secondhand smoke

A new study published in the British Medical Journal has found that secondhand smoke exposure may impact surgical and anesthetic outcomes among children.


Secondhand smoke exposure is breathing the smoke from burning tobacco products, such as cigars, pipes, and cigarettes, and from smoke breathed out from a smoking person. It has a significant health effect on adults and children. In children, it usually leads to ear infections, severe and more frequent asthma attacks, and other lung conditions including coughing, sneezing, shortness of breath and lung infections. As well, children are more susceptible to adverse effects from secondhand smoking than adults. Besides general health, in adults, secondhand smoking may also complicate surgical and anesthetic outcomes.

A recent meta-analysis, published in British Medical Journal, describes, for the first time, the effects of secondhand smoking on surgical and anesthetic outcomes among children. The study critically analyzed multiple research papers based on children aged 0-18 years who were undergoing surgical or anesthetic procedures. The amount of environmental tobacco smoke (ETS) exposure was assessed via parental questioning, observation or measuring biological markers. Fifteen studies were categorized into anesthetic outcomes and twelve studies were categorized into surgical outcomes. Studies related to anesthetic outcomes included children with a mean age of  5.8 years, having had anesthetic procedures among a range of surgical procedures including general or mixed surgery, dental, ophthalmology, and urology surgical procedures. Whereas surgical outcomes category studies were focused on ear, nose, and throat (ENT) patients. One study assessed how the surgery of the child affected the smoking habits among their parents and relatives.

Anesthetic outcomes revealed that ETS exposure increased the risk of sudden and brief narrowing of the vocal cords or contraction of muscles surrounding air passages inside the lungs leading to difficulty breathing and coughing. There was slight evidence that ETS exposure decreased the efficacy of ventilation tubes along with other ear and sinus conditions. The impact of surgery more likely influenced the parents towards cessation of smoking but not necessarily completely quitting smoking.

Effect of ETS exposure on wound healing and infection among children is still not identified. As well, whether awareness of the adverse effects of secondhand smoking on a child’s health would promote smoking cessation among the general population is yet to be explored.


Written By: Alefyah Sunel, Medical Writer

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