Children Deserve Smoke Free World

  • R. Remesh Kumar
  • P. R. Jayakumar
  • R. Krishna Mohan
Review Article


Tobacco smoke, active or passive exposure was the major cause of preventable morbidity and mortality in the world during twentieth century and will continue to be the same in the twenty-first century also if the current trends continue. Both active and passive smoking are having significance in relation to child health. Exposure starts antenatally from placenta to the fetus and later phases through passive exposure to experimental and regular smoking and ultimately addiction and habitual smoking. Evidences are in favour of causal relationship with intrauterine growth restriction, sudden infant death syndrome, decreased pulmonary function, increased risk for respiratory tract infection, otitis media, wheeze, asthma, neurobehavioral disorders, cleft palate and triggering pathogenesis of fetal and childhood onset of adult diseases, especially pulmonary and cardio vascular diseases. All these facts stress the importance of behavioral changes in the population as well as stringent public health measures and legislation for ensuring smoke free work places, public places and households for children. M POWER- Package by WHO is a novel global initiative taking us closer to the target of achieving tobacco free environment for children in the near future.


Preventable mortality Second hand smoke Developmental origin of adult diseases Cancer Sudden infant death syndrome Advocacy Legislation 



JPR: Manuscript preparation; KM: Manuscript finalising. Dr. T. U. Sukumaran, Prof. & HOD, Pushpagiri Institute of Medical Sciences, Tiruvalla, Kerala will act as guarantor for this paper.

