurotoxicol Teratol.
2004
;
26
(3):
373
–385
79
Sexton M, Fox NL, Hebel JR. Prenatal exposure to tobacco: II. Effects on cognitive functioning at age three.
Int J Epidemiol.
1990
;
19
(1):
72
–77
80
Thapar A, Fowler T, Rice F, et al. Maternal smoking during pregnancy and attention deficit hyperactivity disorder symptoms in offspring.
Am J Psychiatry.
2003
;
160
(11):
1985
–1989
81
Wakschlag LS, Lahey BB, Loeber R, Green SM, Gordon RA, Leventhal BL. Maternal smoking during pregnancy and the risk of conduct disorder in boys.
Arch Gen Psychiatry.
1997
;
54
(7):
670
–676
82
Wakschlag LS, Hans SL. Maternal smoking during pregnancy and conduct problems in high-risk youth: a developmental framework.
Dev Psychopathol.
2002
;
14
(2):
351
–369
83
Wakschlag LS, Pickett KE, Cook E Jr, Benowitz NL, Leventhal BL. Maternal smoking during pregnancy and severe antisocial behavior in offspring: a review.
Am J Public Health.
2002
;
92
(6):
966
–974
84
Weissman MM, Warner V, Wickramaratne PJ, Kandel DB. Maternal smoking during pregnancy and psychopathology in offspring followed to adulthood.
J Am Acad Child Adolesc Psychiatry.
1999
;
38
(7):
892
–899
85
Weitzman M, Gortmaker S, Sobol A. Maternal smoking and behavior problems of children.
Pediatrics.
1992
;
90
(3):
342
–349
86
Weitzman M, Byrd RS, Aligne CA, Moss M. The effects of tobacco exposure on children's behavioral and cognitive functioning: implications for clinical and public health policy and future research.
Neurotoxicol Teratol.
2002
;
24
(3):
397
–406
87
Williams GM, O'Callaghan M, Najman JM, et al. Maternal cigarette smoking and child psychiatric morbidity: a longitudinal study.
Pediatrics.
1998
;
102
(1). Available at: www.pediatrics.org/cgi/content/full/102/1/e11
88
Key AP, Ferguson M, Molfese DL, Peach K, Lehman C, Molfese VJ. Smoking during pregnancy affects speech-processing ability in newborn infants.
Environ Health Perspect.
2007
;
115
(4):
623
–629
89
Vestergaard M, Wisborg K, Henriksen TB, Secher NJ, Ostergaard JR, Olsen J. Prenatal exposure to cigarettes, alcohol, and coffee and the risk for febrile seizures.
Pediatrics.
2005
;
116
(5):
1089
–1094
90
Buka SL, Shenassa ED, Niaura R. Elevated risk of tobacco dependence among offspring of mothers who smoked during pregnancy: a 30-year prospective study.
Am J Psychiatry.
2003
;
160
(11):
1978
–1984
91
Cornelius MD, Leech SL, Goldschmidt L, Day NL. Prenatal tobacco exposure: is it a risk factor for early tobacco experimentation?
Nicotine Tob Res.
2000
;
2
(1):
45
–52
92
Kandel DB, Udry JR. Prenatal effects of maternal smoking on daughters' smoking: nicotine or testosterone exposure?
Am J Public Health.
1999
;
89
(9):
1377
–1383
93
Reijneveld SA, Brugman E, Hirasing RA. Infantile colic: maternal smoking as potential risk factor.
Arch Dis Child.
2000
;
83
(4):
302
–303
94
Reijneveld SA, Lanting CI, Crone MR, Van Wouwe JP. Exposure to tobacco smoke and infant crying.
Acta Paediatr.
2005
;
94
(2):
217
–221
95
Søndergaard C, Henriksen TB, Obel C, Wisborg K. Smoking during pregnancy and infantile colic.
Pediatrics.
2001
;
108
(2):
342
–346
96
Canivet CA, Ostergren PO, Jakobsson IL, Dejin-Karlsson E, Hagander BM. Infantile colic, maternal smoking and infant feeding at 5 weeks of age.
Scand J Public Health.
2008
;
36
(3):
284
–291
97
Sørensen HT, Nørgård B, Pedersen L, Larsen H, Johnsen SP. Maternal smoking and risk of hypertrophic infantile pyloric stenosis: 10 year population based cohort study.
BMJ.
2002
;
325
(7371):
1011
–1012
98
Montgomery SM, Ekbom A. Smoking during pregnancy and diabetes mellitus in a British longitudinal birth cohort.
BMJ.
