Advertisement

Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Auswirkungen des Aktiv- und Passivrauchens auf die Gesundheit von Kindern und Jugendlichen

Effects of active and passive smoking on the health of children and adolescents

  • 62 Accesses

Zusammenfassung

Jugendliche in Deutschland waren um die Jahrtausendwende mit über 30 % aktiven Rauchern Europameister. Seitdem haben Rauchverbote, Steuererhöhungen und das gesellschaftliche Umdenken zu einem erheblichen Sinken der Raucherzahlen beigetragen. Nikotinabhängigkeit ist eine „Kinderkrankheit“, und die Tabakabhängigkeit entsteht meistens vor dem 20. Lebensjahr. Ein früher Beginn ist besonders gesundheitsgefährdend: Summationseffekte und die Unreife der Organe führen zu einer stärkeren Gesamtbelastung des Organismus. Nach einem vorübergehenden Rückgang der Raucherquoten hat der Trend zur E‑Zigarette bereits wieder zu einer Zunahme der jugendlichen Nikotinkonsumenten geführt. Nach dem Konsum von vermeintlich harmloseren E‑Zigaretten wurden teils fatal verlaufende, schwere Lungenerkrankungen dokumentiert. Neben der direkten Schädigung durch aktives Rauchen besteht für Kinder und Jugendliche zusätzlich eine Gefahr durch eine Passivrauchexposition in der heimischen Wohnung bzw. im Auto. Bereits vorgeburtlich wird der Fetus durch eine Tabakexposition geschädigt. Vorzeitiger Blasensprung und Frühgeburtlichkeit, verlangsamtes Wachstum von Körper und Lunge stehen in direktem Zusammenhang mit präpartalem mütterlichem Rauchen. Nach der Geburt sind Erkrankungen der kindlichen Atemwege wie die Otitis media, adenoide Vegetationen und Tonsillitiden deutlich häufiger, und das Lungenwachstum ist verlangsamt. Passive Tabakrauchexposition durch rauchende Eltern bleibt der wichtigste Risikofaktor für eine „Raucherkarriere“. Dementsprechend müssen Präventions- und Entwöhnungsbemühungen unter Einbeziehung von Kindern und Jugendlichen weiter intensiviert werden. Nikotin in jeder Darreichungsform ist bei Jugendlichen suchtauslösend, weshalb v. a. diese Gruppe davor geschützt werden muss.

Abstract

With more than 30% active smokers, young people in Germany were the European champions at the turn of the millennium. Since then, smoking bans, tax increases, and social rethinking have contributed to a considerable decline in the number of smokers. Nicotine dependence is a “childhood” disease, and tobacco dependence usually begins before the age of 20. An early onset is particularly hazardous to health, because summation effects and the immaturity of organs lead to a greater overall burden on the organism. After a temporary decline in smoking rates, the trend towards e‑cigarettes has already led to an increase in the number of young nicotine users. Following consumption of supposedly harmless e‑cigarettes, severe—sometimes fatal—lung diseases have been documented. In addition to direct harm from active smoking, children and adolescents are further at risk of secondhand smoke at home or in the car. Even before birth, tobacco exposure is harmful to the fetus. Premature rupture of membranes and preterm birth as well as slower growth of body and lungs are directly related to maternal tobacco use. After birth, pediatric diseases of the respiratory tract such as otitis media, adenoid vegetation, and tonsillitis are much more common, and lung growth is retarded. The most important risk factor for a “smoking career” is still passive exposure to tobacco due to parental smoking. Thus, prevention and cessation efforts involving children and adolescents need to be further intensified. Nicotine leads to dependence in adolescents regardless of the form in which it is administered, and this risk group requires particular protection.

This is a preview of subscription content, log in to check access.

Abb. 1
Abb. 2
Abb. 3

Literatur

  1. 1.

    DKFZ (2009) Tabakatlas

  2. 2.

    Robert Koch Institut (2000) Epidemiologisches Bulletin 22, 31. Mai 2000

  3. 3.

    Conrad KM, Flay BR, Hill D (1992) Why children start smoking cigarettes: predictors of onset. Br J Addict 87:1711–1724

  4. 4.

    Breslau N, Peterson EL (1996) Smoking cessation in young adults: age at initiation of cigarette smoking and other suspected influences. Am J Public Health 86:214–220

  5. 5.

    Chassin L, Presson CC, Rose JS, Sherman SJ (1996) The natural history of cigarette smoking from adolescence to adulthood: demographic predictors of continuity and change. Health Psychol 15:478–484

  6. 6.

    Lando HA, Thai DT, Murray DM, Robinson LA, Jeffery RW, Sherwood NW, Hennrikus DJ (1999) Age of initiation, smoking patterns, and risk in a population of working adults. Prev Med 29:590–598

  7. 7.

