Monday, March 06, 2006

Anti-Smoking Organization Trying to Scare Smokers into Thinking They May Lose Custody of Their Children; Calls Smoking Near Children "Child Abuse"

"Smokers May Lose Custody of Children as a Result of New Study" boasts the headline of a press release issued by Washington, D.C.-based Action on Smoking and Health (ASH).

The release continues: "Decisions Already Denying Custody to Smoking Parent Likely to Multiply in Light of New Evidence of Harmfulness of Tobacco Smoke to Kids."

According to ASH, "parents who exposed children to tobacco smoke have in fact lost custody, and the release of this new study is likely to accelerate this trend... Any other condition or practice in homes which killed almost 300 children each year and made four million sick enough to require a doctor would be immediately condemned as a form of child abuse. ... such complaints [child abuse complaints] are warranted in many cases by existing law, and [ASH] urges physicians, school nurses, and even grandparents to file them where appropriate."

In another press release, ASH claims that: "Parental Smoking Kills 6,200 Kids Each Year and Costs $8.2 Billion; But Law is Finally Beginning to Crack Down on Major Form of Child Abuse; At Least 15 States Will Take Away Custody if Necessary to Protect Kids."

This press release refers to parental smoking as "the most prevalent form of child abuse."

And it encourages people outside of the home, including "a doctor, a school nurse, a grandparent, or even a neighbor" to "file a complaint of suspected child abuse, neglect, or endangerment where smoking in the presence of the child creates a significant health risk." And significant health risk, according to ASH's statement, includes "hay fever," "allergies," and "recurrent ear infections."

According to yet another press release issued by ASH: "ASH pioneered the concept of arguing that deliberate exposure of children to secondhand tobacco smoke can constitute child abuse, and possible grounds for the revocation of custody."

And now, ASH has put out a propaganda piece in which it tries to provoke divorced or separated parents to fight back against their spouse if their spouse smokes by using the spouse's smoking around the child as a means to gain custody:

The piece is entitled "How You Can Fight Back if Your Spouse Smokes Around Your Child" and it solicits donations for ASH by trying to entice divorced or separated parents to donate to ASH in order to obtain access to secret information that ASH has prepared that "you and your lawyer can use as ammunition" to try to gain custody over your child, regardless of whether your obtaining custody is in the best interests of the child.

Please note, however, that "this information is available only to member-supporters of Action on Smoking and Health (ASH). ... Once you join - which you can do conveniently on-line -- you will receive by e-mail the user name and password you need to unlock this valuable information." Only after becoming a member of ASH can you "access the information about protecting your rights as a nonsmoking parent."

The Rest of the Story

First let me say that there are probably some isolated situations in which a smoking parent does smoke around a child with severe asthma and despite being warned about the child's asthma attacks being precipitated by exposure to tobacco smoke, continues to smoke around that child. I do not doubt that such behavior could be termed abusive to the child and that if the abusive parent were involved in a custody dispute, this would be a major and possibly even definitive consideration in that dispute.

However, to claim that parental smoking is a "major form of child abuse" is going a bit far, don't you think?

Certainly, before making such a loaded claim, I would insist that ASH provide documentation to support its assertion that parental smoking is a major form of child abuse. How many situations have there been such as I've presented above, where a child with asthma is repeatedly and intentionally exposed to secondhand smoke by a parent, even in the face of a warning from a physician that the child is sensitive to that smoke and an asthma attack will be triggered if the parent smokes in the presence of that child?

ASH refers to a number of anecdotal cases, but I think you need to document this before making a claim that implies that parental smoking is a major form of child abuse.

But ASH doesn't stop there (stop doesn't seem to be a word in its vocabulary). It refers to parental smoking not merely as a major form of child abuse, but as ""the most prevalent form of child abuse."

Now that claim clearly requires some documentation. It requires, at least, a comparison of the number of cases of child abuse due to intentional and severely harmful secondhand smoke exposure compared to the number of cases of child abuse from other causes.

But the absurdity and irresponsibility of ASH's claims do not end there.

ASH implies that the deaths of 6,200 kids each year from parental smoking represents a form of child abuse. In fact, it uses that precise statistic to back up its claim that parental smoking is a major form of child abuse.

But those deaths are essentially all from SIDS (sudden infant death syndrome), a disease entity in which the infant dies suddenly and without any warning and there is no apparent underlying abnormality or disease that would tip off the parents that the infant might be a potential SIDS victim.

So how can you blame the parents for those deaths? How can you call this a form of child abuse? Moreover, you can never be sure exactly what the cause of SIDS in a particular infant was. So who is ASH to suggest that anyone who smoked around their child and whose child died of SIDS has committed child abuse?

