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QUESTION:

We live in a condominium with our two daughters, ages 15 months and 4 years. I am concerned with the level of secondhand smoke we are receiving from our neighbors. Frequently we notice our home smelling strongly of cigarette smoke. We open windows, doors, turn on fans (not so convenient with the frigid spring we are having) and I just would like to know if our kids are being exposed to a risk since the smoke is entering through our filtration system and what we might be able to do about it if they are, since asking our neighbors not to smoke in their own home seems highly doubtful. Thanks.

Jennifer Moore -- Indianapolis, Indiana

DR. ALAN GREENE:

You are wise, Jennifer, to be concerned about the effects of secondhand smoke. Many people think of passive smoke exposure as a minor issue, and that those who are concerned are being a little extreme. The truth is that the inhalation of secondhand smoke is a major health concern. By measuring blood levels of cotinine (a breakdown product of nicotine), investigators have been able to quantify the extent non-smokers inhale tobacco smoke. Cotinine levels in spouses and children of smokers can even overlap the levels found in smokers themselves.

Nicotine isn't the only dangerous chemical found in the bodies of people exposed to secondhand smoke. Disease-causing polycyclic aromatic hydrocarbons reach their highest concentrations in sidestream smoke, and have a huge effect on non-smokers.

Exposure to secondhand smoke has been strongly linked with a higher incidence of asthma, respiratory infections (including pneumonia), and ear infections in children. Children exposed to passive smoke are hospitalized more frequently, and have a higher chance of dying from Sudden Infant Death Syndrome (SIDS).

Thankfully, there are ways to minimize the amount of secondhand smoke your daughters inhale. Although not having active smoking in the same room greatly reduces the amount of exposure, as long as you can smell the smoke you and your daughters are being affected. Masking the odor with air fresheners does nothing to help. In fact, the added chemicals may hurt. Plenty of real fresh air is quite helpful, but as you mention, often impractical. The filtration systems found in most buildings, unfortunately, are not sufficient.

Good filters are available. You can buy or rent a HEPA filter (a type of filter that efficiently removes 99.97% of particles from the air). These are expensive, but very effective (they also reduce allergy symptoms). The HEPA filter is ideally placed in the rooms where people sleep. Less expensive, but also quite helpful, are houseplants. Plants, such as English ivy, potted mums, peace lilies, and Gerbera daises, take in the contaminated air and then release oxygen. A former member of the Surgeon General's office (and expert on tobacco) has also suggested a fresh coat of low-VOC or no-VOC paint. Tobacco residue clings to the walls and surfaces. The combination of cleaning and painting can give your condominium a fresh start.

Those parents who are reading this who do smoke can give an invaluable gift to their children by stopping. I understand that tobacco can be a real addiction and that stopping can be a monumental task. For all of us, minimizing our children's exposure to smoke is well worth the effort and expense.

Alan Greene, MD, FAAP, is the author of Raising Baby Green (Wiley Books, 2007), From First Kicks to First Steps (McGraw-Hill, 2004), and The Parent’s Complete Guide to Ear Infections (Avon Books, 1997). He is also a co-author of The A.D.A.M. Illustrated Family Health Guide (A.D.A.M., Inc., 2004). He is a Clinical Professor of Pediatrics at the Stanford University School of Medicine.

Review Date: 6/29/2012

Reviewed By: Allen J. Blaivas, DO, Clinical Assistant Professor of Medicine UMDNJ-NJMS, Attending Physician in the Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Veteran Affairs, VA New Jersey Health Care System, East Orange, NJ. Review provided by VeriMed Healthcare Network. Previoulsy reviewed by David A. Kaufman, MD, Section Chief, Pulmonary, Critical Care & Sleep Medicine, Bridgeport Hospital-Yale New Haven Health System, and Assistant Clinical Professor, Yale University School of Medicine, New Haven, CT. Review provided by VeriMed Healthcare Network. (6/1/2010)

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