2002
;
324
(7328):
26
–27
99
Bahmanyar S, Montgomery SM, Weiss RJ, Ekbom A. Maternal smoking during pregnancy, other prenatal and perinatal factors, and the risk of Legg-Calvé-Perthes disease.
Pediatrics.
2008
;
122
(2). Available at: www.pediatrics.org/cgi/content/full/122/2/e459
100
Coghlin J, Gann PH, Hammond SK, et al. 4-Aminobiphenyl hemoglobin adducts in fetuses exposed to the tobacco smoke carcinogen in utero.
J Natl Cancer Inst.
1991
;
83
(4):
274
–280
101
John EM, Savitz DA, Sandler DP. Prenatal exposure to parents' smoking and childhood cancer.
Am J Epidemiol.
1991
;
133
(2):
123
–132
102
Pettersson A, Kaijser M, Richiardi L, Askling J, Ekbom A, Akre O. Women smoking and testicular cancer: one epidemic causing another?
Int J Cancer.
2004
;
109
(6):
941
–944
103
Sasco AJ, Vainio H. From in utero and childhood exposure to parental smoking to childhood cancer: a possible link and the need for action.
Hum Exp Toxicol.
1999
;
18
(4):
192
–201
104
Kulig M, Luck W, Lau S, et al. Effect of pre- and postnatal tobacco smoke exposure on specific sensitization to food and inhalant allergens during the first 3 years of life. Multicenter Allergy Study Group, Germany.
Allergy.
1999
;
54
(3):
220
–228
105
Kulig M, Luck W, Wahn U. The association between pre- and postnatal tobacco smoke exposure and allergic sensitization during early childhood. Multicenter Allergy Study Group, Germany.
Hum Exp Toxicol.
1999
;
18
(4):
241
–244
106
Office of Environmental Health Hazard Assessment, Air Resources Board, California Environmental Protection Agency.
Health Effects of Exposure to Environmental Tobacco Smoke.
Sacramento, CA: California Environmental Protection Agency, Office of Environmental Health Hazard Assessment;
1997
107
California Environmental Protection Agency, Air Resources Board, Office of Environmental Health Hazard Assessment.
Proposed Identification of Environmental Tobacco Smoke as a Toxic Air Contaminant. Executive Summary.
Sacramento, CA: California Environmental Protection Agency; 2005
108
California Environmental Protection Agency, Air Resources Board, Office of Environmental Health Hazard Assessment.
Proposed Identification of Environmental Tobacco Smoke as a Toxic Air Contaminant. Part A: Exposure Assessment.
Sacramento, CA: California Environmental Protection Agency; 2005
109
California Environmental Protection Agency, Air Resources Board, Office of Environmental Health Hazard Assessment.
Proposed Identification of Environmental Tobacco Smoke as a Toxic Air Contaminant. Part B: Health Effects.
Sacramento, CA: California Environmental Protection Agency; 2005
110
DiFranza JR, Lew RA. Morbidity and mortality in children associated with the use of tobacco products by other people.
Pediatrics.
1996
;
97
(4):
560
–568
111
Harlap S, Davies AM. Infant admissions to hospital and maternal smoking.
Lancet.
1974
;
1
(7857):
529
–532
112
Lam TH, Leung GM, Ho LM. The effects of environmental tobacco smoke on health services utilization in the first eighteen months of life.
Pediatrics.
2001
;
107
(6). Available at: www.pediatrics.org/cgi/content/full/107/6/e91
113
Rantakallio P. Relationship of maternal smoking to morbidity and mortality of the child up to the age of five.
Acta Paediatr Scand.
1978
;
67
(5):
621
–631
114
Stone RA, Wilson LB, Ying GS, et al. Associations between childhood refraction and parental smoking.
Invest Ophthalmol Vis Sci.
2006
;
47
(10):
4277
–4287
115
Rivkin MJ, Davis PE, Lemaster JL, et al. Volumetric MRI study of brain in children with intrauterine exposure to cocaine, alcohol, tobacco, and marijuana.
Pediatrics.
2008
;
121
(4):
741
–750
116
Jacobsen LK, Picciotto MR, Heath CJ, et al. Prenatal and adolescent exposure to tobacco smoke modulates the development of white matter microstructure.
J Neurosci.
2007
;
27
(49):
13491
–13498
117
Carmichael SL, Ma C, Rasmussen SA, Honein MA, Lammer EJ, Shaw GM. Craniosynostosis and maternal smoking.
Birth Defects Res A Clin Mol Teratol.
