Study: 99% of Children Living in Apartments May Be Exposed to Secondhand Smoke

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There are fewer and fewer places where smokers can light up these days, with smoking bans being instituted by governments and private companies in virtually every public place, from offices and airplanes to bars and restaurants. And now there’s evidence that supports bringing no-smoking policies to the only remaining place (other than outdoors) where smokers can still light up — inside their homes.

Or, at least where smokers are living in apartments. In a study of tobacco exposure from secondhand smoke in more than 5,000 children, researchers led by Dr. Karen Wilson at University of Rochester found that youngsters aged 6 to 18 years who lived in multi-unit housing had a 45% increase in a chemical byproduct of tobacco in their blood compared with children who lived in detached family homes. And these were youngsters who lived in units where nobody smoked inside the apartment itself, meaning that the exposure was occurring primarily via secondhand smoke drifting in from other units. (More on U.S. Cigarette Warning Labels Are About to Get Graphic)

Previous studies have documented the extent to which secondhand smoke can show up among nonsmokers, but Wilson says the amount of exposure in the children in her study was “a little higher than I expected.” Among white children living in apartment buildings, 99% showed levels of cotinine, the tobacco byproduct, in their blood, while 96% of African American children did as well.

The data, which was funded by the Flight Attendant Medical Research Institute, is particularly disturbing since previous studies have documented that even low levels of cotinine can result in long term cognitive problems and changes in antioxidant levels that can harm the health of children who are exposed. In addition, the Surgeon General’s 2010 report on tobacco concluded that there is no safe level of exposure to tobacco smoke. (More on A Single Cigarette Can Raise the Risk of Cancer and Heart Disease)

“Our results, combined with other studies, provides the basis for us to start saying yes, we really think that…any exposure is dangerous to children,” says Wilson. “If you think about it, we protect bartenders and wait staff and flight attendants from secondhand smoke, and yet we don’t protect children where they “work” all day long and live at night. If we think about it that way, it makes sense to think about how we can protect children better.”

The results need to be replicated and confirmed, but the bulk of evidence to date supports the fact that higher cotinine levels among apartment-dwelling children are due to secondhand smoke exposure. While certain foods such as eggplant and tomatoes do contain cotinine, those levels are likely to be negligible given to the amounts found in the children’s blood, says Wilson.

And although recent studies have raised the possibility that another source of tobacco exposure known as thirdhand smoke, which involves physical tobacco residue that may remain on the clothing and hair of smokers, could be contributing to the higher cotinine levels among these children, Wilson says that exposure is also unlikely to explain the entire amount recorded in the subjects of her study. (More on What Is Thirdhand Smoke?)

The findings highlight the tension between the rights of children as well as nonsmoking adults to protect themselves from the health hazards of secondhand smoke exposure, and the rights of smokers to light up in their own homes. But federal health experts are already moving toward addressing secondhand smoke by urging public housing authorities to adopt smoke-free policies.

The American Academy of Pediatrics (AAP) also supports smoke-free environments for children. “This new study makes clear that multi-unit housing must be completely smoke-free to achieve this goal,” said Dr. O. Marion Burton, president of AAP in a statement. “All children deserve to live in a healthy environment, and this can only be achieved by eliminating tobacco smoke where they live.” (More on The Science Behind Moving Smoking Bans Outside)

In addition, experts like Wilson hope that with such objective documentation of the extent of tobacco exposure in young children, perhaps more smokers will be motivated to kick the habit. “It’s hard to tell somebody they can’t do something in their own home,” she says. “But if legislators do enact smoking bans in multi-unit housing, it’s important to remember that we have to make resources available to people who need to quit because they want to protect the children in apartments.”

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