Smoking study proves link to allergies in children

Smoking parents giving a ‘very bad example’

Consultant respiratory physician Stephen Montefort (inset): “Education seems to bearing fruit.”

Consultant respiratory physician Stephen Montefort (inset): “Education seems to bearing fruit.”

The severe detrimental effects of passive smoking on Maltese children can no longer be questioned now that hard evidence is available for the first time to substantiate these concerns.

A study by Maltese doctors has finally established that cigarette smoking plays a major role in the significant problem schoolchildren have with allergic conditions.

And if mothers were worried about smoking during pregnancy because of its effects on their unborn children, they should be equally worried about doing so in the first year of their lives, warned one of the authors, consultant respiratory physician Stephen Montefort.

The study found that 31 per cent of five- to eight-year-olds were passive smokers, followed by 51 per cent of 13- to 15-year-olds – in both age groups their father was more likely to be the smoker. The child’s first year of life is vital, according to the research, part of the International Study on Asthma and other Allergies in Childhood (ISAAC). Children were more likely to be wheezers if their mothers smoked in their first year.

The study also shows the developing lung is more affected given that, if the mother smokes in the first year of life, the child seems to suffer more.

Looking at about 8,000 schoolchildren, it provides unprecedented concrete evidence that passive smoking in the home and personal smoking in teenagers already “really affects” allergic conditions in children.

Prof. Montefort’s main message is that the evidence is no longer anecdotal, so an even stronger argument can be used to stop parents from smoking.

“Mothers are concerned about harming their babies in their womb but they are not really worried about them when they are born. They should continue worrying,” Prof. Montefort insisted.

“I meet women whose children have asthma, who stopped smoking in pregnancy and now give the excuse that they go out to smoke on the balcony. But it still affects the child.”

The study also shows a dose-related effect whereby, because children spend more time with their mother, her smoking leaves more of an impact on them than the father. In fact, the effect on teenagers of their mother smoking is much stronger, Prof. Montefort noted.

Moreover, both parents smoking has an additive effect, and the damage is even more significant.

The study reveals that teenage smokers (13 to 15 years old) are more likely to have parents who smoked and, therefore, to have been passive smokers themselves.

Apart from more extensive exposure to direct and second-hand smoke, it has now been confirmed that smoking parents impart a “very bad example” to their children and induce them to start smoking themselves.

“In this age group, there was an obvious detrimental effect, especially on wheezing. But what is also impressive is that, even at this tender age, smoking has adverse effects on health,” Prof. Montefort said.

“Its deleterious impact on the bronchial tree is present even in the relatively small amount and short period of active cigarette smoking carried out by the “novice” smokers.

“Kids, therefore, need to be told not to start smoking because the habit is affecting them from the onset,” Prof. Montefort said.


The percentage of passive smokers among five- to eight-year-olds

“Thankfully, the study has also shown that passive smoking among teenagers is on the decline, so education seems to bearing fruit,” he continued.

The study was also carried out by Pierre Ellul, Maxine Montefort, Simone Caruana, Victor Grech and Hugo Agius Muscat from the departments of medicine, paediatrics and health information.

It enquired about passive smoking among the parents of 3,816 five- to eight-year-old children and about passive and personal smoking to 4,139 13- to 15-year-olds.

The paper, The Effect of Cigarette Smoking on Allergic Conditions in Maltese Children, is to be published in the peer review journal Paediatric Allergy and Immunology.

The global research, which targeted 500,000 children in 150 centres worldwide, is also about to be published, and the findings are “pretty similar” to Malta’s, Prof. Montefort said, adding that the next study is scheduled to start in October.

No more anecdotal evidence

• Maternal and paternal smoking resulted in the children having an increased chance of wheezing sometime in their life, exercise-induced wheezing, nocturnal cough and asthma.

• Maternal smoking in the first year of the child’s life resulted in the children having an increased chance of ever wheezing in their lives, exercise-induced wheezing and asthma.

• Current smoking by the mother also led to the child having current rhinitis.

• Current smoking by the mother was more common in children having current rhinitis, while current smoking by both mother and father led to itchy and watery eyes accompanying rhinitis.

• Recurrent itchy rashes were also more likely in passive smokers.

• Children (13 to 15 years old) smoking more than 10 cigarettes a day persisted with wheezing, had more frequent episodes of exercise-induced wheezing, nocturnal cough and rhinoconjunctivitis than milder smokers.

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