2008
;
82
(2):
78
–85
118
Perera FP, Tang D, Rauh V, et al. Relationship between polycyclic aromatic hydrocarbon-DNA adducts, environmental tobacco smoke, and child development in the World Trade Center cohort.
Environ Health Perspect.
2007
;
115
(10):
1497
–1502
119
Amir LH. Maternal smoking and reduced duration of breastfeeding: a review of possible mechanisms.
Early Hum Dev.
2001
;
64
(1):
45
–67
120
Amir LH, Donath SM. Does maternal smoking have a negative physiologic effect on breastfeeding? The epidemiologic evidence.
Breastfeed Rev.
2003
;
11
(2):
19
–29
121
Di Napoli A, Di Lallo D, Pezzotti P, Forastiere F, Porta D. Effects of parental smoking and level of education on initiation and duration of breastfeeding.
Acta Paediatr.
2006
;
95
(6):
678
–685
122
Liu J, Rosenberg KD, Sandoval AP. Breastfeeding duration and perinatal cigarette smoking in a population-based cohort.
Am J Public Health.
2006
;
96
(2):
309
–314
123
Horta BL, Kramer MS, Platt RW. Maternal smoking and the risk of early weaning: a meta-analysis.
Am J Public Health.
2001
;
91
(2):
304
–307
124
Jedrychowski W, Perera F, Mroz E, et al. Prenatal exposure to passive smoking and duration of breastfeeding in nonsmoking women: Krakow inner city prospective cohort study.
Arch Gynecol Obstet.
2008
;
278
(5):
411
–417
125
Matheson I, Rivrud GN. The effect of smoking on lactation and infantile colic.
JAMA.
1989
;
261
(1):
42
–43
126
Laurberg P, Nohr SB, Pedersen KM, Fuglsang E. Iodine nutrition in breastfed infants is impaired by maternal smoking.
J Clin Endocrinol Metab.
2004
;
89
(1):
181
–187
127
Berkey CS, Ware JH, Dockery DW, Ferris BG Jr, Speizer FE. Indoor air pollution and pulmonary function growth in preadolescent children.
Am J Epidemiol.
1986
;
123
(2):
250
–260
128
Burchfiel CM, Higgins MW, Keller JB, Howatt WF, Butler WJ, Higgins IT. Passive smoking in childhood: respiratory conditions and pulmonary function in Tecumseh, Michigan.
Am Rev Respir Dis.
1986
;
133
(6):
966
–973
129
Chen Y, Li WX, Yu SZ, Qian WH. Chang-Ning epidemiologic study of children's health: I. Passive smoking and children's respiratory diseases.
Int J Epidemiol.
1988
;
17
(2):
348
–355
130
Colley JR, Holland WW, Corkhill RT. Influence of passive smoking and parental phlegm on pneumonia and bronchitis in early childhood.
Lancet.
1974
;
2
(7888):
1031
–1034
131
Cook DG, Strachan DP. Parental smoking, bronchial reactivity and peak flow variability in children.
Thorax.
1998
;
53
(4):
295
–301
132
Cook DG, Strachan DP, Carey IM. Health effects of passive smoking: 9. Parental smoking and spirometric indices in children.
Thorax.
1998
;
53
(10):
884
–893
133
Corbo GM, Agabiti N, Forastiere F, et al. Lung function in children and adolescents with occasional exposure to environmental tobacco smoke.
Am J Respir Crit Care Med.
1996
;
154
(3 pt 1):
695
–700
134
Ekwo EE, Weinberger MM, Lachenbruch PA, Huntley WH. Relationship of parental smoking and gas cooking to respiratory disease in children.
Chest.
1983
;
84
(6):
662
–668
135
Fergusson DM, Horwood LJ. Parental smoking and respiratory illness during early childhood: a six-year longitudinal study.
Pediatr Pulmonol.
1985
;
1
(2):
99
–106
136
Ferris BG Jr, Ware JH, Berkey CS, Dockery DW, Spiro A 3rd, Speizer FE. Effects of passive smoking on health of children.
Environ Health Perspect.
1985
;
62
:
289
–295
137
Gergen PJ, Fowler JA, Maurer KR, Davis WW, Overpeck MD. The burden of environmental tobacco smoke exposure on the respiratory health of children 2 months through 5 years of age in the United States: Third National Health and Nutrition Examination Survey, 1988 to 1994.
Pediatrics.
1998
;
101
(2). Available at: www.pediatrics.org/cgi/content/full/101/2/e8
138
Li YF, Gilliland FD, Berhane K, et al. Effects of in utero and environmental tobacco smoke exposure on lung function in boys and girls with and without asthma.
