How Passive Smoking Affects the Health of Newborns and Infants
Dear Parents,
As a pediatrician, I see many families who want to give their children the healthiest start in life. One important topic that every parent should understand is passive smoking and how it affects our youngest and most vulnerable little ones. This guide will help you understand the risks and learn how to protect your newborn and infant from tobacco smoke.
Passive smoking, also called secondhand smoke exposure, happens when someone breathes in smoke from another person's cigarette, cigar, or pipe. It includes two types of smoke:
- Smoke that comes directly from the burning end of the tobacco product
- Smoke that a smoker breathes out into the air
According to the Centers for Disease Control and Prevention, secondhand smoke contains over 4,000 different chemicals. Many of these chemicals are harmful, and at least 69 of them are known to cause cancer.
Newborns and infants are much more sensitive to tobacco smoke than older children and adults. Here is why:
Baby lungs are delicate and still growing. When smoke enters their tiny airways, it causes damage that can last a lifetime. Research from the National Center for Biotechnology Information shows that exposure to tobacco smoke during pregnancy and early life can affect lung development, leading to smaller lungs and reduced breathing capacity.
Newborn babies breathe much faster than adults. While adults breathe about 14 to 18 times per minute, newborns can breathe as fast as 60 times per minute. This means babies take in much more air, and if that air contains smoke, they breathe in more harmful chemicals.
Unlike older children who can move to another room, babies completely depend on us to provide them with clean, safe air. They have no way to protect themselves from smoky environments.
According to the CDC, infants exposed to secondhand smoke after birth are more likely to die from SIDS than babies who are not exposed to tobacco smoke. The chemicals in smoke appear to affect the brain in ways that interfere with how babies regulate their breathing during sleep.
Babies exposed to tobacco smoke have a much higher chance of developing serious breathing problems:
- Pneumonia and Bronchiolitis: These serious lung infections happen more frequently in smoke-exposed babies
- More Frequent Colds: Smoke irritates the airways and makes babies catch colds more often
- Asthma Development: Secondhand smoke can cause new cases of asthma in children and make existing asthma much worse
- Wheezing and Coughing: These become more common in babies exposed to smoke
The American Academy of Pediatrics reports that secondhand smoke causes thousands of hospital admissions every year for young children with respiratory illnesses.
Many parents are surprised to learn that smoke exposure increases ear infections. Tobacco smoke irritates and causes swelling in the middle ear tube (called the Eustachian tube). This swelling leads to more frequent and severe ear infections. Since ear infections are the most common cause of hearing loss in children, protecting babies from smoke is important for their hearing development too.
When a mother is exposed to secondhand smoke during pregnancy, it can affect the baby even before birth:
- Lower Birth Weight: Babies may be born smaller and weaker, which increases health risks
- Premature Birth: Babies may be born too early, leading to serious health complications
- Smaller Lungs: Exposure during pregnancy leads to reduced lung development that can affect breathing throughout life
- Learning Problems: Children exposed to tobacco smoke before birth may be more likely to have difficulties with learning, attention, and behavior in school
Many parents think that if they smoke outside or in another room, their baby will be safe. Unfortunately, this is not completely true because of something called thirdhand smoke.
Thirdhand smoke is the toxic residue from tobacco smoke that stays behind on surfaces, furniture, carpets, walls, clothing, and even hair and skin long after someone has finished smoking. These harmful chemicals do not just disappear when the visible smoke clears.
Research published by the University of California San Francisco shows that 26 chemicals found in thirdhand smoke are known to cause cancer, birth defects, and reproductive harm. These chemicals can remain on surfaces for weeks, months, or even years.
