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Smoking Could Kill Your Baby . . . Years Later!

Risk for lung cancer was increased nearly fourfold among never-smokers who had frequent exposure to tobacco smoke during childhood.

These investigators examined the association between environmental tobacco smoke exposure during childhood and the development of respiratory disease later in life. Using data from the European Prospective Investigation into Cancer and Nutrition (EPIC) study, they performed a nested, case-control analysis involving 123,479 nonsmoking adults (never smokers or those stopping 10 years earlier) who provided information on environmental tobacco smoke exposure. Cotinine measurements, performed in a subset of subjects, supported self-reported exposure histories.

Cases were 131 subjects who developed respiratory cancers or died of respiratory disease during the study. They were matched to 286 controls for various parameters including sex, age, and smoking status (never/former smoker). The researchers found that, even among never-smokers, risk for lung cancer was significantly elevated among those with frequent exposure to environmental tobacco smoke during childhood (hazard ratio, 3.63).

Comment: Quitting should be a priority for all smokers (for tools to help patients quit, see Journal Watch Women's Health Mar 5 2002). According to a 2001 report of the Surgeon General, more women stop smoking during pregnancy than at any other time in life, but only one third are still nonsmokers a year after delivery. Why do women stop smoking during pregnancy? Because they are concerned that their habit is affecting their unborn child's life. Yet, they must understand that smoking cessation after delivery also is critical to their child's health. Women should be counseled that if they or other household members smoke around their child, the child's chance of developing lung cancer increases nearly fourfold. The postpartum visit provides an ideal opportunity for this brief, but likely powerful, intervention.

— Ann J. Davis, MD

Published in Journal Watch Women's Health March 22, 2005

Citation(s):

Vineis P et al. Environmental tobacco smoke and risk of respiratory cancer and chronic obstructive pulmonary disease in former smokers and never smokers in the EPIC prospective study. BMJ 2005 Feb 5; 330:277.

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