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Monatsschrift Kinderheilkunde

, Volume 160, Issue 5, pp 447–454 | Cite as

Tabakrauchexposition von Kindern und Jugendlichen

Folgen und Präventionsstrategien
  • A. Zacharasiewicz
  • F. Horak
  • T. Fazekas
  • J. Riedler
Leitthema

Zusammenfassung

Es wird versucht, in möglichst prägnanter Form die wesentlichen Schadwirkungen durch Tabakrauchexposition auf die Gesundheit von Kindern und Jugendlichen zu beschreiben, Präventionsstrategien vorzuschlagen, um diese vor den Auswirkungen des Tabakrauchs zu schützen, und die wichtige Rolle des Pädiaters hierbei hervorzuheben. Passivrauchexposition, „third hand smoking“ und aktives Rauchen bedrohen in vielfältiger Weise die Gesundheit von Kindern und Jugendlichen. Präpartale Schädigungen im Sinne des fetalen Tabaksyndroms werden ebenso wie die postpartalen Folgen beschrieben. Präventionsmaßnahmen für Jugendliche sind von entscheidender Bedeutung, um den besonders gefährlichen frühen Einstieg zu verhindern. Schutz unserer Patienten vor Tabakrauch muss ein fester Bestandteil der Aufklärung von Eltern und Erziehungsberechtigten sein. Der Stellenwert des Pädiaters bei der Tabakprävention kann dabei nicht deutlich genug hervorgehoben werden.

Schlüsselwörter

Tabakexposition Rauchen Fetales Tabaksyndrom Tabakprävention Kinder 

Tobacco smoke exposure in children and adolescents

Effects and preventive strategies

Abstract

The aim is to describe the main detrimental effects of tobacco exposure on the health of children and adolescents in a concise manner, to suggest prevention strategies to protect children and adolescents against these effects and to stress the important role of pediatricians regarding protection from these harmful effects. Secondary and tertiary smoke exposure as well as active smoking threaten the health of children and adolescents in many different ways. Prenatal damage, such as the fetal tobacco syndrome and postnatal effects are described. Smoking prevention strategies for adolescents are crucial especially in order to prevent the particularly dangerous early start of smoking. Protection from tobacco exposure for patients has to be a permanent part of every consultation with parents and caregivers. The pediatrician plays a key role in tobacco prevention.

Keywords

Environmental tobacco smoke pollution (ETS) Smoking Fetal tobacco syndrome Tobacco prevention Children 

Notes

Interessenkonflikt

Der korrespondierende Autor gibt für sich und seine Koautoren an, dass kein Interessenkonflikt besteht.

