The Great American Smokeout: Why We Need to Clear the Air…for Our Children’s Sake

I am pleased to note that November 18th is the 35th anniversary of the American Cancer Society’s Great American Smokeout. That said, I have to admit that the existence of this day also makes me a bit sad. Sad because people still smoke. Sad because even those who don’t – including children – are nevertheless at risk. And most of all, sad because smoking is both deadly and powerfully addictive.

The fact of the matter is that despite decades of clear messages about the risk of cigarette smoking, there’s still more than enough smoke to go around. So much so that the FDA has now decided to resort to more drastic, scare-tactic measures, since high taxes and an ever-present surgeon general’s warning that “Smoking causes lung cancer, heart disease, emphysema, and may complicate pregnancy” hasn’t sufficed. Soon, fully half of each entire cigarette pack will be required to show grim images of what smoking actually does to you, with images of diseased lungs, toe tags and body bags up for consideration.

As a pediatrician, of course, my focus is on helping insure that all babies are born healthy; that all children are raised in environments that are nurturing, healthy and safe; and whenever humanly possible, keeping kids from trying out risky behaviors for themselves. Unfortunately, smoking puts children in the direct line of fire on all three fronts.

While getting people to stop smoking (or not to start in the first place) can be admittedly challenging, it is my sincere hope that it’s possible. Whenever anyone is faced with having to change a habit or behavior because it’s “good for them” – whether it has to do with losing weight, exercising more, improving one’s diet, or quitting smoking – they first have to want to change. I hope that a closer look at some compelling dangers our children face from cigarette smoke will provide added motivation to help clear the air of cigarette smoke once and for all.

  • Babies are at risk, even before they are born. According to the March of Dimes, expectant mothers who smoke are at greater risk for pregnancy complications including bleeding, serious problems with the placenta, and even stillbirth. Babies born to mothers who smoke are at greater risk for being born prematurely, being low birthweight, having birth defects such as cleft lip/palate, and a whole list of other serious health problems.
  • Sudden Infant Death (SIDS). According to the American Academy of Pediatrics, maternal smoking during pregnancy has emerged as a major risk factor in almost every study of SIDS and several studies also suggest that smoke in an infant’s environment after birth poses an added risk.
  • Breathing problems and increased infections. The EPA estimates that as many as 300,000 children under 18 months of age get bronchitis or pneumonia resulting in thousands of hospitalizations each year just from exposure to secondhand smoke….and this is only the tip of the cigarette iceberg. Children who are exposed to cigarette smoke also get more ear infections, and breathing problems include everything from coughing, wheezing, bronchitis and pneumonia to an increased risk of developing asthma, or more frequent and severe asthma attacks for those kids who already have asthma.
  • Smoke lingers. Smoking in a different room or away from your child may lessen the exposure a bit, but not enough to protect them. No amount of exposure is safe. Even when cigarette smoke is delivered secondhand, the end result is still dangerous exposure.
  • Glorified images of cigarette smoking are influencing our children. Most parents are unaware of the fact that despite all the known dangers of smoking, a CDC report reveals that more than half of PG-13 movies in 2009 still contained images of tobacco use. While you may be understandably tempted to say “so what?” this statistic becomes far more frightening when partnered up with the CDC’s statement that “exposure to onscreen smoking in movies increases the probability that youths will start smoking.” In fact, there are pediatricians who consider images of smoking in movies “the single biggest media risk to young people.” Yet Hollywood still allows for paid placement of cigarettes in movies. For anyone still tempted to blow off the impact that smoking in the movies has on children, I suggest you find out more at Smoke Free Movies.
  • Teens are still being tempted. When it comes to protecting kids from the dangers of cigarette smoke, we’re up against some very powerful forces: The addictive nature of tobacco makes it very difficult to quit once someone starts, and the continued portrayal of cigarettes as sexy and powerful in everything from celebrity magazines to movies serves as a powerful lure for our children. It’s no wonder that an estimated 20 percent of high schoolers smoke, and 4000 US teens each day still opt to gain firsthand experience of cigarettes’ harmful effects by trying out smoking for the first time.

Like elsewhere around the country, the good news is that if you want to quit, there are people, organizations and resources right here in Nebraska that are ready, willing and able to help you – from a free confidential Nebraska Tobacco Quitline (800-784-8669) to online support at QuitNow.ne.gov.

Whether you decide to take the first step for yourself, or for your children, you can start by joining Tobacco Free Nebraska, the American Cancer Society and Nebraska’s Department of Health and Human Services’ efforts as part of Thursday’s Great American Smokeout.

Originally posted on Omaha World Herald’s Live Well Nebraska

Life-Saving Safe Sleep Tips for All Parents & Caregivers

Of all the topics I routinely discuss with parents, sleep has to rank right at the top of the list. This shouldn’t come as a big surprise, given that a good night’s sleep (or the lack thereof) can have a significant effect on just about everything else we do. When it comes to children’s overall health and well-being, it’s hard to sleep through all of the studies that reinforce that teenagers need more sleep (9 hours a night as compared to 8 for adults) in order to perform well at school, and that plenty of nighttime sleep (on the order of at least 10 hours a night) appears to be as important for keeping obesity at bay in young children as diet and exercise.

What I want to discuss today, however, isn’t just children’s need for an adequate amount of sleep, but the importance of safe sleep. While there are certainly aspects of safe sleep that apply to older children (bunk beds spring to mind), safe sleep has held a particularly prominent place in the national parenting consciousness every since the 1990s when the identified link between belly sleeping and Sudden Infant Death Syndrome (SIDS) led the American Academy of Pediatrics to recommend back sleeping in 1992. This was followed in 1995 with the official launch of the Back To Sleep Campaign.

While over a decade of subsequent parent education efforts have resulted in a dramatic increase in the number of back-sleeping babies (from 25% in 1992 to 85% in 2008), recent years have brought no additional increase in back sleeping. In fact, we may have started to backslide when it comes to insuring babies’ safety while sleeping. In the course of little over a single devastating month back in Feb/March of 2008, six babies died in Douglas County alone – all classified as SIDS attributed to bed sharing and suffocation.

While any increase in infant deaths is concerning, to say the least, the good news is that we know a great deal about what we need to do to keep babies safe while sleeping and reduce their risk of SIDS. The much larger task at hand is simply to make sure that all new and expectant parents and infant caregivers know the most effective ways to create safe sleep environments for babies.

This is the challenge being addressed in a new National Safe Sleep Education Campaign by the US Consumer Product Safety Commission, the American Academy of Pediatrics and Keeping Babies Safe. Their latest recommendations for providing a safe sleep for all babies include:

  • Place infants to sleep on their backs
  • Use a firm, tight-fitting mattress
  • Never use extra padding, blankets or pillows under baby
  • Remove pillows or thick comforters
  • Do not use positioning devices – they are not necessary and can be deadly
  • Regularly check cribs for loose, missing or broken parts or slats
  • Do not try to fix a broken crib
  • Place cribs or playpens away from windows and window covering cords to avoid fall and strangulation hazards
  • Place baby monitor cords away from cribs or playpens to avoid strangulation

These life-saving safe sleep tips can also be found in the campaign’s newly released 7 minute video, narrated by renowned journalist Joan Lunden and available for viewing or download on the AAP’s HealthyChildren.org and on the Keeping Babies Safe website. Additional information about safe sleep can also be found on in the newly revised 2nd Edition of my book, Heading Home With Your Newborn (AAP, Sept 2010), and on the Nebraska Department of Health & Human Services Website.

Originally posted on Omaha World Herald’s Live Well Nebraska