It's rather cruel and inhumane if you ask me. Isn't it enough that the parents of a child who died from SIDS have to suffer with one of the greatest losses imaginable? Do we have to torture them by suggesting that they are child abusers? Do we have to suggest that they should not have had custody of their children (if they were divorced or separated) based on the way they behaved?

Moreover, ASH is encouraging physicians, nurses, school nurses, grandparents, and even neighbors to file child abuse complaints against parents who smoke in the presence of their children.

Is this the kind of society that we want? Do we want our neighbors (and God forbid our parents and in-laws) snooping around and monitoring all of our parenting behaviors?

And where do we draw the line in defining what constitutes abusive behavior and behavior that would argue for taking custody away from a parent?

If I fail to put sunscreen on my child because I don't think we're going out for a long time, but then we get distracted and my child ends up with a severe sunburn, am I a child abuser? Have I just ruined my chances of retaining custody of my child if I get divorced or separated?

What about taking my kids to McDonalds and letting them eat Big Macs and french fries. Haven't I just contributed to them being at increased risk of obesity? What about feeding them tater tots? Perhaps my neighbor who smells those tater tots sizzling in the pan should call DSS immediately.

What about exposing a kid to lead paint? I treated probably 30-40 kids for lead poisoning during my time as a medical student, and virtually all of them got lead poisoning because their parents allowed them to eat peeling paint chips. Some of these kids required hospitalization, some had life-threatening illness, and all were at high risk of severe neuropsychological problems. Are these parents child abusers? Should these parents, most of whom were single parents and many of whom were separated or divorced, have lost custody of their children because of this?

In fact, I am quite sure that beyond any reasonable doubt, exposure to lead paint chips was the predominant source of "child abuse" that I observed during my pediatric experience. It was far more of a problem than exposure to secondhand smoke. If ASH really wants to recruit parents to fight back against their spouses, how about trying to make lead poisoning an issue in child custody disputes. That's a winner if I've ever heard of one.

Some of the examples of supposed child abuse that ASH provides - smoking around a kid with hay fever - for example, leave a lot to be desired. In fact, some of them seem less severe of a health hazard then the examples I've given above. I, for example, had severe hay fever as a kid, but was not at all sensitive to secondhand smoke. My parents smoked in my presence anyway. Does that make them child abusers? If so, then all kids should have child abusers for parents, because mine did a pretty darn good job (of course I'm talking about my two sisters!)

Look -it's one thing to conduct an educational campaign designed to try to educate parents about the hazards of secondhand smoke and the potential hazardous effects of exposing their children to secondhand smoke. I'm all for campaigns to urge parents not to smoke in the presence of their children and to try to protect their kids from secondhand smoke exposure as much as possible.

But this is way more than an educational campaign. For one, ASH is using scare tactics. It seems to me that they are literally trying to scare the daylights out of smokers and make them feel like their smoking may cause their children to be seized from them. I don't think I'm exaggerating. I think it's a very real fear. Add to that the irresponsible and undocumented claims that ASH makes and what you have is anything but a legitimate public health campaign.

Plus, if it is so critical that parents be educated about the most prevalent form of child abuse out there in an effort to prevent it, then how can ASH possibly justify withholding critical information from the public unless they make a financial contribution to ASH. What if they don't want to? What if they can't afford it? (and many of the parents who most need to know the facts are those who are least able to afford making a donation)

I just can't see a public health group using the enticement of free legal ammunition as a ploy to try to recruit new members to their organization. People should join ASH because they want to join ASH, not because they have been coerced into joining because they have been enticed into "buying" free legal counsel.

But perhaps the most disturbing aspect of this story to me is the apparent lack of respect for the parent-child bond that ASH shows, and the lack of understanding that secondhand smoke is not the be-all and end-all of what determines what is in the best interests of a child.

ASH is clearly advertising to help parents obtain custody of their children by using smoking by the other parent as ammunition in the courtroom. That is certainly the legal right of a parent. But it is not a public health issue. It is an issue for the judge to decide based on the best interests of the child in the case.

I really don't like the idea of ASH intruding upon court cases which should be all about, and only about, determining what is in the best interests of the child. There is no way ASH can know that. And providing this kind of legal ammunition could well result in a judgment that is not in the best interests of the child.

I have no problem with ASH providing information about the health effects of secondhand smoke on children, but to intervene and try to make this an issue in custody battles, to try to rile up divorcing parents to take it out on their spouses by making this issue a dominant one, to try to scare parents into thinking their children may be taken away from them because they smoke, and to suggest that this is the most important form of child abuse to address is both irresponsible and, I think, likely to be damaging.

And if this weren't enough...

... where ASH does appropriately provide information about the health effects of secondhand smoke... provides misleading information at that. But that's a different story.

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