Literatur

  1. 1.
    Anderko L, Braun J, Auinger P (2010) Contribution of tobacco smoke exposure to learning disabilities. J Obstet Gynecol Neonatal Nurs 39:111–117PubMedCrossRefGoogle Scholar
  2. 2.
    Arbes SJ Jr, Agustsdottir H, Slade GD (2001) Environmental tobacco smoke and periodontal disease in the United States. Am J Public Health 91:253–257PubMedCrossRefGoogle Scholar
  3. 3.
    Babu KS, Arshad SH (2003) The role of allergy in the development of airway inflammation in children. Paediatr Respir Rev 4:40–46PubMedCrossRefGoogle Scholar
  4. 4.
    Beaglehole R, Bonita R, Horton R et al (2011) Priority actions for the non-communicable disease crisis. Lancet 377:1438–1447PubMedCrossRefGoogle Scholar
  5. 5.
    Best D (2009) From the American Academy of Pediatrics: technical report – secondhand and prenatal tobacco smoke exposure. Pediatrics 124:e1017–1044PubMedCrossRefGoogle Scholar
  6. 6.
    Blair PS, Platt MW, Smith IJ et al (2006) Sudden infant death syndrome and the time of death: factors associated with night-time and day-time deaths. Int J Epidemiol 35:1563–1569PubMedCrossRefGoogle Scholar
  7. 7.
    Boffetta P, Tredaniel J, Greco A (2000) Risk of childhood cancer and adult lung cancer after childhood exposure to passive smoke: a meta-analysis. Environ Health Perspect 108:73–82PubMedCrossRefGoogle Scholar
  8. 8.
    Braun JM, Daniels JL, Kalkbrenner A et al (2009) The effect of maternal smoking during pregnancy on intellectual disabilities among 8-year-old children. Paediatr Perinat Epidemiol 23:482–491PubMedCrossRefGoogle Scholar
  9. 9.
    Brooks DR, Mucci LA, Hatch EE et al (2004) Maternal smoking during pregnancy and risk of brain tumors in the offspring. A prospective study of 1.4 million Swedish births. Cancer Causes Control 15:997–1005PubMedCrossRefGoogle Scholar
  10. 10.
    Bundeszentrale für gesundheitliche Aufklärung (2011) Der Tabakkonsum Jugendlicher und junger Erwachsener in Deutschland 2010. Ergebnisse einer aktuellen Repräsentativbefragung. Bundeszentrale für gesundheitliche Aufklärung, Köln, http://www.bzga.de/pdf.php?id=0919bc86b7c6f975e8cf21eee67ff527. Zugegriffen: 07.08.2011 Google Scholar
  11. 11.
    Burguet A, Kaminski M, Abraham-Lerat L et al (2004) The complex relationship between smoking in pregnancy and very preterm delivery. Results of the epipage study. BJOG 111:258–265PubMedCrossRefGoogle Scholar
  12. 12.
    Burton A (2011) Does the smoke ever really clear? Thirdhand smoke exposure raises new concerns. Environ Health Perspect 119:A70–74PubMedCrossRefGoogle Scholar
  13. 13.
    Castellazzi AM, Maccario R, Moretta A et al (1999) Effect of active and passive smoking during pregnancy on natural killer-cell activity in infants. J Allergy Clin Immunol 103:172–173PubMedCrossRefGoogle Scholar
  14. 14.
    Charlesworth JC, Curran JE, Johnson MP et al (2010) Transcriptomic epidemiology of smoking: the effect of smoking on gene expression in lymphocytes. BMC Med Genomics 3:29PubMedCrossRefGoogle Scholar
  15. 15.
    Cnattingius S (2004) The epidemiology of smoking during pregnancy: smoking prevalence, maternal characteristics, and pregnancy outcomes. Nicotine Tob Res [Suppl 2] 6:125–140Google Scholar
  16. 16.
    Colley JR, Holland WW, Corkhill RT (1974) Influence of passive smoking and parental phlegm on pneumonia and bronchitis in early childhood. Lancet 2:1031–1034PubMedCrossRefGoogle Scholar
  17. 17.
