Children and second-hand smoke

As noted in a recent CMAJ news brief,¹ there appears to be a general belief that the number of smokers is declining. Nonetheless, working in an area where tobacco production is a big industry and often a family business, I am astounded by the large number of my patients who smoke. For many of these people, I see a direct conflict between health issues and their need to make a living.

As a head and neck surgeon, I see many patients with cancer of the head and neck, and, not surprisingly, almost all of them are smokers. As part of my history-taking for all pediatric patients, I ask the parents whether there is any smoking in the house and, if the answer is yes, I require the parents to state exactly how many cigarettes the child is exposed to daily. This number is recorded in the patient's chart. I want these parents to acknowledge that when they smoke, their children are also smoking.

Parents must be made to realize the effect of their smoking on the short-term and long-term health of their children — they gave their children life and now are taking it away.

A. Wiesenthal Chief, Department of Otolaryngology Brantford General Hospital Brantford, Ont.