Am J Respir Crit Care Med.
2000
;
162
(6):
2097
–2104
139
Mannino DM, Moorman JE, Kinglsey B, Rose D, Repace J. Health effects related to environmental tobacco smoke exposure in children in the United States: data from the Third National Health and Nutrition Examination Survey.
Arch Pediatr Adolesc Med.
2001
;
155
(1):
36
–41
140
Mannino DM, Homa DM, Redd SC. Involuntary smoking and asthma severity in children: data from the Third National Health and Nutrition Examination Survey.
Chest.
2002
;
122
(2):
409
–415
141
Margolis PA, Keyes LL, Greenberg RA, Bauman KE, LaVange LM. Urinary cotinine and parent history (questionnaire) as indicators of passive smoking and predictors of lower respiratory illness in infants.
Pediatr Pulmonol.
1997
;
23
(6):
417
–423
142
Nafstad P, Kongerud J, Botten G, Hagen JA, Jaakkola JJ. The role of passive smoking in the development of bronchial obstruction during the first 2 years of life.
Epidemiology.
1997
;
8
(3):
293
–297
143
Schulte-Hobein B, Schwartz-Bickenbach D, Abt S, Plum C, Nau H. Cigarette smoke exposure and development of infants throughout the first year of life: influence of passive smoking and nursing on cotinine levels in breast milk and infant's urine.
Acta Paediatr.
1992
;
81
(6–7):
550
–557
144
Sheikh S, Goldsmith LJ, Howell L, Parry L, Eid N. Comparison of lung function in infants exposed to maternal smoking and in infants with a family history of asthma.
Chest.
1999
;
116
(1):
52
–58
145
Somerville SM, Rona RJ, Chinn S. Passive smoking and respiratory conditions in primary school children.
J Epidemiol Community Health.
1988
;
42
(2):
105
–110
146
Strachan DP, Cook DG. Health effects of passive smoking: 1. Parental smoking and lower respiratory illness in infancy and early childhood.
Thorax.
1997
;
52
(10):
905
–914
147
Strachan DP, Cook DG. Health effects of passive smoking: 5. Parental smoking and allergic sensitization in children.
Thorax.
1998
;
53
(2):
117
–123
148
Tager IB, Weiss ST, Munoz A, Rosner B, Speizer FE. Longitudinal study of the effects of maternal smoking on pulmonary function in children.
N Engl J Med.
1983
;
309
(12):
699
–703
149
US Environmental Protection Agency.
Respiratory Health Effects of Passive Smoking: Lung Cancer and Other Disorders.
Washington, DC: US Environmental Protection Agency, Office of Research and Development, Office of Air and Radiation;
1992
150
Wang X, Wypij D, Gold DR, et al. A longitudinal study of the effects of parental smoking on pulmonary function in children 6–18 years.
Am J Respir Crit Care Med.
1994
;
149
(6):
1420
–1425
151
Ware JH, Dockery DW, Spiro A 3rd, Speizer FE, Ferris BG Jr. Passive smoking, gas cooking, and respiratory health of children living in six cities.
Am Rev Respir Dis.
1984
;
129
(3):
366
–374
152
Wright AL, Holberg C, Martinez FD, Taussig LM. Relationship of parental smoking to wheezing and nonwheezing lower respiratory tract illnesses in infancy. Group Health Medical Associates.
J Pediatr.
1991
;
118
(2):
207
–214
153
Mennella JA, Yourshaw LM, Morgan LK. Breastfeeding and smoking: short-term effects on infant feeding and sleep.
Pediatrics.
2007
;
120
(3):
497
–502
154
Weiss ST, Tager IB, Speizer FE, Rosner B. Persistent wheeze: its relation to respiratory illness, cigarette smoking, and level of pulmonary function in a population sample of children.
Am Rev Respir Dis.
1980
;
122
(5):
697
–707
155
Cook DG, Strachan DP. Health effects of passive smoking: 3. Parental smoking and prevalence of respiratory symptoms and asthma in school age children.
Thorax.
1997
;
52
(12):
1081
–1094
156
Dodge R. The effects of indoor pollution on Arizona children.
Arch Environ Health.
1982
;
37
(3):
151
–155
157
Lebowitz MD, Burrows B. Respiratory symptoms related to smoking habits of family adults.
Chest.
1976
;
69
(1):
48
–50
158
Carroll KN, Gebretsadik T, Griffin MR, et al. Maternal asthma and maternal smoking are associated with increased risk of bronchiolitis during infancy.
Pediatrics.