    Cook DG, Strachan DP (1997) Health effects of passive smoking. 3. Parental smoking and prevalence of respiratory symptoms and asthma in school age children. Thorax 52:1081–1094PubMedCrossRefGoogle Scholar
  18. 18.
    Craig WY, Palomaki GE, Johnson AM et al (1990) Cigarette smoking-associated changes in blood lipid and lipoprotein levels in the 8- to 19-year-old age group: a meta-analysis. Pediatrics 85:155–158PubMedGoogle Scholar
  19. 19.
    Daisey JM, Mahanama KR, Hodgson AT (1998) Toxic volatile organic compounds in simulated environmental tobacco smoke: emission factors for exposure assessment. J Expo Anal Environ Epidemiol 8:313–334PubMedGoogle Scholar
  20. 20.
    Demarini DM (2004) Genotoxicity of tobacco smoke and tobacco smoke condensate: a review. Mutat Res 567:447–474PubMedCrossRefGoogle Scholar
  21. 21.
    Dietz PM, England LJ, Shapiro-Mendoza CK et al (2010) Infant morbidity and mortality attributable to prenatal smoking in the U.S. Am J Prev Med 39:45–52PubMedCrossRefGoogle Scholar
  22. 22.
    Difranza JR, Aligne CA, Weitzman M (2004) Prenatal and postnatal environmental tobacco smoke exposure and children’s health. Pediatrics 113:1007–1015PubMedGoogle Scholar
  23. 23.
    Difranza JR, Savageau JA, Fletcher K et al (2007) Symptoms of tobacco dependence after brief intermittent use: the development and assessment of nicotine dependence in youth-2 study. Arch Pediatr Adolesc Med 161:704–710PubMedCrossRefGoogle Scholar
  24. 24.
    DKFZ, Deutsches Krebsforschungszentrum (2005) Erhöhte Gesundheitsgefährdung durch Zusatzstoffe in Tabakerzeugnissen – Konsequenzen für die Produktregulation. DKFZ, Heidelberg, S 1–1287Google Scholar
  25. 25.
    DKFZ, Deutsches Krebsforschungszentrum (2009) Tabakatlas Deutschland 2009. Steinkopff, Heidelberg, S 52Google Scholar
  26. 26.
    Einarson A, Riordan S (2009) Smoking in pregnancy and lactation: a review of risks and cessation strategies. Eur J Clin Pharmacol 65:325–330PubMedCrossRefGoogle Scholar
  27. 27.
    Fortmann AL, Romero RA, Sklar M et al (2010) Residual tobacco smoke in used cars: futile efforts and persistent pollutants. Nicotine Tob Res 12:1029–1036PubMedCrossRefGoogle Scholar
  28. 28.
    Frischer T, Kuehr J, Meinert R et al (1992) Maternal smoking in early childhood: a risk factor for bronchial responsiveness to exercise in primary-school children. J Pediatr 121:17–22PubMedCrossRefGoogle Scholar
  29. 29.
    Gilliland FD, Berhane K, Islam T et al (2003) Environmental tobacco smoke and absenteeism related to respiratory illness in schoolchildren. Am J Epidemiol 157:861–869PubMedCrossRefGoogle Scholar
  30. 30.
    Gurkan F, Kiral A, Dagli E et al (2000) The effect of passive smoking on the development of respiratory syncytial virus bronchiolitis. Eur J Epidemiol 16:465–468PubMedCrossRefGoogle Scholar
  31. 31.
    Haberg SE, Bentdal YE, London SJ et al (2010) Prenatal and postnatal parental smoking and acute otitis media in early childhood. Acta Paediatr 99:99–105PubMedGoogle Scholar
  32. 32.
    Hathout EH, Beeson WL, Ischander M et al (2006) Air pollution and type 1 diabetes in children. Pediatr Diabetes 7:81–87PubMedCrossRefGoogle Scholar
  33. 33.
    Hein HO, Suadicani P, Skov P et al (1991) Indoor dust exposure: an unnoticed aspect of involuntary smoking. Arch Environ Health 46:98–101PubMedCrossRefGoogle Scholar
  34. 34.
