Monday, February 22, 2010

Action on Smoking and Health Cites Purported Hazards of Fourth-Hand Smoke to Promote Bans on Adoption of Children by Smokers

In a press release issued last Friday, Action on Smoking and Health (ASH) uses the purported effects of fourth-hand tobacco smoke to promote policies by which the adoption or fostering of children by smokers is not allowed, even if the prospective parents agree not to smoke inside the home.

To more accurately describe the important difference between two "new" types of tobacco smoke exposure, I am today introducing the term fourth-hand smoke to make an important distinction that has not heretofore been recognized.

Thirdhand smoke has been described as the off-gassing of residues that occurs after smoking has ceased in a room. In other words, if a smoker smokes inside a living room and then leaves for work, smoke residues that deposit on surfaces like the carpet and furniture in that living room can give rise to smoke chemicals via off-gassing. Nicotine residues and their chemical reaction products (such as tobacco-specific nitrosamines) can also be ingested by infants and young children. I will continue to refer to such exposures as thirdhand smoke.

However, "thirdhand" smoke has also been described in a different way. It has been described as also consisting of residues that smokers carry around with them and which can then give rise to chemical exposure even in rooms where smoking has never occurred. It is this exposure - which is one level removed from thirdhand smoke - which I will from now on refer to as "fourth-hand" smoke.

This distinction is a very important one. Thirdhand smoke only occurs in rooms where smoking occurs and is therefore of little to no consequence because nonsmokers will be exposed to the secondhand smoke in those rooms, which will dwarf any thirdhand smoke exposures. In contrast, fourth-hand smoke may occur in rooms or locations where smoking is never present, thus potentially resulting in meaningful exposure for nonsmokers.

The distinction is important, for example, in guiding parents as to whether smoking outside the home is enough to protect children. By smoking only outside the home, parents can ensure that there is no thirdhand smoke exposure. However, fourth-hand smoke exposure will still occur. This distinction is therefore important in evaluating policies that bar smokers from adopting or fostering children. If they agree not to smoke inside the home, there will be no thirdhand smoke exposure. But fourth-hand smoke exposure will still occur.

Nowhere is the distinction more important than in policy decisions about whether to allow smokers to take care of children, such as in schools and day care settings. If these smokers only smoke outside of the school or day care location, then there will be no thirdhand smoke. But fourth-hand smoke will still occur. So if fourth-hand smoke is a true and serious health hazard, then anti-smoking groups will have ammunition to promote policies that strip smokers of the right to teach in schools or work in day care facilities.

In its press release, ASH cites the effects of fourth-hand smoke in supporting policies that bar smokers from adopting children, stating that: "the invisible yet toxic brew of gases and particles clinging to smokers’ hair and clothing, has just been reported by researchers at Lawrence Berkeley Laboratory to combine with a common indoor air pollutant to form very potent cancer causing substances. This, the researchers say, places children at serious risk, even if parents smoke only outside the home, because they carry the residues inside with them."

"Dr. Lara Gundel, a co-author of this study just published in the Proceedings of the National Academy of Sciences warned: "Smoking outside is better than smoking indoors but nicotine residues will stick to a smoker's skin and clothing. Those residues follow a smoker back inside and get spread everywhere. The biggest risk is to young children. Dermal uptake of the nicotine through a child's skin is likely to occur when the smoker returns and if nitrous acid is in the air, which it usually is, then TSNAs [tobacco-specific nitrosamines] will be formed."

"Indeed, as another researcher has reported, thirdhand tobacco smoke is "much more toxic" than secondhand tobacco smoke because the aging of secondhand smoke absorbed on surfaces gives risk to new toxicants not present in fresh secondhand smoke."

"...a related study shows that the tobacco-residue chemicals in smokers’ breath were by themselves sufficient to cause or aggravate respiratory illnesses -- including asthma, coughs, and colds -- among children in smokers’ homes as compared with kids in homes with nonsmokers, even if the parents only smoked outside the home."

ASH goes on to state that smoking around children is "the most prevalent and dangerous form of child abuse."

The Rest of the Story

First of all, I find it disgusting to claim that smoking around children is the most "dangerous" form of child abuse. It is a disgraceful statement that completely undermines and salts the wounds of actual victims of child abuse.

To claim that smoking around children is child abuse is, in the first place, a disgraceful charge. To compare the intentional infliction of serious, immediate, and direct harm with what is in close to all cases not an intentional desire to harm anyone is disgusting and insensitive. It makes a mockery out of actual child abuse and I condemn the comparison in the strongest terms.

Second of all, there simply is no solid evidence that fourth-hand smoke exposure poses any substantial harm to the public, including children. There has yet to be a study in which significant exposure to toxic substances has been documented in a home that is known to be smoke-free. There is no evidence that the residues deposited on a smoker's clothing or hair or exhaled in their breath after smoking has ceased pose any significant danger.

In the absence of such evidence, it is untenable to support policies that prohibit smokers from adopting children, even if they agree to smoke only outside the home.

What ASH is essentially saying is that they would rather children remain in orphanages than be placed in a loving home if that loving home is being provided by a smoker, even if that smoker promises never to smoke in the home. Even if the smoker truly loves the child and would never cause harm to the child, ASH would rather the child remain in the orphanage. What if there is a shortage of adoptive parents (which there is in most places)? ASH would rather the children remain in the orphanage. This is a frighteningly disgusting policy that ASH is supporting. It is an anti-smoking policy that is truly going to cause substantial harm to children. And it is ironic that in the name of protecting children, ASH is supporting a policy that is going to cause severe harm to those very same children it claims to be trying to protect.

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