2007
;
119
(6):
1104
–1112
159
Vork KL, Broadwin RL, Blaisdell RJ. Developing asthma in childhood from exposure to secondhand tobacco smoke: insights from a meta-regression.
Environ Health Perspect.
2007
;
115
(10):
1394
–1400
160
Adair-Bischoff CE, Sauve RS. Environmental tobacco smoke and middle ear disease in preschool-aged children.
Arch Pediatr Adolesc Med.
1998
;
152
(2):
127
–133
161
Bland M, Bewley BR, Pollard V, Banks MH. Effect of children's and parents' smoking on respiratory symptoms.
Arch Dis Child.
1978
;
53
(2):
100
–105
162
Chilmonczyk BA, Salmun LM, Megathlin KN, et al. Association between exposure to environmental tobacco smoke and exacerbations of asthma in children.
N Engl J Med.
1993
;
328
(23):
1665
–1669
163
Colley JR. Respiratory symptoms in children and parental smoking and phlegm production.
Br Med J.
1974
;
2
(912):
201
–204
164
Ehrlich R, Kattan M, Godbold J, et al. Childhood asthma and passive smoking: urinary cotinine as a biomarker of exposure.
Am Rev Respir Dis.
1992
;
145
(3):
594
–599
165
Etzel RA, Pattishall EN, Haley NJ, Fletcher RH, Henderson FW. Passive smoking and middle ear effusion among children in day care.
Pediatrics.
1992
;
90
(2 pt 1):
228
–232
166
Evans D, Levison MJ, Feldman CH, et al. The impact of passive smoking on emergency department visits of urban children with asthma.
Am Rev Respir Dis.
1987
;
135
(3):
567
–572
167
Ey JL, Holberg CJ, Aldous MB, Wright AL, Martinez FD, Taussig LM. Passive smoke exposure and otitis media in the first year of life. Group Health Medical Associates.
Pediatrics.
1995
;
95
(5):
670
–677
168
Hinton AE, Herdman RC, Martin-Hirsch D, Saeed SR. Parental cigarette smoking and tonsillectomy in children.
Clin Otolaryngol.
1993
;
18
(3):
178
–180
169
Maier WC, Arrighi HM, Morray B, Llewellyn C, Redding GJ. Indoor risk factors for asthma and wheezing among Seattle school children.
Environ Health Perspect.
1997
;
105
(2):
208
–214
170
Martinez FD, Cline M, Burrows B. Increased incidence of asthma in children of smoking mothers.
Pediatrics.
1992
;
89
(1):
21
–26
171
Murray AB, Morrison BJ. The effect of cigarette smoke from the mother on bronchial responsiveness and severity of symptoms in children with asthma.
J Allergy Clin Immunol.
1986
;
77
(4):
575
–581
172
Murray AB, Morrison BJ. Passive smoking by asthmatics: its greater effect on boys than on girls and on older than on younger children.
Pediatrics.
1989
;
84
(3):
451
–459
173
Murray AB, Morrison BJ. The decrease in severity of asthma in children of parents who smoke since the parents have been exposing them to less cigarette smoke.
J Allergy Clin Immunol.
1993
;
91
(1 pt 1):
102
–110
174
O'Connell EJ, Logan GB. Parental smoking in childhood asthma.
Ann Allergy.
1974
;
32
(3):
142
–145
175
O'Connor GT, Weiss ST, Tager IB, Speizer FE. The effect of passive smoking on pulmonary function and nonspecific bronchial responsiveness in a population based sample of children and young adults.
Am Rev Respir Dis.
1987
;
135
(4):
800
–804
176
Oldigs M, Jorres R, Magnussen H. Acute effect of passive smoking on lung function and airway responsiveness in asthmatic children.
Pediatr Pulmonol.
1991
;
10
(2):
123
–131
177
Owen MJ, Baldwin CD, Swank PR, Pannu AK, Johnson DL, Howie VM. Relation of infant feeding practices, cigarette smoke exposure, and group child care to the onset and duration of otitis media with effusion in the first two years of life.
J Pediatr.
1993
;
123
(5):
702
–711
178
Rowe-Jones JM, Brockbank MJ. Parental smoking and persistent otitis media with effusion in children.
Int J Pediatr Otorhinolaryngol.
1992
;
24
(1):
19
–24
179
Said G, Zalokar J, Lellouch J, Patois E. Adenoidectomy and tonsillectomy in children and parental smoking.
Lancet.
1977
;
1
(8015):
797
180
Said G, Zalokar J, Lellouch J, Patois E. Parental smoking related to adenoidectomy and tonsillectomy in children.
