This month, the city of Bangor, Maine is starting to outlaw smoking in cars when kids are riding in the vehicle: this is a small step in the right direction toward minimizing the damage to public health caused by cigarette smoking. In recent times, cities and states (including a state as backwards as my home, Louisiana) have outlawed smoking in public gathering places such as restaurants, coffee shops, offices and some bars (though some still permit smoking). It’s ancient history now, but if you’re actually paying attention to the theater management’s messages before the movie or the safety instructions prior to takeoff on a plane, you will note that most of these businesses have forbade the use of cigarettes for many years now. It might not actually be a new idea, but I would like to propose this next step: smoking with children present (in the home or otherwise) should be considered child abuse (and should be penalized accordingly).
One of my potential interests with respect to future specialization is Pulmonary and Critical Care Medicine, particularly due to my longstanding interest in asthma. With asthma playing a significant role in my childhood as well as being detrimental to the health of my physician-stepmother, I’m very interested in taking an active role in combatting this common disease, clinically and in research. Another realm to manage the effects of this (at best) troublesome and (at worst) fatal disease is through public health. I understand that at this time, starting smoking is a lifestyle choice for many individuals (though continuing may be a health matter with regards to nicotine addiction), but the victims of the effects of secondhand smoke do not volunteer to be exposed. Most significant of these victims are children of parents who smoke: they have no choice but to continue to live with their parents who might otherwise be the best parents that they can possibly have.
Nonetheless, secondhand smoke exposure to children dramatically increases the incidence of asthma, pneumonia, bronchitis, and even Otitis Media (Middle Ear Infection) . Secondhand smoke not only can trigger the development of the diseases, but they can also trigger episodes such as potentially lethal asthma attacks. Although less common now, it is well known that smoking during pregnancy increases the risk of disastrous events: miscarriage, stillbirth, low birth weight, and SIDS (Sudden Infant Death Syndrome).
There are many things that good parents normally wouldn’t do to their children: beat them (i.e. cause physical blunt/sharp trauma), verbally and emotionally abuse them (i.e. learding to psychiatric disorders), or intentionally starve them (i.e. severe nutritional deficiencies). Parents also don’t normally offer alcoholic drinks to their 8-year-old kids. Properly managed alcohol consumption is perfectly acceptable in adults. Mismanaged alcohol consumption (i.e. binge-drinking, alcoholism) is not. Similarly, although it is clear that smoking increases the risk of developing many diseases, properly managed smoking among adults is legally acceptable (though increasingly less socially acceptable). Smoking, unlike alcohol, has nonbehavioral side effects that must be managed: secondhand smoke, as opposed to violent or abusive behavior associated with alcohol. As such, secondhand smoke should be a legal liability, just as physical, traumatic abuse (as assault and battery among adults or child abuse with children) is a legal liability. Adults can legally smoke as much as they would like in their own homes, private spaces, and public facilities that allow smoke. Adults who don’t smoke can easily choose to avoid these areas. Children sometimes don’t have that choice.