Answers from Dr. Greene

QUESTION:

We live in a condominium with our two daughters, ages 15 months and 4 years. I am concerned with the level of secondhand smoke we are receiving from our neighbors. Frequently we notice our home smelling strongly of cigarette smoke. We open windows, doors, turn on fans (not so convenient with the frigid spring we are having) and I just would like to know if our kids are being exposed to a risk since the smoke is entering through our filtration system and what we might be able to do about it if they are, since asking our neighbors not to smoke in their own home seems highly doubtful. Thanks.

Jennifer Moore -- Indianapolis, Indiana

DR. ALAN GREENE:

You are wise, Jennifer, to be concerned about the effects of secondhand smoke. Many people think of passive smoke exposure as a minor issue, and that those who are concerned are being a little extreme. The truth is that the inhalation of secondhand smoke is a major health concern. By measuring blood levels of cotinine (a breakdown product of nicotine), investigators have been able to quantify the extent non-smokers inhale tobacco smoke. Cotinine levels in spouses and children of smokers can even overlap the levels found in smokers themselves.

Nicotine isn't the only dangerous chemical found in the bodies of people exposed to secondhand smoke. Disease-causing polycyclic aromatic hydrocarbons reach their highest concentrations in sidestream smoke, and have a huge effect on non-smokers.

Exposure to secondhand smoke has been strongly linked with a higher incidence of asthma, respiratory infections (including pneumonia), and ear infections in children. Children exposed to passive smoke are hospitalized more frequently, and have a higher chance of dying from Sudden Infant Death Syndrome (SIDS).

Thankfully, there are ways to minimize the amount of secondhand smoke your daughters inhale. Although not having active smoking in the same room greatly reduces the amount of exposure, as long as you can smell the smoke you and your daughters are being affected. Masking the odor with air fresheners does nothing to help. In fact, the added chemicals may hurt. Plenty of real fresh air is quite helpful, but as you mention, often impractical. The filtration systems found in most buildings, unfortunately, are not sufficient.

Good filters are available. You can buy or rent a HEPA filter (a type of filter that efficiently removes 99.97% of particles from the air). These are expensive, but very effective (they also reduce allergy symptoms). The HEPA filter is ideally placed in the rooms where people sleep. Less expensive, but quite helpful, are houseplants. Plants take in the contaminated air and then release oxygen. A former member of the Surgeon General's office (and expert on tobacco) has also suggested a fresh coat of low-VOC or no-VOC paint. Tobacco residue clings to the walls and surfaces. The combination of cleaning and painting can give your condominium a fresh start.

Those parents who are reading this who do smoke can give an invaluable gift to their children by stopping. I understand that tobacco can be a real addiction and that stopping can be a monumental task. For all of us, minimizing our children's exposure to smoke is well worth the effort and expense.

Alan Greene, M.D., earned a bachelor's degree from Princeton University and graduated from medical school at University of California at San Francisco. Upon completion of his pediatric residency program at Children's Hospital Medical Center of Northern California in 1993, he served as Chief Resident. During his Chief year, Dr. Greene passed the pediatric boards in the top 5% of the nation.

Dr. Greene entered primary care pediatrics in January 1993. He is on the Clinical Faculty at Stanford University School of Medicine where he sees patients and teaches Residents. He serves as the Chief Medical Officer of A.D.A.M., Inc., a leading provider of consumer health information, and helps direct A.D.A.M.'s editorial process. As A.D.A.M.'s CMO, he served as a founding member of Hi-Ethics (Health Internet Ethics) and helped URAC develop its standards for eHealth accreditation. He is also the Founder & CEO of DrGreene.com. Dr. Greene was also named Intel's Internet Health Hero for children's health. He is an author, medical expert, and a media personality.

Dr. Greene is the author of Raising Baby Green (Wiley Books, 2007), From First Kicks to First Steps (McGraw-Hill, 2004), and The Parent’s Complete Guide to Ear Infections (Avon Books, 1997). He is also a co-author of The A.D.A.M. Illustrated Family Health Guide (A.D.A.M., Inc., 2004).Dr. Greene has appeared in numerous publications including the Wall Street Journal, Parenting, Parent, Child, American Baby, Baby Talk, Working Mother, Better Home's & Gardens , and Reader's Digest . He also appears frequently on television and radio shows as a medical expert.

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