    Laucht M, Schmid B (2007) Early onset of alcohol and tobacco use-indicator of enhanced risk of addiction? Z Kinder Jugendpsychiatr Psychother 35(2):137–143

  8. 8.

    DiFranza JR, Rigotti NA, McNeill AD, Ockene JK, Savageau JA, Cyr StD, Coleman M (2000) Initial symptoms of nicotine dependence in adolescents. Tob Control 9(3):313–319

  9. 9.

    Tyczynski JE, Bray F, Parkin DM (2003) Lung cancer in Europe in 2000: epidemiology, prevention, and early detection. Lancet Oncol 4(1):45–55

  10. 10.

    US Department of Health and Human Services (1994) Preventing tobacco use among young people: a report of the Surgeon General Atlanta, Georgia: US Department of Health and Human Services, Public Health Service, Centres for Disease Control, Centre for Health Promotion and Education, Office on Smoking and Health

  11. 11.

    Paavola M, Vartiainen E, Puska P (1996) Predicting adult smoking: the influence of smoking during adolescence and smoking among friends and family. Health Educ Res 11:309–315

  12. 12.

    KiGGS Studie des Robert-Koch-Institutes (www.kiggs.de) Mai 2003 bis Mai 2006

  13. 13.

    Currie C, Roberts C, Morgan A, Smith R, Settertobulte W, Samdal O, Barnekow Rasmussen V Eds. (2004) Health Behaviour in School-aged Children (HBSC) study: international report from the 2001/2002 survey. Health Policy for Children and Adolescents, No. 4. WHO. http://www.euro.who.int/__data/assets/pdf_file/0008/110231/e82923.pdf

  14. 14.

    Castles A, Adams EK, Melvin CL, Kelsch C, Boulton ML (1999) Effects of smoking during pregnancy. Five meta-analyses. Am J Prev Med 16(3):208–215

  15. 15.

    Nabet C, Lelong N, Ancel PY, Saurel-Cubizolles MJ, Kaminski M (2007) Smoking during pregnancy according to obstetric complications and parity: results of the EUROPOP study. Eur J Epidemiol 22(10):715–721 (Epub 2007 Aug 29)

  16. 16.

    US Department of Health and Human Services (2004) The health consequences of smoking: a report of the Surgeon General. 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

  17. 17.

    Edwards CA, Osman LM, Godden DJ, Campbell DM, Douglas JG (2003) Relationship between birth weight and adult lung function: controlling for maternal factors. Thorax 58:1061–1065

  18. 18.

    Moshammer H, Hoek G, Luttmann-Gibson H, Neuberger MA, Antova T, Gehring U, Hruba F, Pattenden S, Rudnai P, Slachtova H et al (2006) Parental smoking and lung function in children: an international study. Am J Respir Crit Care Med 173:1255–1263

  19. 19.

    Tager IB, Ngo L, Hanrahan JP (1995) Maternal smoking during pregnancy: effects on lung function during the first 18 months of life. Am J Respir Crit Care Med 152:977–983

  20. 20.

    Wang X, Wypij D, Gold DR, Speizer FE, Ware JH, Ferris BG Jr, Dockery DW (1994) A longitudinal study of the effects of parental smoking on pulmonary function in children 6–18 years. Am J Respir Crit Care Med 149:1420–1425

  21. 21.

    Stick SM, Burton PR, Gurrin L, Sly PD, LeSouef PN (1996) Effects of maternal smoking during pregnancy and a family history of asthma on respiratory function in newborn infants. Lancet 348:1060–1064

  22. 22.

    Cook DG, Strachan DP, Carey IM (1998) Parental smoking and spirometric indices in children. Thorax 53:884–893

  23. 23.

    U.S. Environmental Protection Agency (1992) Respiratory health effects of passive smoking: lung cancer and other disorders. Washington, DC: U.S. Environmental Protection Agency

  24. 24.

    Li YF, Gilliland FD, Berhane K, McConnell R, Gauderman WJ, Rappaport EB, Peters JM (2000) 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 162(6):2097–2104

  25. 25.

    Sherrill DL, Martinez FD, Lebowitz D et al (1992) Longitudinal effects of passive smoking on pulmonary function in New Zealand children. Am Rev Respir Dis 145:1136–1141

  26. 26.

    Hanrahan JP, Tager IB, Segal MR et al (1992) The effect of maternal smoking during pregnancy on early infant lung function. Am Rev Respir Dis 145:1129–1135

  27. 27.

    Tager IB, Hanrahan JP, Tosteson TD et al (1993) Lung function, pre and post natal smoke exposure, and wheezing in the first year of life. Am Rev Respir Dis 147:811–817

  28. 28.