J Epidemiol Community Health.
1978
;
32
(2):
97
–101
181
Sherman CB, Tosteson TD, Tager IB, Speizer FE, Weiss ST. Early childhood predictors of asthma.
Am J Epidemiol.
1990
;
132
(1):
83
–95
182
Ståhlberg MR, Ruuskanen O, Virolainen E. Risk factors for recurrent otitis media.
Pediatr Infect Dis.
1986
;
5
(1):
30
–32
183
Strachan DP, Jarvis MJ, Feyerabend C. Passive smoking, salivary cotinine concentrations, and middle ear effusion in 7 year old children.
BMJ.
1989
;
298
(6687):
1549
–1552
184
Strachan DP, Cook DG. Health effects of passive smoking: 6. Parental smoking and childhood asthma: longitudinal and case-control studies.
Thorax.
1998
;
53
(3):
204
–212
185
Weitzman M, Gortmaker S, Walker DK, Sobol A. Maternal smoking and childhood asthma.
Pediatrics.
1990
;
85
(4):
505
–511
186
Adair-Bischoff CE, Sauve RS, Kimberley B, Brant R. Smoking and middle ear disease.
Otolaryngol Head Neck Surg.
1996
;
114
(6):
837
–840
187
Black N. The etiology of glue ear: a case-control study.
Int J Pediatr Otorhinolaryngol.
1985
;
9
(2):
121
–133
188
Brook I, Gober AE. Recovery of potential pathogens and interfering bacteria in the nasopharynx of otitis media-prone children and their smoking and nonsmoking parents.
Arch Otolaryngol Head Neck Surg.
2005
;
131
(6):
509
–512
189
Charlton A. Children's coughs related to parental smoking.
Br Med J (Clin Res Ed).
1984
;
288
(6431):
1647
–1649
190
Kraemer MJ, Richardson MA, Weiss NS, et al. Risk factors for persistent middle-ear effusions: otitis media, catarrh, cigarette smoke exposure, and atopy.
JAMA.
1983
;
249
(8):
1022
–1025
191
Strachan DP, Cook DG. Health effects of passive smoking: 4. Parental smoking, middle ear disease and adenotonsillectomy in children.
Thorax.
1998
;
53
(1):
50
–56
192
De S, Fenton JE, Jones AS, Clarke RW. Passive smoking, allergic rhinitis and nasal obstruction in children.
J Laryngol Otol.
2005
;
119
(12):
955
–957
193
Hinton AE. Surgery for otitis media with effusion in children and its relationship to parental smoking.
J Laryngol Otol.
1989
;
103
(6):
559
–561
194
Ilicali OC, Keles N, De er K, Sa un OF, Guldiken Y. Evaluation of the effect of passive smoking on otitis media in children by an objective method: urinary cotinine analysis.
Laryngoscope.
2001
;
111
(1):
163
–167
195
Lakshmipathy N, Bokesch PM, Cowen DE, Lisman SR, Schmid CH. Environmental tobacco smoke: a risk factor for pediatric laryngospasm.
Anesth Analg.
1996
;
82
(4):
724
–727
196
Lyons B, Frizelle H, Kirby F, Casey W. The effect of passive smoking on the incidence of airway complications in children undergoing general anaesthesia.
Anaesthesia.
1996
;
51
(4):
324
–326
197
Koop CE. Adverse anesthesia events in children exposed to environmental tobacco smoke: exposure to environmental tobacco smoke and the risk of adverse respiratory events in children receiving general anesthesia.
Anesthesiology.
1998
;
88
(5):
1141
–1142
198
Skolnick ET, Vomvolakis MA, Buck KA, Mannino SF, Sun LS. Exposure to environmental tobacco smoke and the risk of adverse respiratory events in children receiving general anesthesia.
Anesthesiology.
1998
;
88
(5):
1144
–1153
199
Drongowski RA, Lee D, Reynolds PI, et al. Increased respiratory symptoms following surgery in children exposed to environmental tobacco smoke.
Paediatr Anaesth.
2003
;
13
(4):
304
–310
200
Kriz P, Bobak M, Kriz B. Parental smoking, socioeconomic factors, and risk of invasive meningococcal disease in children: a population based case-control study.
Arch Dis Child.
2000
;
83
(2):
117
–121
201
Stanwell-Smith RE, Stuart JM, Hughes AO, Robinson P, Griffin MB, Cartwright K. Smoking, the environment and meningococcal disease: a case control study.
Epidemiol Infect.