    Henderson AJ (2008) The effects of tobacco smoke exposure on respiratory health in school-aged children. Paediatr Respir Rev 9:21–27, quiz 27–28PubMedCrossRefGoogle Scholar
  35. 35.
    Hersoug LG, Husemoen LL, Sigsgaard T et al (2010) Indoor exposure to environmental cigarette smoke, but not other inhaled particulates associates with respiratory symptoms and diminished lung function in adults. Respirology 15:993–1000PubMedCrossRefGoogle Scholar
  36. 36.
    Hoffmann D, Hoffmann I (1997) The changing cigarette, 1950–1995. J Toxicol Environ Health 50:307–364PubMedCrossRefGoogle Scholar
  37. 37.
    Horak F, Fazekas T, Zacharasiewicz A et al (2011) Das Fetale Tabaksyndrom – Ein Statement der Österreichischen Gesellschaften für Allgemein- und Familienmedizin (ÖGAM), Gynäkologie und Geburtshilfe (ÖGGG), Hygiene, Mikrobiologie und Präventivmedizin (ÖGHMP), Kinder- und Jugendheilkunde (ÖGKJ) sowie Pneumologie (ÖGP). Wien Klin Wochenschr Dec 21. [Epub ahead of print]Google Scholar
  38. 38.
    Huncharek M, Kupelnick B, Klassen H (2002) Maternal smoking during pregnancy and the risk of childhood brain tumors: a meta-analysis of 6566 subjects from twelve epidemiological studies. J Neurooncol 57:51–57PubMedCrossRefGoogle Scholar
  39. 39.
    Ilicali OC, Keles N, De Er K et al (2001) Evaluation of the effect of passive smoking on otitis media in children by an objective method: urinary cotinine analysis. Laryngoscope 111:163–167PubMedCrossRefGoogle Scholar
  40. 40.
    Ino T (2010) Maternal smoking during pregnancy and offspring obesity: meta-analysis. Pediatr Int 52:94–99PubMedCrossRefGoogle Scholar
  41. 41.
    Johansson A, Hermansson G, Ludvigsson J (2008) Tobacco exposure and diabetes-related autoantibodies in children: results from the ABIS study. Ann N Y Acad Sci 1150:197–199PubMedCrossRefGoogle Scholar
  42. 42.
    Kaufman NJ, Castrucci BC, Mowery PD et al (2002) Predictors of change on the smoking uptake continuum among adolescents. Arch Pediatr Adolesc Med 156:581–587PubMedGoogle Scholar
  43. 43.
    Keller R, Radtke T, Krebs H, Hornung R (2011) Der Tabakkonsum der Schweizer Wohnbevölkerung in den Jahren 2001 bis 2010. Tabakmonitoring – Schweizerische Umfrage zum Tabakkonsum. Sozial- und Gesundheitspsychologie, Psychologisches Institut, Universität Zürich. http://www.tabakmonitoring.ch/Berichte/Tabakkonsum_Schweiz/Forschungsbericht/Gesamt_Tabakkonsum_10_dt.pdf. Zugegriffen: März 2012Google Scholar
  44. 44.
    Konig A, Lehmann C, Rompel R et al (1999) Cigarette smoking as a triggering factor of hidradenitis suppurativa. Dermatology 198:261–264PubMedCrossRefGoogle Scholar
  45. 45.
    Kramer U, Lemmen CH, Behrendt H et al (2004) The effect of environmental tobacco smoke on eczema and allergic sensitization in children. Br J Dermatol 150:111–118PubMedCrossRefGoogle Scholar
  46. 46.
    Kum-Nji P, Meloy L, Herrod HG (2006) Environmental tobacco smoke exposure: prevalence and mechanisms of causation of infections in children. Pediatrics 117:1745–1754PubMedCrossRefGoogle Scholar
  47. 47.
    Lanari M, Giovannini M, Giuffre L et al (2002) Prevalence of respiratory syncytial virus infection in Italian infants hospitalized for acute lower respiratory tract infections, and association between respiratory syncytial virus infection risk factors and disease severity. Pediatr Pulmonol 33:458–465PubMedCrossRefGoogle Scholar
  48. 48.