Compliance with Ethical Standards

Conflict of Interest


Source of Funding



  1. 1.
    Sinha DN, Singh PK, Thakur JS. Trend of tobacco use and exposure to secondhand smoke among students aged 13-15 years in India and selected countries of south-east Asia region. Indian J Community Med. 2011;36:S78–80.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    US Department of Health and Human Services. The health consequences of smoking; a report of the surgeon general. Atlanta: US Department of Health and Human Services, Center for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion; Office on Smoking and Health; 2004.Google Scholar
  3. 3.
    CDC. Smoking and tobacco use, health effects of second hand smoke, health consequences linked to exposure to second hand smoke. Atlanta, GA: CDC Factsheet- Health, Office on Smoking and Health; 2017.Google Scholar
  4. 4.
    de Boo HA, Harding JE. The developmental origins of adult diseases (Barker) hypothesis. Aust N Z J Obstet Gynaecol. 2006;46:4–14.CrossRefPubMedGoogle Scholar
  5. 5.
    Barker DJ, Osmond C. Infant mortality, childhood nutrition, and ischemic heart disease in England and Wales. Lancet. 1986;1:1077–81.CrossRefPubMedGoogle Scholar
  6. 6.
    Ezzati M, Lopez AD. Estimates of global mortality attributable to smoking in 2000. Lancet. 2003;362:847–52.CrossRefPubMedGoogle Scholar
  7. 7.
    Samet JM. Tobacco smoke, active and passive smoking. In: Landrigan PJ, Etzel RA, editors. Text book of chidren’s environmental health. Oxford: Oxford University Press; 2013. Chapter 24. p. 222–31.Google Scholar
  8. 8.
    Stjernfeldt M, Lindsten J, Berglund K. Maternal smoking during pregnancy and risk of childhood cancer. Lancet. 1986;37:1350–2.CrossRefGoogle Scholar
  9. 9.
    Barker DJ, Osmond C, Simmons SJ, Wield GA. The relation of small head circumference and thinness at birth to death from cardiovascular diseases in adult life. Br Med J. 1993;306:422–6.CrossRefGoogle Scholar
  10. 10.
    Barker DJ. Foetal origins of adult disease. In: Barker DJ, editor. Growing up in the UK-ensuring a healthy future for our children. UK: BMA Board of Science; 2013. Chapter 8. p. 149–67.Google Scholar
  11. 11.
    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. BMJ. 1996;313:195–8.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Willinger M, James LS, Catz C. Defining the sudden infant death syndrome (sids): deliberations of an expert panel convened by the National Institute of Child Health and Human Development. Pediatr Pathol. 1991;11:677–84.CrossRefPubMedGoogle Scholar
  13. 13.
    Kyu HH, Georgiades K, Boyle MH. Maternal smoking, biofuel smoke exposure and child height-for-age in seven developing countries. Int J Epidemiol. 2009;38:1342–50.CrossRefPubMedGoogle Scholar
  14. 14.
    Goel P, Raditra A, Singh I, Aggarwal A, Dua D. Effects of passive smoking on outcome in pregnancy. J Postgrad Med. 2004;50:12–6.PubMedGoogle Scholar
  15. 15.
    Khattar D, Aswasthi S, Das V. Residential environmental tobacco smoke exposure during pregnancy and low birth weight of neonates; case control study in a public hospital in Lucknow, India. Indian Pediatr. 2013;50:134–8.CrossRefPubMedGoogle Scholar
  16. 16.
    Norsa’adah B, Salinar O. The effect of second-hand smoke exposure during pregnancy on the newborn weight in Malaysia. Malays J Med Sci. 2014;21:44–53.PubMedPubMedCentralGoogle Scholar
  17. 17.
    Gupta S, Malhotra AK, Varma SK, Deka M, Yadav R, Singh S. Effects of passive smoking (environmental tobacco smoke) on pregnancy outcome at district hospital Jhansi, Uttar Pradesh. Int J Med Sci Public Health. 2015;4:1090–4.CrossRefGoogle Scholar
  18. 18.
    Patra S, Sharma S, Behera D. Passive smoking, indoor air pollution and childhood tuberculosis : a case control study. Indian J Tuberc. 2012;59:151–5.PubMedGoogle Scholar
  19. 19.
    Altet MN, Alcaide J, Plans P, et al. Passive smoking and risk of pulmonary tuberculosis in children immediately following infection. A case-control study. Tuber Lung Dis. 1996;77:537–44.CrossRefPubMedGoogle Scholar
  20. 20.
    Von Mutius E. Environmental factors influencing the development and progression of pediatric asthma. J Allergy Clin Immunol. 2002;109:S525–32.CrossRefGoogle Scholar
  21. 21.
    Strachan DP, Cook DG. Health effects of passive smoking. Parental smoking and childhood asthma: longitudinal and case-control studies. Thorax. 1998;53:204–12.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Weitzman M, Gortmaker S, Walker DK, Sobol A. Maternal smoking and childhood asthma. Pediatrics. 1990;85:505–11.PubMedGoogle Scholar
  23. 23.
    Strachan DP, Cook DG. Health effects of passive smoking. 4. Parental smoking, middle ear disease and adenotonsillectomy in children. Thorax. 1998;53:50–6.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Becker S, Soukup JM. Effect of nitrogen dioxide on respiratory viral infection in airway epithelial cells. Environ Res. 1999;81:159–66.CrossRefPubMedGoogle Scholar
  25. 25.
    Montgomery SM, Ekbom A. Smoking during pregnancy and diabetes mellitus in a British longitudinal birth cohort. BMJ. 2002;324:26–7.CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Schick S, Glantz S. Philip Morris toxicological experiments with fresh sidestream smoke: more toxic than mainstream smoke. Tob Control. 2005;14:396–404.CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Lau EM, Celerinajer DS. Protecting our children from environmental tobacco smoke: one of our great healthcare challenges. Eur Heart J. 2014;35:2452–3.CrossRefPubMedGoogle Scholar
  28. 28.
    Celermajer DS, Sorensen KE, Georgakopoulos D, et al. Cigarette smoking is associated with dose related and potentially reversible impairment of endothelium dependent dilation in healthy young adults. Circulation. 1993;88:2149–55.CrossRefPubMedGoogle Scholar
  29. 29.
    WHO report on the Global Tobacco Epidemic, 2008: the MPOWER package. Geneva: World Health Organization; 2008.Google Scholar
  30. 30.
    WHO Report on the Global Tobacco Epidemic. Raising taxes on tobacco, executive summary; 2015.Google Scholar
  31. 31.
    Callahan-Lyon P. Electronic cigarettes: human health effects. Tob Control. 2014;23:ii36–40.CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Dinakar C, Connor GTO. The health effects of electronic cigarettes. N Engl J Med. 2016;375:1372–81.CrossRefPubMedGoogle Scholar

Copyright information

© Dr. K C Chaudhuri Foundation 2018

Authors and Affiliations

  1. 1.Department of PediatricsN.S.S. Medical Mission HospitalPathanamthitta Dist.India
  2. 2.Department of NeonatologyGovernment Medical College HospitalKottayamIndia
  3. 3.Department of PediatricsKerala Government Health ServicesKozhikodeIndia

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