Passive smokingPassive smokingand childrenand children

Dr. Khaled Mahmoud Abd ElazizDr. Khaled Mahmoud Abd Elaziz Assistant Professor of public health Assistant Professor of public health

and preventive medicineand preventive medicine Faculty of Medicine- Ain Shams Faculty of Medicine- Ain Shams

UniversityUniversity

This lecture will cover the following This lecture will cover the following itemsitems

Passive smoking and children: Passive smoking and children: Environmental Tobacco Smoke ETSEnvironmental Tobacco Smoke ETS

Epidemiology of smoking in EgyptEpidemiology of smoking in Egypt Health effects of passive smokingHealth effects of passive smoking Measurement and diagnosisMeasurement and diagnosis

Tobacco smoking Tobacco smoking is a major public is a major public health problem in health problem in

EgyptEgypt

Why smoking is a public health problemWhy smoking is a public health problem

Figures talk:Figures talk:

Almost half of Egyptian men smoke Almost half of Egyptian men smoke (44.4%)(44.4%)

Death rates attributed to smoking is very Death rates attributed to smoking is very high 893 per 100.000 deathshigh 893 per 100.000 deaths

Why smoking is a public health problemWhy smoking is a public health problem

Figures talk:Figures talk: Among females also high 4.8% among youth Among females also high 4.8% among youth

20 to 29% smoke and starting smoking at 20 to 29% smoke and starting smoking at the age of 11 years.the age of 11 years.

At least 29% of the children are exposed at At least 29% of the children are exposed at their home for passive smoking putting them their home for passive smoking putting them at risk of developing health hazards of at risk of developing health hazards of active smokers.active smokers.

Efforts were done by MOH in previous Efforts were done by MOH in previous campaignscampaigns

(Your health … Your wealth) health education (Your health … Your wealth) health education campaign to reduce smokingcampaign to reduce smoking

the message was directed to not exposing the message was directed to not exposing children and pregnant women to tobacco children and pregnant women to tobacco smoking as a step all Egyptians can take for smoking as a step all Egyptians can take for the health of their familiesthe health of their families

Effects of smoking on childrenEffects of smoking on children

2525 effects published in literature effects published in literatureBefore life (pregnancy) active smokingBefore life (pregnancy) active smoking1-Smoking with pregnancy is associated with 10% 1-Smoking with pregnancy is associated with 10%

increase in perinatal mortality.increase in perinatal mortality.2-premature labour2-premature labour3-placental abruption3-placental abruption4-congenital damage to developing respiratory 4-congenital damage to developing respiratory

systemsystem5-immunosuppression of the infant5-immunosuppression of the infant6-mild neurodevelopmental handicap 6-mild neurodevelopmental handicap

Effects of smoking on childrenEffects of smoking on children

Poor growthPoor growth7-Lower birth weight of infants of smoker 7-Lower birth weight of infants of smoker

mothersmothers8-Studies have shows short stunted growth 8-Studies have shows short stunted growth

for children born to smoker mothers (shorter for children born to smoker mothers (shorter children compared to non smoker mothers)children compared to non smoker mothers)

9-Negative correlation between attained 9-Negative correlation between attained height and the no. of cigarettes smoked by height and the no. of cigarettes smoked by mothers.mothers.

Respiratory illnessRespiratory illness::

10-10-Parental smoking has been shown to enhance allergic sensitization in infants and school children with a close family history of atopic disease

11-increased number of lower RTI of infants 11-increased number of lower RTI of infants of smoker mothersof smoker mothers

12-children exposed to ETS have more 12-children exposed to ETS have more liability to RTIliability to RTI

Respiratory illnessRespiratory illness::

13- Persistent middle Ear effusion (glue ear)– 13- Persistent middle Ear effusion (glue ear)– lead to deafness– delayed language lead to deafness– delayed language developmentdevelopment

14- viral respiratory tract infections14- viral respiratory tract infections

15-Increased incidence of tonsillectomy and 15-Increased incidence of tonsillectomy and adenoidectomy (repeated infections)adenoidectomy (repeated infections)

With smoker parents the rate of removal of With smoker parents the rate of removal of tonsils and adenoids 51% compared to 28% tonsils and adenoids 51% compared to 28% among non smoker parentsamong non smoker parents

16-Abnormality of leucocytic function16-Abnormality of leucocytic function

Respiratory illnessRespiratory illness::

17- increased hospital admission with 17- increased hospital admission with bronchitisbronchitis

18-increased hospital admission with 18-increased hospital admission with pneumoniapneumonia

Annual incidence with non smoking 7.9%Annual incidence with non smoking 7.9%

With one smoking parent 11.4%With one smoking parent 11.4%

With both smoking parents 17.6%With both smoking parents 17.6%

Atopy and asthmaAtopy and asthma

19- Higher prevalence of asthma with parental 19- Higher prevalence of asthma with parental smokingsmoking

20-Higher visits to emergency units in cases 20-Higher visits to emergency units in cases with childhood asthmawith childhood asthma

21-Asthmatic children with smoking mother 21-Asthmatic children with smoking mother have 13-23% lower lung function indiceshave 13-23% lower lung function indices

22-airway growth is adversely correlated with 22-airway growth is adversely correlated with passive smoking at homepassive smoking at home

23-Wheezing illnesses 23-Wheezing illnesses

Coronary heart diseaseCoronary heart disease

24- Reduction of HDL of children with parental 24- Reduction of HDL of children with parental smoking by 11.2%smoking by 11.2%

(saving the best for last)(saving the best for last)25-Sudden infant death syndrome25-Sudden infant death syndromeIs defined as sudden death of an infant that Is defined as sudden death of an infant that

could not be explained by clinical or autopsy could not be explained by clinical or autopsy findings. (27% of deaths of infants between findings. (27% of deaths of infants between 1 week and 1 year of age is attributed to 1 week and 1 year of age is attributed to smoking)smoking)

19-Sudden infant death syndrome19-Sudden infant death syndrome

Why smoking is associated with SIDSWhy smoking is associated with SIDS

Some explanationSome explanation

It may be that smoking is associated with abnormalities in brain development and that one manifestation of this might be a tendency to central apnea.

Policies to combat tobacco use

1-Increase taxation and tobacco companies litigation.

2-Stop smuggling

3-Ban advertisement (Direct and indirect)

4-Ban smoking in public places and implement

5-Religious Fatwas

6-Mass education at media, schools and hospitals

Tobacco prevention success requires;Tobacco prevention success requires; long-term cooperative partnerships.long-term cooperative partnerships.Government roleGovernment rolestrong political commitmentstrong political commitment presidental, ministreal leadershippresidental, ministreal leadership multinational agreementsmultinational agreements

Role of the mediaRole of the mediaSupport and challenge humanSupport and challenge human

resourcesresources Political support/ change of normsPolitical support/ change of norms Multinational collaborationMultinational collaboration

NGO’sNGO’sContinuous strong advocacyContinuous strong advocacy Real-time surveillanceReal-time surveillance Internet organization toolsInternet organization tools

THANK YOU