    Larsson ML, Frisk M, Hallstrom J et al (2001) Environmental tobacco smoke exposure during childhood is associated with increased prevalence of asthma in adults. Chest 120:711–717PubMedCrossRefGoogle Scholar
  49. 49.
    Lee CC, Middaugh NA, Howie SR et al (2010) Association of secondhand smoke exposure with pediatric invasive bacterial disease and bacterial carriage: a systematic review and meta-analysis. PLoS Med 7:e1000374PubMedCrossRefGoogle Scholar
  50. 50.
    Lee CH, Chuang HY, Hong CH et al (2011) Lifetime exposure to cigarette smoking and the development of adult-onset atopic dermatitis. Br J Dermatol 164:483–489PubMedGoogle Scholar
  51. 51.
    Lichtenschopf A (2011) Guidelines for smoking cessation – update 2010. Wien Klin Wochenschr 23:299–315CrossRefGoogle Scholar
  52. 52.
    Linnet KM, Dalsgaard S, Obel C et al (2003) Maternal lifestyle factors in pregnancy risk of attention deficit hyperactivity disorder and associated behaviors: review of the current evidence. Am J Psychiatry 160:1028–1040PubMedCrossRefGoogle Scholar
  53. 53.
    Little J, Cardy A, Munger RG (2004) Tobacco smoking and oral clefts: a meta-analysis. Bull World Health Organ 82:213–218PubMedGoogle Scholar
  54. 54.
    Lux R, Borutta B, Walter U (2010) Passivrauchexposition und Tabakkonsum. Pädiatrische Präventionsansätze. Monatsschr Kinderheilkd 158:774–782CrossRefGoogle Scholar
  55. 55.
    Mackay D, Haw S, Ayres JG et al (2010) Smoke-free legislation and hospitalizations for childhood asthma. N Engl J Med 363:1139–1145PubMedCrossRefGoogle Scholar
  56. 56.
    Mannino DM, Homa DM, Redd SC (2002) Involuntary smoking and asthma severity in children: data from the third national health and nutrition examination survey. Chest 122:409–415PubMedCrossRefGoogle Scholar
  57. 57.
    Marcy TW, Merrill WW (1987) Cigarette smoking and respiratory tract infection. Clin Chest Med 8:381–391PubMedGoogle Scholar
  58. 58.
    Matt GE, Quintana PJ, Hovell MF et al (2004) Households contaminated by environmental tobacco smoke: sources of infant exposures. Tob Control 13:29–37PubMedCrossRefGoogle Scholar
  59. 59.
    Mccarron P, Smith GD, Okasha M et al (2001) Smoking in adolescence and young adulthood and mortality in later life: prospective observational study. J Epidemiol Community Health 55:334–335PubMedCrossRefGoogle Scholar
  60. 60.
    Mitrou F, Gaudie J, Lawrence D et al (2010) Antecedents of hospital admission for deliberate self-harm from a 14-year follow-up study using data-linkage. BMC Psychiatry 10:82PubMedCrossRefGoogle Scholar
  61. 61.
    Morales Suarez-Varela M, Garcia-Marcos L, Kogan MD et al (2008) Parents‘ smoking habit and prevalence of atopic eczema in 6–7 and 13–14 year-old schoolchildren in Spain. ISAAC phase III. Allergol Immunopathol (Madr) 36:336–342Google Scholar
  62. 62.
    Moshammer H, Hoek G, Luttmann-Gibson H et al (2006) Parental smoking and lung function in children: an international study. Am J Respir Crit Care Med 173:1255–1263PubMedCrossRefGoogle Scholar
  63. 63.
    Nieburg P, Marks JS, Mclaren NM et al (1985) The fetal tobacco syndrome. JAMA 253:2998–2999PubMedCrossRefGoogle Scholar
  64. 64.
    O’Dempsey TJ, Mcardle TF, Morris J et al (1996) A study of risk factors for pneumococcal disease among children in a rural area of west Africa. Int J Epidemiol 25:885–893CrossRefGoogle Scholar
  65. 65.
    Oberg M, Jaakkola MS, Woodward A et al (2011) Worldwide burden of disease from exposure to second-hand smoke: a retrospective analysis of data from 192 countries. Lancet 377:139–146PubMedCrossRefGoogle Scholar
