Impact of Smoking on Child Health

Impact of Smoking on Child HealthEnvironment and Hazard -5The Home Environment plays an important role in me rattling issues affecting child health crossways the globe. Children in general may be vulnerable and become uncovered to various other home base hazards such as vulnerabilitys to known harmful building materials, chemicals, radon, drinking water and well-water and nitrogen dioxide.Poor housing conditions and poor ventilation together with household childs play pollution may also increase the fortunes of child hood diseases. Indoor exposure to environmental baccy smoke (ETS) may also be dubious and impart to health consequences like asthma in those children that be affected.Full exposure PathwayExposures to tobacco smoking may occur at any level along the entire stages of human development and these may embroil preconception (maternal and paternal smoking), pregnancy (maternal smoking and passive smoking), infancy (passive smoking), childhood (passive and restless smoking) and young and adulthood (active and passive smoking). 1The key internal exposure pathways and their possible routes for exposure to tobacco smoking that may lead to asthma acceptIn utero exposure 2 mainly concerns the maternal exposure to environmental tobacco smoke(ETS) associated with pregnancy via active or passive smoking.Route Trans placentalMothers who are pregnant and are either active smokers or passive smokers run a risk of their developing fetus being undefendable to the chemical toxicants of tobacco smoke transmitted via the placenta.2 The tobacco smoke constituents are initially inhaled through the respiratory flight paths to the smaller haloways in the lungs (bronchioles) and then absorbed through the tiny gas-exchanging airway sacs (alveoli) and into the maternal blood circulation.Indoor air exposure particularly second hand smoke, where the children at household level are frequently getting exposed if their family members are smokers. Studies have show ed that children are (the two reasons highlighted). 3 Route InhalationActive smoking refers to the active smokers who inhale the undiluted smoke directly into their lungs from the check of cigarette which is called mainstream smoke (MS). 4 Theconstituents ofmainstream smoke are believed to contain higher in doses of tobacco chemicals compared to passive smoking.Second Hand Smoking or peaceable smoking- refers to the non-active smokers who mostly inhale what is called second-hand smoke (SHS) which is a mixture of side-stream smoke(SS) comprised of both the smoke from the glowing cigarette and the exhaled air (mainstream smoke).4 Thus, the side-stream smoke is diluted because it contains both the exhaled mainstream smoke and air and may be less in concentration of the tobacco chemical constituents.4Third-hand smoke refers to the surface-deposited tobacco smoke chemical components which may be left in indoor environments for periods that allow change to their compositions and rende r them harmful to humans especially infants and toddlers who commonly practice hand-mouth on contaminated surfaces.5AsthmaAsthma can be defined as an inflammatory airway disease involving inflammation and impairment of airway due to a complex interaction of immune cells and nonimmune environmental factors that trigger asthma such as tobacco smoking and second hand smoke. 6Scope and nature of problemAsthma is a very common chronic disease affecting children and is believed to affect almost 300 million people world-wide.7Evidence has shown that the prevalence of asthma has been on the rise in the give-up the ghost 50 years (Ref) with increasing trends noted in the industrialised and developed regions. The increase in the global burden of asthma disease ensures that important environmental factors that contribute to asthma are clearly identified for improved intervention and prevention strategies.Risk factors The risk factors for asthma that are commonly known include allergies, posit ive family history of asthma, cock-roach allergen, environmental tobacco smoke exposure(ETS), and prenatal smoking. 8 The diagram shown below in figure 1 summarises the early life risk factors for persistent asthma 9. It shows the different pathways in which environmental exposures and genetic predispositions lead to asthma. As illustrated, environmental exposures to tobacco smoke may affect a foetus in prenatal and later postnatal through impairment and inflammation of the lung resulting in asthma.Figure 1 Showing how environmental exposures and genetic predispositions may contribute to asthma in different pathways in early life. Prenatal exposures Postnatal exposuresViral URTI spread Severe LRTIRepeated episodesPrimary atopic Allergen PersistentSensitization exposure inflammationGenetic Predispositions Genetic PredispositionsDisease association and hazardStudies in the past and recent have looked at the causal relationship between ETS or second hand smoke and asthma disease and ha ve identified that ETS has been a significant indoor air hazard with the potential to causing in effect(p) health consequences such as asthma. GoodwinAccording to the Global Youth Tobacco Survey carried out by World Health Organization in 2007 (WHO), almost 44% of all the children living in the world were exposed to environmental Tobacco smoke at household level. 10An updated meta-analysis study from Surgeon Generals authorship (SGR) of the United States (DHHS 2006), a causal relationship between SHS and childhood induction of asthma could not be drawn to conclusion due to insufficient present from smaller number of studies. 11 However, a similar systematic review and meta-analysis study that examined prenatal and passive smoke exposure and asthma incidence at the UK Centre for Tobacco train studies at University of Nottingham (2011) found that the incidence of wheeze and asthma in children and young people increased by 20% when exposed to passive smoking.12Long term implicati onsThe health implications of tobacco smoking are well recognized across the globe. The exposure to environmental tobacco smoke (ETS) happens across the entire life span of an individual and therefore long term implications are inevitable. Persistent asthma can be a long-term implication which adds to the global burden of asthma disease. Identifying the risk factors and aiming for primary prevention through life style changes such as avoiding maternal smoking during pregnancy could service of process prevent asthma. Environmental modifications and lifestyle changes may help reduce risks for asthma.The use of international health guidelines such as the WHO traffic pattern Framework for Tobacco Control (FCTC) 13 may provide benchmarks for health professionals and policy makers to implement strategies and interventions.ReferenceBreton CV, Byun HM, Wenton M, Pan F, Yang A, Gilliland FD. Prenatal tobacco smoke exposure affects global and gene-specific DNA methylaton. Am J Respir Crit c are Med 2009 180462-7Sly P, Flack F. 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Journal of the American Board of Family Medicine JABFM. 201124(3)313-22.The Global Asthma Report 2011.Paris, France.The foreign Union Against Tuberculosis and Lung Disease.2011.Goodwin RD, Cowles RA. Household smoking and childhood asthma in the United States a state-level analysis. The Journal of asthma official journal of the Association for the caution of Asthma. 200845(7)607-10.Guilbert TW, Singh AM,Danov Z, et al. Decreased lung function after preschool wheezing rhinovirus illnesses in children at risk to develop asthma. J Allergy Clin Immunol 2011 128532-8. e10.WHO, 2007. Only 100% smoke-free environments adequately cherish from dangers of second-hand smoke. New WHO policy recommendations point to extensive evidence. World Health Organization, Geneva, Switzerland.U.S. DHHS. 2006. The Health Consequences of Involuntary Exposure to Tobacco Smoke A Report of the Surgeon General. Atlanta, GA U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promoti on, Ofce on Smoking and Health.Burke H, Leonardi-Bee J, Hashim A, Pine-Abata H, Chen Y, Cook DG, et al. Prenatal and passive smoke exposure and incidence of asthma and wheeze systematic review and meta-analysis. Pediatrics. 2012129(4)735-44Shibuya,K., et al., 2003.Framework Convention on Tobacco Control development of an evidence based global public health treaty. BMJ 327,154-157