Passive smoking and children

1. Passive smokingPassive smoking
and childrenand children
Dr. Khaled Mahmoud Abd ElazizDr. Khaled Mahmoud Abd Elaziz
Assistant Professor of public healthAssistant Professor of public health
and preventive medicineand preventive medicine
Faculty of Medicine- Ain ShamsFaculty of Medicine- Ain Shams
UniversityUniversity

2. This lecture will cover the followingThis lecture will cover the following
itemsitems
 Passive smoking and children:Passive smoking and children:
Environmental Tobacco Smoke ETSEnvironmental Tobacco Smoke ETS
 Epidemiology of smoking in EgyptEpidemiology of smoking in Egypt
 Health effects of passive smokingHealth effects of passive smoking
 Measurement and diagnosisMeasurement and diagnosis

3. Tobacco smokingTobacco smoking
is a major publicis a major public
health problem inhealth problem in
EgyptEgypt

4. Why smoking is a public health problemWhy smoking is a public health problem
Figures talk:Figures talk:
Almost half of Egyptian men smokeAlmost half of Egyptian men smoke
(44.4%)(44.4%)
Death rates attributed to smoking is veryDeath rates attributed to smoking is very
high 893 per 100.000 deathshigh 893 per 100.000 deaths

5. Why smoking is a public health problemWhy smoking is a public health problem
Figures talk:Figures talk:
Among females also high 4.8% among youthAmong females also high 4.8% among youth
20 to 29% smoke and starting smoking at20 to 29% smoke and starting smoking at
the age of 11 years.the age of 11 years.
At least 29% of the children are exposed atAt least 29% of the children are exposed at
their home for passive smoking putting themtheir home for passive smoking putting them
at risk of developing health hazards ofat risk of developing health hazards of
active smokers.active smokers.

6. Efforts were done by MOH in previousEfforts were done by MOH in previous
campaignscampaigns
(Your health … Your wealth) health education(Your health … Your wealth) health education
campaign to reduce smokingcampaign to reduce smoking
 the message was directed to not exposingthe message was directed to not exposing
children and pregnant women to tobaccochildren and pregnant women to tobacco
smoking as a step all Egyptians can take forsmoking as a step all Egyptians can take for
the health of their familiesthe health of their families

8. Effects of smoking on childrenEffects of smoking on children
2525 effects published in literatureeffects published in literature
Before life (pregnancy) active smokingBefore life (pregnancy) active smoking
1-Smoking with pregnancy is associated with 10%1-Smoking with pregnancy is associated with 10%
increase in perinatal mortality.increase in perinatal mortality.
2-premature labour2-premature labour
3-placental abruption3-placental abruption
4-congenital damage to developing respiratory4-congenital damage to developing respiratory
systemsystem
5-immunosuppression of the infant5-immunosuppression of the infant
6-mild neurodevelopmental handicap6-mild neurodevelopmental handicap

9. Effects of smoking on childrenEffects of smoking on children
Poor growthPoor growth
7-Lower birth weight of infants of smoker7-Lower birth weight of infants of smoker
mothersmothers
8-Studies have shows short stunted growth8-Studies have shows short stunted growth
for children born to smoker mothers (shorterfor children born to smoker mothers (shorter
children compared to non smoker mothers)children compared to non smoker mothers)
9-Negative correlation between attained9-Negative correlation between attained
height and the no. of cigarettes smoked byheight and the no. of cigarettes smoked by
mothers.mothers.

11. Respiratory illnessRespiratory illness::
10-10-Parental smoking has been shown to
enhance allergic sensitization in infants and
school children with a close family history of
atopic disease
11-increased number of lower RTI of infants11-increased number of lower RTI of infants
of smoker mothersof smoker mothers
12-children exposed to ETS have more12-children exposed to ETS have more
liability to RTIliability to RTI

12. Respiratory illnessRespiratory illness::
13- Persistent middle Ear effusion (glue ear)–13- Persistent middle Ear effusion (glue ear)–
lead to deafness– delayed languagelead to deafness– delayed language
developmentdevelopment
14- viral respiratory tract infections14- viral respiratory tract infections
15-Increased incidence of tonsillectomy and15-Increased incidence of tonsillectomy and
adenoidectomy (repeated infections)adenoidectomy (repeated infections)
With smoker parents the rate of removal ofWith smoker parents the rate of removal of
tonsils and adenoids 51% compared to 28%tonsils and adenoids 51% compared to 28%
among non smoker parentsamong non smoker parents
16-Abnormality of leucocytic function16-Abnormality of leucocytic function

13. Respiratory illnessRespiratory illness::
17- increased hospital admission with17- increased hospital admission with
bronchitisbronchitis
18-increased hospital admission with18-increased hospital admission with
pneumoniapneumonia
Annual incidence with non smoking 7.9%Annual incidence with non smoking 7.9%
With one smoking parent 11.4%With one smoking parent 11.4%
With both smoking parents 17.6%With both smoking parents 17.6%

15. Atopy and asthmaAtopy and asthma
19- Higher prevalence of asthma with parental19- Higher prevalence of asthma with parental
smokingsmoking
20-Higher visits to emergency units in cases20-Higher visits to emergency units in cases
with childhood asthmawith childhood asthma
21-Asthmatic children with smoking mother21-Asthmatic children with smoking mother
have 13-23% lower lung function indiceshave 13-23% lower lung function indices
22-airway growth is adversely correlated with22-airway growth is adversely correlated with
passive smoking at homepassive smoking at home
23-Wheezing illnesses23-Wheezing illnesses

17. Coronary heart diseaseCoronary heart disease
24- Reduction of HDL of children with parental24- Reduction of HDL of children with parental
smoking by 11.2%smoking by 11.2%
(saving the best for last)(saving the best for last)
25-Sudden infant death syndrome25-Sudden infant death syndrome
Is defined as sudden death of an infant thatIs defined as sudden death of an infant that
could not be explained by clinical or autopsycould not be explained by clinical or autopsy
findings. (27% of deaths of infants betweenfindings. (27% of deaths of infants between
1 week and 1 year of age is attributed to1 week and 1 year of age is attributed to
smoking)smoking)

18. 19-Sudden infant death syndrome19-Sudden infant death syndrome
Why smoking is associated with SIDSWhy smoking is associated with SIDS
Some explanationSome explanation
It may be that smoking is associated with
abnormalities in brain development and that
one manifestation of this might be a
tendency to central apnea.

20. Policies to combat tobacco use
1-Increase taxation and tobacco companies
litigation.
2-Stop smuggling
3-Ban advertisement (Direct and indirect)
4-Ban smoking in public places and
implement
5-Religious Fatwas
6-Mass education at media, schools and
hospitals

21. Tobacco prevention success requires;Tobacco prevention success requires;
 long-term cooperative partnerships.long-term cooperative partnerships.
Government roleGovernment role
strong political commitmentstrong political commitment
 presidental, ministreal leadershippresidental, ministreal leadership
 multinational agreementsmultinational agreements

22. Role of the mediaRole of the media
Support and challenge humanSupport and challenge human
resourcesresources
 Political support/ change of normsPolitical support/ change of norms
 Multinational collaborationMultinational collaboration
NGO’sNGO’s
Continuous strong advocacyContinuous strong advocacy
 Real-time surveillanceReal-time surveillance
 Internet organization toolsInternet organization tools

23. THANK YOU