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Welcome, Introductions, and Charge

September 18, 2007: Reducing Children's Exposure to Secondhand Smoke

Dana Shelton, Associate Director for Policy, CDC's Office on Smoking and Health, and Executive Secretary for the Interagency Committee on Smoking and Health (ICSH)

Dana Shelton, Associate Director for Policy in the CDC's Office on Smoking and Health (OSH) and Executive Secretary for the ICSH welcomed participants and noted that this meeting was the second gathering of the Committee in 2007. Ms. Shelton mentioned the morning's press event held at the Edward C. Mazique Parent Child Center in Washington, DC and how it set the stage for the Committee meeting. She then turned the meeting over to Rear Admiral (RADM) and Acting Surgeon General Kenneth P. Moritsugu.

RADM Kenneth Moritsugu, M.D., M.P.H., Acting U.S. Surgeon General, U.S. Department of Health and Human Services

RADM Moritsugu welcomed the Committee and began by introducing the newest member, Dr. Lourdes Baezconde-Garbanati. He reminded members that Dr. Baezconde-Garbanati had presented at the March 2007 focusing her talk on how California was addressing disparities in secondhand smoke exposure. Her special areas of interest include health disparities, culturally competent research and the translation of scientific findings into community initiatives.

Dr. Moritsugu went on to describe to Committee members the initiatives that were announced during the morning's press conference. First, the Department of Health and Human Services released a publication that excerpts key findings from the 2006 Surgeon General's Report on the Health Consequences of Involuntary Exposure to Tobacco Smoke related to ways in which secondhand smoke damages children's health and how children can be better protected.

A second publication released by DHHS during the morning event was Sabemos, the Spanish phrase for "We Know." This resource is a bilingual, culturally appropriate tool developed for Hispanic/Latino families to help them protect their children from secondhand smoke exposure by reinforcing positive norms and practices.

Two major national initiatives were also announced during the morning's press conference. The first, a joint effort by the Administration for Children and Families and the Environmental Protection Agency, will provide parents of children enrolled in Head Start with information to help them protect their children from secondhand smoke. The second initiative is a call to action by the Academy of Pediatrics to ask all pediatricians to identify household members who smoke, advise parents to take steps to eliminate children's secondhand smoke exposure, and provide information to help parents quit smoking.

RADM Moritsugu continued by reviewing the evidence from the 2006 Surgeon General's Report detailing the harmful effects of secondhand smoke exposure on children's health. Some of the conclusions are that secondhand smoke exposure—

  • Causes a number of serious health problems including sudden infant death syndrome, acute respiratory infections, middle ear disease, more severe asthma, respiratory symptoms, and slowed lung growth
  • Leads to an estimated 430 infant deaths from sudden infant death syndrome (SIDS)
  • Can lead to impaired endothelial function in children as young as 11 years old—a sign of arterial damage
  • Caused infants in one study to exhibit a biological marker for a potent tobacco-specific lung carcinogen in their urine

In short, children are powerless to protect themselves from this risk yet are especially vulnerable to the health effects caused by secondhand smoke because of their developing respiratory, immune, and nervous systems.

While secondhand smoke exposure among U.S. non-smokers has fallen substantially in recent years thanks to increased smoking restrictions in workplaces and public places, children continue to be more heavily exposed than non-smoking adults. The reason for this is that children's exposure occurs primarily in homes and cars (not covered by laws and regulations) where they spend most of their time, especially when they are very young.

The only effective way to reduce secondhand smoke exposure in homes is through the adoption of voluntary household rules making homes 100% smoke-free. This means that no one smokes in the home at any time. The CDC reports that in 2003 72% of U.S. households had smoke-free home rules. However, only 32% of households with one or more smokers had smoke-free home rules in that same year.

While we know that smoke-free homes reduce children's exposure, we also know there are other benefits which include reducing nonsmoking adults' secondhand smoke exposure, helping smokers quit and decreasing smoking initiation among youth. What we don't know with certainty are the best strategies to help people make their homes smoke-free and more research is urgently needed on this topic.

However, because we can't afford to wait until the research results are in, we need to use the best available evidence to undertake initiatives to educate parents and caregivers about misconceptions regarding the impact of secondhand smoke on children's health and the importance of 100% smoke-free environments. Helping parents overcome barriers such as concern about leaving children unattended while they go outside to smoke or the lack of a suitable and safe outside area in which to smoke are critical.

While quitting smoking is the single best step that parents and caregivers can take to protect their own and their children's health, initiatives to promote smoke-free homes should suggest that parents and caregivers go outside to smoke as an intermediate step as they prepare to quit. Smokers should be referred to proven resources such as the National Network of Quitlines at 1-800-QUIT NOW and FDA-approved medications that make it easier to quit once someone is ready to do so. It is also critical that affected populations must be engaged in partnership with tobacco control professionals to help in understanding what will and will not work. Educational materials need to be written at an appropriate literacy level and need to be culturally and linguistically appropriate.

To be most effective, both governmental and nongovernmental national, state and local agencies must work together closely and include parent groups, voluntary associations, nonprofits, professional associations, grassroots community groups and organizations that work with or represent specific population groups. These efforts to reduce secondhand smoke exposure must also be implemented within the broader framework of comprehensive state and local tobacco control programs. These programs use evidence-based interventions to reduce youth initiation of tobacco use, help tobacco users quit, eliminate nonsmokers' secondhand smoke exposure, and identify and eliminate tobacco-related population disparities.

RADM Moritsugu closed his remarks by encouraging the Committee to identify concrete solutions and opportunities to address the problem of secondhand smoke exposure. He asked that a follow-up meeting on this topic be held in two years to report back on progress and determine additional steps that are needed. He then announced that he would be stepping down from his post as Acting Surgeon General within the next couple of weeks and felt there was no more fitting way to end his tenure than presiding over the ICSH meeting.

Following his remarks, RADM Moritsugu asked Committee members to introduce themselves.

Matthew McKenna, Director of the CDC's Office on Smoking and Health, followed the introductions by thanking Admiral Moritsugu for his service and dedication to tobacco prevention and control and presented him with a plaque. Dr. McKenna then introduced Dr. Corinne Husten.

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