1994
;
112
(2):
315
–328
202
den Boon S, Verver S, Marais BJ, et al. Association between passive smoking and infection with Mycobacterium tuberculosis in children.
Pediatrics.
2007
;
119
(4):
734
–739
203
Goodman KJ, Cockburn M. Parental smoking and Helicobacter pylori in children.
Epidemiology.
1999
;
10
(5):
564
–566
204
Cockburn M, Goodman KJ. Parental smoking and infection with Helicobacter pylori among preschool children.
Epidemiology.
2000
;
11
(2):
230
–232
205
Anderson LJ, Parker RA, Strikas RA, et al. Day-care center attendance and hospitalization for lower respiratory tract illness.
Pediatrics.
1988
;
82
(3):
300
–308
206
Berg AT, Shapiro ED, Capobianco LA. Group day care and the risk of serious infectious illnesses.
Am J Epidemiol.
1991
;
133
(2):
154
–163
207
Hall CB, Hall WJ, Gala CL, MaGill FB, Leddy JP. Long-term prospective study in children after respiratory syncytial virus infection.
J Pediatr.
1984
;
105
(3):
358
–364
208
Pullan CR, Hey EN. Wheezing, asthma, and pulmonary dysfunction 10 years after infection with respiratory syncytial virus in infancy.
Br Med J (Clin Res Ed).
1982
;
284
(6330):
1665
–1669
209
Shenassa ED, Brown MJ. Maternal smoking and infantile gastrointestinal dysregulation: the case of colic.
Pediatrics.
2004
;
114
(4). Available at: www.pediatrics.org/cgi/content/full/114/4/e497
210
Alaswad B, Toubas PL, Grunow JE. Environmental tobacco smoke exposure and gastroesophageal reflux in infants with apparent life-threatening events.
J Okla State Med Assoc.
1996
;
89
(7):
233
–237
211
Kadakia SC, Kikendall JW, Maydonovitch C, Johnson LF. Effect of cigarette smoking on gastroesophageal reflux measured by 24-hour ambulatory esophageal pH monitoring.
Am J Gastroenterol.
1995
;
90
(10):
1785
–1790
212
Holl RW, Grabert M, Heinze E, Debatin KM. Objective assessment of smoking habits by urinary cotinine measurement in adolescents and young adults with type 1 diabetes: reliability of reported cigarette consumption and relationship to urinary albumin excretion.
Diabetes Care.
1998
;
21
(5):
787
–791
213
Bauman KE, Flewelling RL, LaPrelle J. Parental cigarette smoking and cognitive performance of children.
Health Psychol.
1991
;
10
(4):
282
–288
214
Burdette HL, Whitaker RC, Harvey-Berino J, Kahn RS. Depressive symptoms in low-income mothers and emotional and social functioning in their preschool children.
Ambul Pediatr.
2003
;
3
(6):
288
–294
215
Aligne CA, Moss ME, Auinger P, Weitzman M. Association of pediatric dental caries with passive smoking.
JAMA.
2003
;
289
(10):
1258
–1264
216
Arbes SJ Jr, Agustsdottir H, Slade GD. Environmental tobacco smoke and periodontal disease in the United States.
Am J Public Health.
2001
;
91
(2):
253
–257
217
Gilliland FD, Berhane K, Islam T, et al. Environmental tobacco smoke and absenteeism related to respiratory illness in schoolchildren.
Am J Epidemiol.
2003
;
157
(10):
861
–869
218
Mannino DM, Siegel M, Husten C, Rose D, Etzel R. Environmental tobacco smoke exposure and health effects in children: results from the 1991 National Health Interview Survey.
Tob Control.
1996
;
5
(1):
13
–18
219
Jendryczko A, Szpyrka G, Gruszczynski J, Kozowicz M. Cigarette smoke exposure of school children: effect of passive smoking and vitamin E supplementation on blood antioxidant status.
Neoplasma.
1993
;
40
(3):
199
–203
220
Sandler DP, Everson RB, Wilcox AJ, Browder JP. Cancer risk in adulthood from early life exposure to parents' smoking.
Am J Public Health.
1985
;
75
(5):
487
–492
221
Sandler DP, Wilcox AJ, Everson RB. Cumulative effects of lifetime passive smoking on cancer risk.
Lancet.
1985
;
1
:
312
–315
222
Tang D, Warburton D, Tannenbaum SR, et al. Molecular and genetic damage from environmental tobacco smoke in young children.
Cancer Epidemiol Biomarkers Prev.
1999
;
8
(5):
427
–431
223
Bricker JB, Leroux BG, Peterson AV Jr, et al. Nine-year prospective relationship between parental smoking cessation and children's daily smoking.