    Law BJ, Carbonell-Estrany X, Simoes EA (2002) An update on respiratory syncytial virus epidemiology: a developed country perspective. Respir Med 96(Suppl B):S1–S7

  29. 29.

    Huang SW, Giannoni C (2001) The risk of adenoid hypertrophy in children with allergic rhinitis. Ann Allergy Asthma Immunol 87:350–355

  30. 30.

    Corbo GM, Fuciarelli F, Foresi A, De Benedetto F (1989) Snoring in children: association with respiratory symptoms and passive smoking. BMJ 299:1491–1494

  31. 31.

    Stahlberg MR, Ruuskanen O, Virolainen E (1986) Risk factors for recurrent otitis media. Pediatr Infect Dis 5:30–32

  32. 32.

    Strachan D, Cook D (1998) Health effects of passive smoking 4: parental smoking, middle ear disease, and adenotonsillectomy in children. Thorax 53:50–56

  33. 33.

    Fleming P, Blair PS (2007) Sudden Infant Death Syndrome and parental smoking. Early Hum Dev 83(11):721–725 (Epub 2007 Sep 18. Review)

  34. 34.

    Eliot J, Vullermin P, Robinson P (1998) Maternal cigarette smoking is associated with increased inner airway wall thickness in children who die from Sudden Infant Death Syndrome. AJRCCM 158:802–806

  35. 35.

    Menzies D, Nair A, Williamson PA, Schembri S et al (2006) Respiratory symptoms, pulmonary function, and markers of inflammation among bar workers before and after a legislative ban on smoking in public places. JAMA 296:1742–1748

  36. 36.

    Goodman P, Agnew M, McCaffrey M, Paul G, Clancy L (2007) Effects of the Irish smoking ban on respiratory health of bar workers and air quality in Dublin pubs. Am J Respir Crit Care Med 175:840–845

  37. 37.

    Genuneit J, Weinmayr G, Radon K, Dressel H, Windstetter D, Rzehak P, Vogelberg C, Leupold W, Nowak D, von Mutius E, Weiland SK (2006) Smoking and the incidence of asthma during adolescence: results of a large cohort study in Germany. Thorax 61(7):572–578 (Epub 2006 Mar 14)

  38. 38.

    Barrett EG, Wilder JA, March TH, Espindola T (2002) Bice Cigarette smoke-induced airway hyperresponsiveness is not dependent on elevated immunoglobulin and eosinophilic inflammation in a mouse model of allergic airway disease. Am J Respir Crit Care Med 165(10):1410–1418

  39. 39.

    Adler S, Rosewich M, Rose MA, Schulze R, Schubert R, Zielen S (2008) Untersuchung der Lungenfunktion bei jugendlichen Rauchern. GPP, Zurich

  40. 40.

    Franklin PJ, Turner S, Mutch R, Stick SM (2006) Parental smoking increases exhaled nitric oxide in young children. Eur Respir J 28(4):730–733

  41. 41.

    Maniscalco M, Vatrella A, Sofia M (2002) Passive smoke and exhaled nitric oxide. Am J Respir Crit Care Med 165(8):1188

  42. 42.

    Kharitonov SA, Robbins RA, Yates D, Keatings V, Barnes PJ (1995) Acute and chronic effects of cigarette smoking on exhaled nitric oxide. Am J Respir Crit Care Med 152(2):609–612

  43. 43.

    Sato S, Nishimura K, Koyama H, Tsukino M, Oga T, Hajiro T, Mishima M (2003) Optimal cutoff level of breath carbon monoxide for assessing smoking status in patients with asthma and COPD. Chest 124(5):1749–1754

  44. 44.

    Pearce MS, Hayes L, Newcastle Heart Project, Newcastle Thousand Families Study (2005) Self-reported smoking status and exhaled carbon monoxide: results from two population-based epidemiologic studies in the North of England. Chest 128(3):1233–1238

  45. 45.

    Franklin PJ, Turner S, Mutch R, Stick SM (2006) Parental smoking increases exhaled nitric oxide in young children. Eur Respir J 28(4):730–733

  46. 46.

    Aronson MD, Weiss ST, Ben RL, Komaroff AL (1982) Association between cigarette smoking and acute respiratory tract illness in young adults. JAMA 248(2):181–183

  47. 47.

    Birrell MA, Wong S, Catley MC, Belvisi MG (2008) Impact of tobacco-smoke on key signaling pathways in the innate immune response in lung macrophages. J Cell Physiol 214(1):27–37

  48. 48.

    Hurd S (2000) The impact of COPD on lung health worldwide: epidemiology and incidence. Chest 117(2 Suppl):1S–4S

  49. 49.

