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-W. Bradford Wilcox
Associate Professor of Sociology, University of Virginia 

Smoke Gets in Your (Children’s) Eyes

Bryce J. Christensen and Nicole M. King

With good reason, pediatricians worry when parents smoke. Children exposed to such second-hand smoke are at risk for a number of worrisome health problems. But a new international review of the relevant empirical investigations of the issue indicates that the children who face the greatest risk of exposure are those living with unmarried or divorced parents.

Completed by researchers from Harvard University in the United States and from the Universities of Nottingham and Birmingham in the United Kingdom, this new review systematically examines forty-one studies of pediatric exposure to second-hand smoke, studies specially chosen for their focus on the social predictors of such exposure. The authors of the new study explain the need for such a review by citing a 1999 World Health Organization (WHO) report identifying second-hand smoke as “a substantial threat to child health,” a threat evident in a demonstrable linkage between children’s exposure to second-hand smoke and “increased risks of respiratory tract infections, middle ear infections, sudden unexplained death in infancy, and asthma.”

In summarizing their findings, the U.S. and UK scholars remark, “There was some evidence in this review that children whose parents were single, separated or divorced were at an increased risk of S[econd]H[and]S[moke] exposure in the home.” The reviewers interpret this evidence against the backdrop of studies showing “single mothers to be more likely [than married mothers] to relapse to smoking after pregnancy, and unmarried or divorced adults to be more likely [than married peers] to be daily smokers or heavier smokers.” The reviewers also align their review findings with studies concluding that “children from single-parent families or whose parents/carers are unmarried have . . . been shown to have worse health outcomes compared to those from traditional nuclear families.”

Few would argue when the reviewers conclude that since “the largest observed risks were for children living in households with smokers, the best way to reduce child S[econd]H[and]S[moke] exposure in the home . . . is for smoking parents to quit.” Still, as this new review of the literature indicates, physicians and health officials have reason to concern themselves not only with whether a parent puts a cigarette in the mouth but also with whether that parent has put a wedding band on the finger.

(Sophie Orton et al.,“Predictors of Children’s Smoke Exposure at Home: A Systematic Review and Narrative Synthesis of the Evidence,” PLoS One 9.11 [2014]: e112690, Web.)