  66. 66.
    Oken E, Huh SY, Taveras EM et al (2005) Associations of maternal prenatal smoking with child adiposity and blood pressure. Obes Res 13:2021–2028PubMedCrossRefGoogle Scholar
  67. 67.
    Olivo-Marston SE, Yang P, Mechanic LE et al (2009) Childhood exposure to secondhand smoke and functional mannose binding lectin polymorphisms are associated with increased lung cancer risk. Cancer Epidemiol Biomarkers Prev 18:3375–3383PubMedCrossRefGoogle Scholar
  68. 68.
    Pabst MJ, Pabst KM, Collier JA et al (1995) Inhibition of neutrophil and monocyte defensive functions by nicotine. J Periodontol 66:1047–1055PubMedCrossRefGoogle Scholar
  69. 69.
    Pattenden S, Antova T, Neuberger M et al (2006) Parental smoking and children’s respiratory health: independent effects of prenatal and postnatal exposure. Tob Control 15:294–301PubMedCrossRefGoogle Scholar
  70. 70.
    Poole-Di Salvo E, Liu YH, Brenner S et al (2010) Adult household smoking is associated with increased child emotional and behavioral problems. J Dev Behav Pediatr 31:107–115CrossRefGoogle Scholar
  71. 71.
    Riedler J (2005) Raucherprävention. Der Salzburger Arzt 11:16–18Google Scholar
  72. 72.
    Roberts SE, Wotton CJ, Williams JG et al (2011) Perinatal and early life risk factors for inflammatory bowel disease. World J Gastroenterol 17:743–749PubMedCrossRefGoogle Scholar
  73. 73.
    Ruckinger S, Rzehak P, Chen CM et al (2010) Prenatal and postnatal tobacco exposure and behavioral problems in 10-year-old children: results from the GINI-plus prospective birth cohort study. Environ Health Perspect 118:150–154PubMedGoogle Scholar
  74. 74.
    Rushton L, Courage C, Green E (2003) Estimation of the impact on children’s health of environmental tobacco smoke in England and Wales. J R Soc Promot Health 123:175–180PubMedCrossRefGoogle Scholar
  75. 75.
    Schafer T, Nienhaus A, Vieluf D et al (2001) Epidemiology of acne in the general population: the risk of smoking. Br J Dermatol 145:100–104PubMedCrossRefGoogle Scholar
  76. 76.
    Scragg R, Wellman RJ, Laugesen M et al (2008) Diminished autonomy over tobacco can appear with the first cigarettes. Addict Behav 33:689–698PubMedCrossRefGoogle Scholar
  77. 77.
    Simonetti GD, Schwertz R, Klett M et al (2011) Determinants of blood pressure in preschool children: the role of parental smoking. Circulation 123:292–298PubMedCrossRefGoogle Scholar
  78. 78.
    Simpson WJ (1957) A preliminary report on cigarette smoking and the incidence of prematurity. Am J Obstet Gynecol 73:807–815PubMedGoogle Scholar
  79. 79.
    Sleiman M, Gundel LA, Pankow JF et al (2010) Formation of carcinogens indoors by surface-mediated reactions of nicotine with nitrous acid, leading to potential thirdhand smoke hazards. Proc Natl Acad Sci USA 107:6576–6581PubMedCrossRefGoogle Scholar
  80. 80.
    Somm E, Schwitzgebel VM, Vauthay DM et al (2008) Prenatal nicotine exposure alters early pancreatic islet and adipose tissue development with consequences on the control of body weight and glucose metabolism later in life. Endocrinology 149:6289–6299PubMedCrossRefGoogle Scholar
  81. 81.
    Stathis SL, O’Callaghan DM, Williams GM et al (1999) Maternal cigarette smoking during pregnancy is an independent predictor for symptoms of middle ear disease at five years‘ postdelivery. Pediatrics 104:e16PubMedCrossRefGoogle Scholar
