‘Looking after little lungs’ should be the priority and responsibility of everyone
THE Western Cape has the unenviable distinction of having South Africa’s highest proportion of adults who smoke. A total of 43% of men smoke and 25% of women smoke.
These proportions are not evenly distributed. In some communities more than three-quarters of households have someone who smokes living in them. Smoking rates are higher in poorer communities, which are where most children live.
Respiratory illnesses (that is, those involving the lungs, windpipe, throat, nose and ears) are the commonest illnesses among children in the Western Cape. Pneumonia is the commonest cause of death and admission to hospital beyond the newborn period in young children, with many thousands being hospitalised every year. Asthma affects about one in every five children, also causing many hospitalisations. Ear infections are very common, often causing hearing loss.
All of these illnesses are made significantly worse in the presence of air pollutants. For example, in a young child a mild throat infection can be turned into a life-threatening chest infection in the presence of polluted air. A severe asthma attack can be set off if a child with asthma breathes in smoky air.
Where young children spend most of their lives in and around homes, cigarette smoke is the main air pollutant.
Passive smoking, also called secondary smoking, is the term that describes the effect on others of the vapours produced by someone who is smoking. Cigarette smoke, by virtue of the noxious chemicals it contains, is the worst of these smoking-associated pollutants.
It exerts its effects not only via the smoke that is breathed out by the person smoking, but also via their clothes, breath and skin, even when the cigarette or pipe is finished.
Many parents are aware that passive smoking is dangerous. “No one smokes inside our house” is the repeated mantra that I hear in clinical practice. Unfortunately, even if this were true, this is not enough to protect their children.
No one should smoke where a child can be exposed to that smoke, inside or outside a building. And anyone who has recently smoked should not be near a child unless they have removed that smoke from their skin and breath, and taken off their contaminated clothing. Those who have been with the smoker are also contaminated by smoke, though to a lesser extent.
Existing legal regulations support the need to protect children from passively smoking. No one may smoke in a vehicle in which a child is travelling.
There are clear regulations regarding the distance from buildings one must be if smoking. These and further regulations in a draft bill represent South Africa’s clear intention to minimise the health effects of tobacco and nicotine (hereinafter named Very Nasty Nic), including those on children.
Society pays dearly when children are exposed to smoke. Health services are busier; babies die, some before they are born; parents miss work; children miss school; children grow to adulthood with damaged lungs and consequently damaged lives.
In Paarl, research led by UCT has shown that many babies are being damaged by passive smoking even before they are born.
Pregnant women too must not be exposed to smoke, for their own sake and for the sake of their unborn child.
We must all actively play our part in protecting pregnant women, babies and children from passive smoking.
Families must support parents by establishing standards of behaviour in and around homes. Families can support family members who wish to stop smoking. Taxi drivers and lift club drivers can protect children by adhering to smoking regulations.
Passengers must help them enforce these. I have seen drivers smoking at the door to the school bus as the children board.
Children must be empowered by parents, health workers and educators to be advocates for their own respiratory and lung health. People who smoke (whatever they smoke) must ensure that their habit is not damaging anyone else, especially children.
Society can help them break the habit. Children must be protected from those who would (for reasons of profit) entice them to start smoking. One puff of Very Nasty Nic can be all it takes, and the cigarette pedlars know this.
We must all “look after little lungs” and never, ever smoke (or allow anyone else to smoke) anywhere near pregnant women, babies and children. Never ever.
Westwood is a paediatrician working in the public sector in the Western Cape.