Addiction.
2003
;
98
(5):
585
–593
224
Chassin L, Presson C, Rose J, Sherman SJ, Prost J. Parental smoking cessation and adolescent smoking.
J Pediatr Psychol.
2002
;
27
(6):
485
–496
225
Distefan JM, Gilpin EA, Choi WS, Pierce JP. Parental influences predict adolescent smoking in the United States, 1989–1993.
J Adolesc Health.
1998
;
22
(6):
466
–474
226
Sargent JD, Dalton M. Does parental disapproval of smoking prevent adolescents from becoming established smokers?
Pediatrics.
2001
;
108
(6):
1256
–1262
227
Copeland AR. Accidental fire deaths: the 5-year Metropolitan Dade Country experience from 1979 until 1983.
Z Rechtsmed.
1985
;
94
(1):
71
–79
228
Leistikow BN, Martin DC, Milano CE. Fire injuries, disasters, and costs from cigarettes and cigarette lights: a global overview.
Prev Med.
2000
;
31
(2 pt 1):
91
–99
229
Miller AL.
The US Smoking-Material Fire Problem Through 1990: The Role of Lighted Tobacco Products in Fire.
Quincy, MA: National Fire Protection Association;
1993
230
Runyan CW, Bangdiwala SI, Linzer MA, Sacks JJ, Butts J. Risk factors for fatal residential fires.
N Engl J Med.
1992
;
327
(12):
859
–863
231
Squires T, Busuttil A. Can child fatalities in house fires be prevented?
Inj Prev.
1996
;
2
(2):
109
–113
232
Tager IB. The effects of second-hand and direct exposure to tobacco smoke on asthma and lung function in adolescence.
Paediatr Respir Rev.
2008
;
9
(1):
29
–37
233
Jaddoe VW, de Ridder MA, van den Elzen AP, Hofman A, Uiterwaal CS, Witteman JC. Maternal smoking in pregnancy is associated with cholesterol development in the offspring: a 27-years follow-up study.
Atherosclerosis.
2008
;
196
(1):
42
–48
234
Xiao D, Huang X, Lawrence J, Yang S, Zhang L. Fetal and neonatal nicotine exposure differentially regulates vascular contractility in adult male and female offspring.
J Pharmacol Exp Ther.
2007
;
320
(2):
654
–661
235
Strohsnitter WC, Hatch EE, Hyer M, et al. The association between in utero cigarette smoke exposure and age at menopause.
Am J Epidemiol.
2008
;
167
(6):
727
–733
236
Celermajer DS, Adams MR, Clarkson P, et al. Passive smoking and impaired endothelium-dependent arterial dilatation in healthy young adults.
N Engl J Med.
1996
;
334
(3):
150
–154
237
Feldman J, Shenker IR, Etzel RA, et al. Passive smoking alters lipid profiles in adolescents.
Pediatrics.
1991
;
88
(2):
259
–264
238
Moskowitz WB, Mosteller M, Schieken RM, et al. Lipoprotein and oxygen transport alterations in passive smoking preadolescent children: the MCV twin study.
Circulation.
1990
;
81
(2):
586
–592
239
Larsson ML, Frisk M, Hallstrom J, Kiviloog J, Lundback B. Environmental tobacco smoke exposure during childhood is associated with increased prevalence of asthma in adults.
Chest.
2001
;
120
(3):
711
–717
240
David GL, Koh WP, Lee HP, Yu MC, London SJ. Childhood exposure to environmental tobacco smoke and chronic respiratory symptoms in nonsmoking adults: the Singapore Chinese Health Study.
Thorax.
2005
;
60
(12):
1052
–1058
241
Stockwell HG, Goldman AL, Lyman GH, et al. Environmental tobacco smoke and lung cancer risk in nonsmoking women.
J Natl Cancer Inst.
1992
;
84
(18):
1417
–1422
242
Asomaning K, Miller DP, Liu G, et al. Second hand smoke, age of exposure and lung cancer risk.
Lung Cancer.
2008
;
61
(1):
13
–20
243
Meeker JD, Missmer SA, Cramer DW, Hauser R. Maternal exposure to second-hand tobacco smoke and pregnancy outcome among couples undergoing assisted reproduction.
Hum Reprod.
2007
;
22
(2):
337
–345
244
Meeker JD, Missmer SA, Vitonis AF, Cramer DW, Hauser R. Risk of spontaneous abortion in women with childhood exposure to parental cigarette smoke.
Am J Epidemiol.
2007
;
166
(5):
571
–575