    Teramoto S (2007) 1. COPD pathogenesis from the viewpoint of risk factors. Intern Med 46(2):77–79 (Epub 2007 Jan 15. Review)

  50. 50.

    Gold DR, Wang X, Wypij D, Speizer FE, Ware JH, Dockery DW (1996) Effects of cigarette smoking on lung function in adolescent boys and girls. N Engl J Med 335(13):931–937

  51. 51.

    Hasday JD, Bascom R, Costa JJ, Fitzgerald T, Dubin W (1999) Bacterial endotoxin is an active component of cigarette smoke. Chest 115(3):829–835

  52. 52.

    Miech R, Johnston L, O’Malley PM, Bachman JG, Patrick ME (2019) Trends in adolescent vaping, 2017–2019. N Engl J Med 381(15):1490–1491

  53. 53.

    Butt YM, Smith ML, Tazelaar HD, Vaszar LT, Swanson KL, Cecchini MJ, Boland JM, Bois MC, Boyum JH, Froemming AT, Khoor A, Mira-Avendano I, Patel A, Larsen BT (2019) Pathology of vaping-associated lung injury. N Engl J Med 381(18):1780–1781

  54. 54.

    Maddock SD, Cirulis MM, Callahan SJ, Keenan LM, Pirozzi CS, Raman SM, Aberegg SK (2019) Pulmonary lipid-laden macrophages and vaping. N Engl J Med 381(15):1488–1489

  55. 55.

    Andreas S, Batra A, Behr J, Berck H, Chenot JF, Gillissen A, Herin T, Herth F, Meierjürgen R, Mühlig S, Nowak D, Pfeifer M, Raupach T, Schultz K, Sitter H, Worth H (2008) Guidelines for Smoking Cessation in Patients with COPD Issued by the Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin. Pneumologie 62:255–272

  56. 56.

    DiFranza JR et al (2006) Tobacco promotion and the initiation of tobacco use: assessing the evidence for causality. Pediatrics 117:e1237–e1248

  57. 57.

    DiFranza JR et al (2002) Measuring the loss of autonomy over nicotine use in adolescents: the DANDY (Development and Assessment of Nicotine Dependence in Youths) study. Arch Pediatr Adolesc Med 156:397–403

  58. 58.

    Hanewinkel R, Sargent JD (2008) Exposure to smoking in internationally distributed American movies and youth smoking in Germany: a cross-cultural cohort study. Pediatrics 121(1):e108–e117

  59. 59.

    Gervais A et al (2006) Milestones in the natural course of onset of cigarette use among adolescents. Cmaj 175(3):255–261

  60. 60.

    Wiborg G, Hanewinkel R (2002) Effectiveness of the “Smoke-Free Class Competition” in delaying the onset of smoking in adolescence. Prev Med 35(3):241–249

  61. 61.

    Hanewinkel R (2007) “Be smart-don’t start”. Results of a non-smoking competition in Germany 1997–2007. Gesundheitswesen 69:38–44

  62. 62.

    Thomas R, Perera R (2002) School-based programmes for preventing smoking. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD001293.pub2

  63. 63.

    Peto R et al (1992) Mortality from tobacco in developed countries: indirect estimation from national vital statistics. Lancet 339:1268–1278

  64. 64.

    Doll R, Peto R, Boreham J, Sutherland I (2004) Mortality in relation to smoking: 50 years’ observations on male British doctors. BMJ 328(7455):1519

  65. 65.

    Orth B, Merkel C (2019) Rauchen bei Jugendlichen und jungen Erwachsenen in Deutschland. Ergebnisse des Alkoholsurveys 2018 und Trends. BZgA-Forschungsbericht. Bundeszentrale für gesundheitliche Aufklärung, Köln

  66. 66.

    Pötschke-Langer et al (2015) Tabakatlas Deutschland 2015. DKFZ, Heidelberg

Download references

Author information

Correspondence to PD Dr. med. M. Rosewich.

Ethics declarations

Interessenkonflikt

M. Rosewich gibt an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

Additional information

Redaktion

M. Gappa, Düsseldorf

M. Rose, Stuttgart

M. Rosewich, Altötting

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Rosewich, M. Auswirkungen des Aktiv- und Passivrauchens auf die Gesundheit von Kindern und Jugendlichen. Pneumologe 17, 51–56 (2020). https://doi.org/10.1007/s10405-019-00298-1

Download citation

Schlüsselwörter

  • E‑Zigaretten-Rauchen
  • Tabakrauchen
  • E‑Zigaretten
  • Luftverschmutzung durch Tabakrauch
  • Substanzbezogene Störungen

Keywords

  • Vaping
  • Tobacco smoking
  • E‑cigarettes
  • Tobacco smoke pollution
  • Substance-related disorders