- Touching Contaminated Surfaces: Babies crawl on floors and furniture where smoke residue has settled
- Hand to Mouth: Young children frequently put their hands and objects in their mouths, directly ingesting these chemicals
- Breathing It In: Smoke particles can be released back into the air when dust is disturbed
- Skin Absorption: Chemicals can be absorbed through the delicate skin of infants
Thirdhand smoke is very difficult to remove. Opening windows, using fans or air conditioners, and even regular cleaning with vacuums and detergents cannot completely eliminate it. The chemicals penetrate deep into carpets, upholstery, wallboard, and other porous materials.
Quitting smoking is challenging, but you do not have to do it alone. Talk to your doctor about programs, support groups, and medicines that can help. Many people need to try several times before they quit successfully, so do not give up.
Whether you are working on quitting or dealing with visitors who smoke, here are important steps to protect your baby:
- Make Your Home Completely Smoke-Free: Do not allow anyone to smoke inside your home, even when the baby is not present. Remember that thirdhand smoke lingers long after smoking stops
- Keep Your Car Smoke-Free: Never smoke in a car, even with windows open. In many places, it is actually illegal to smoke in a car with children present
- Ask Smokers to Go Outside: If visitors need to smoke, ask them to do it far away from your home and away from open windows and doors
- Change Clothes and Wash Hands: Anyone who smokes should change their outer clothing, wash their hands thoroughly, and rinse their mouth before holding or being near your baby
- Choose Smoke-Free Childcare: Make sure any daycare or place where your child spends time has a strict no-smoking policy
- Avoid Smoky Places: Keep your baby away from restaurants, parks, or other public areas where people are smoking
- Stay away from all secondhand smoke
- Ask smokers not to smoke near you
- If you smoke, quit as early in pregnancy as possible. The earlier you quit, the better for your baby, but quitting at any time during pregnancy helps
If you are moving, ask about the smoking history of the home. If people smoked heavily in the house:
- Replace carpets and padding
- Wash and repaint all walls with several coats
- Replace curtains and blinds
- Clean ventilation ducts and replace filters
- Thoroughly clean or replace furniture
Beyond the immediate risks, passive smoking can affect your child's health for years:
- Increased Cancer Risk: Long-term exposure to secondhand and thirdhand smoke increases the risk of lung cancer and other cancers later in life
- Heart Disease: Children exposed to smoke have a higher chance of developing heart problems as adults
- Lifelong Breathing Problems: Lungs that are damaged during development may never reach their full potential, leading to reduced lung function throughout life
- More Likely to Smoke: Children who grow up around smokers are twice as likely to become smokers themselves, continuing the cycle of health problems
While research on e-cigarettes is still ongoing, we know that the vapor from these devices contains harmful substances that can affect children's developing lungs and overall health. Apply the same protective rules to vaping as you would to traditional smoking.
It can be difficult to ask family members or friends not to smoke around your baby, but your child's health must come first. Here are some tips:
- Explain that this is about your baby's health, not personal judgment
- Share information about how smoke affects babies
- Be firm but kind in enforcing your rules
- Remember that you are being a good parent by protecting your child
True friends and family who care about you and your baby will respect your wishes to keep your child healthy.
Every baby deserves to breathe clean, healthy air. Protecting your newborn and infant from passive smoking is one of the most important things you can do as a parent. The good news is that the damage from smoke exposure can be reduced when exposure stops, and creating a smoke-free environment has immediate benefits for your baby's health.
If you smoke, remember that quitting is a gift you give not only to yourself but also to your child. Your efforts to create a smoke-free environment show your love and commitment to your baby's wellbeing.
As parents and caregivers, we all want what is best for our children. Understanding the risks of passive smoking and taking action to protect our babies is an essential part of giving them a healthy start in life.
For more information on protecting children from tobacco smoke exposure, consider these trusted sources:
- Websites: Centers for Disease Control and Prevention (CDC), American Academy of Pediatrics (AAP), World Health Organization (WHO), National Cancer Institute
- Books: Pediatric health and child development books available through your local library or pediatrician's office
- Support: Speak with your child's pediatrician about smoke exposure concerns and smoking cessation resources in your area