Updates of Secondhand Smoke Exposure on Infants' and Children's Health


  • Tinapa Himathongkam,

  • Arnauld Nicogossian,

  • Otmar Kloiber,

  • Nelya Ebadirad


The purpose of this study is to determine if the existing evidence on the health effects of exposure to secondhand smoke (SHS) is adequate to warrant consideration of legislative smoke-free bans in private spaces and in the presence of infants and children. The 1.1 billion smokers worldwide expose an estimated 700 million children daily to SHS. Harmful health effects of SHS are adequately documented, smoking bans in public spaces is advocated, and the number of countries adopting smoke-free legislations is increasing. Similar measures for private spaces, and especially in the presence of infants and children, despite the published evidence by the World Health Organization and the U.S. Surgeon General, lag behind. A systematic review of English-language meta-analyses, published between 2000 and 2013, was conducted. This literature search overlapped the literature cited in the 2006 U.S. Surgeon General Report. Medical Search Headings (MeSH) were used to query large databases. A qualitative rating scale was used to determine the strength of evidence. Thirteen meta-analyses met the established inclusion criteria. Seven studies provided strong evidence for health effects of SHS on children's health including asthma, middle ear diseases, lower respiratory infections (LRIs), acute lymphoblastic leukemia (ALL), and congenital malformations. Children aged two years or younger, living with smoking mothers, show the strongest correlation between SHS and diagnosed health problems. Available information on morbidity and mortality from SHS warrants intervention efforts and policies targeting voluntary and legislated smoking bans for private spaces. Adequate knowledge base for chronic health effects from SHS exposures, during infancy and childhood, and their economic burden is still fragmented. Further carefully designed studies will help advocate and promote evidence-based intervention strategies.