  82. 82.
    Sussman S, Dent CW, Stacy AW et al (1993) Project towards no tobacco use: 1-year behavior outcomes. Am J Public Health 83:1245–1250PubMedCrossRefGoogle Scholar
  83. 83.
    Suzuki M, Thiem VD, Yanai H et al (2009) Association of environmental tobacco smoking exposure with an increased risk of hospital admissions for pneumonia in children under 5 years of age in Vietnam. Thorax 64:484–489PubMedCrossRefGoogle Scholar
  84. 84.
    Talbot P, Riveles K (2005) Smoking and reproduction: the oviduct as a target of cigarette smoke. Reprod Biol Endocrinol 3:52PubMedCrossRefGoogle Scholar
  85. 85.
    Taylor B, Wadsworth J (1987) Maternal smoking during pregnancy and lower respiratory tract illness in early life. Arch Dis Child 62:786–791PubMedCrossRefGoogle Scholar
  86. 86.
    Thiering E, Bruske I, Kratzsch J et al (2011) Prenatal and postnatal tobacco smoke exposure and development of insulin resistance in 10 year old children. Int J Hyg Environ Health 214(5):361–368PubMedCrossRefGoogle Scholar
  87. 87.
    US Department of Human Services (2009) Treating tobacco use and dependence: 2008 update. US Department of Human Services, RockvilleGoogle Scholar
  88. 88.
    Van Der Heide F, Dijkstra A, Weersma RK et al (2009) Effects of active and passive smoking on disease course of Crohn’s disease and ulcerative colitis. Inflamm Bowel Dis 15:1199–1207CrossRefGoogle Scholar
  89. 89.
    Wasserman CR, Shaw GM, O’malley CD et al (1996) Parental cigarette smoking and risk for congenital anomalies of the heart, neural tube, or limb. Teratology 53:261–267PubMedCrossRefGoogle Scholar
  90. 90.
    Weitzman M, Cook S, Auinger P et al (2005) Tobacco smoke exposure is associated with the metabolic syndrome in adolescents. Circulation 112:862–869PubMedCrossRefGoogle Scholar
  91. 91.
    Windlin B Kuntsche E, Delgrande Jordan M (2009) Befindlichkeit, Substanzkonsum und Aggressivität bei Jugendlichen. Suchtmagazin 5:27–31Google Scholar
  92. 92.
    World Health Organisation (WHO) (2008) HBSC (Health behavior in school-aged children) international report from the 2005/2006 survey. Inequalities in young people’s health. WHO, Genf, Chap 2Google Scholar
  93. 93.
    World Health Organisation (WHO) (2009) WHO Report on the global tobacco epidemic, 2009. WHO, Genf, S 25Google Scholar
  94. 94.
    Wu LT, Anthony JC (1999) Tobacco smoking and depressed mood in late childhood and early adolescence. Am J Public Health 89:1837–1840PubMedCrossRefGoogle Scholar
  95. 95.
    Zhang S, Petro TM (1996) The effect of nicotine on murine CD4 T cell responses. Int J Immunopharmacol 18:467–478PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • A. Zacharasiewicz
    • 1
  • F. Horak
    • 2
    • 3
  • T. Fazekas
    • 4
  • J. Riedler
    • 5
  1. 1.Abteilung für Kinder und Jugendheilkunde, Kinderklinik GlanzingAkademisches Lehrkrankenhaus Wilhelminenspital WienWienÖsterreich
  2. 2.Abteilung für Pädiatrische Pulmologie, Allergologie und Endokrinologie, Universitätsklinik für Kinder- und JugendheilkundeMedizinische Universität WienWienÖsterreich
  3. 3.Allergiezentrum Wien WestWienÖsterreich
  4. 4.St. Anna Kinderspital, Universitätsklinik für Kinder- und JugendheilkundeMedizinische Universität WienWienÖsterreich
  5. 5.Abteilung für Kinder- und JugendheilkundeKardinal Schwarzenberg’sches KrankenhausSchwarzachÖsterreich

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