Take My Breath Away: Smoking Parents and Asthmatic Kids

Although most obstetricians recommend that soon-to-be parents quit smoking, some parents just can't kick their nicotine habit. The repercussions, especially for kids with asthma, can be breathtaking.

By Gordon Young

Joanne Tone, 54, seems to be from another era when it comes to smoking. She started when she was 15, and didn't stop when she became pregnant.

"Twenty years ago, pregnant women smoked and thought nothing of it," she explains. "My doctor didn't even suggest I quit!"

Joanne continued to smoke even after her son, Joe, was born in 1978.

"I don't remember the pediatrician telling me not to smoke around him, but I did try to limit it and keep the windows in the house open," she says. "But I never even considered quitting. In fact, I remember one night I ran out of cigarettes and woke Joe up so we could go to the store."

Joe, now a 21-year-old college student, remembers that night.

"I started to realize how incredibly important those little white sticks were to her," he says. "It wasn't until late in high school that I realized the smoke could be hurting me, too."

Joe had his first full-blown asthma attack when he was around 13. He was congested and wheezing, then, for a few seconds, his airways were completely blocked. Joanne rushed him to the emergency room where a doctor finally told her that she should stop smoking around her son.

But for Joanne, the addiction to cigarettes was just too powerful.

"I love Joe more than anything in the world, but I knew I could never quit," she says.

When Joe left for college, his asthma improved dramatically. He still suffers from mild allergies, especially when he's chasing errant balls on the golf course, but the mild congestion and watery eyes are more of an annoyance than a major health concern. The wheezing and blocked airways have disappeared completely.

"I don't blame her at all," Joe says. "I understand the fact that she wanted to quit smoking but didn't know how to go about it, and that she didn't think she would be successful."

With government warnings, anti-smoking advertising campaigns, and well-publicized evidence of the dangers posed by smoking, it would seem that stories like Joanne's are a thing of the past, but, unfortunately, that's not the case.

Physicians, researchers and children's advocates have found that a distressing number of mothers continue to smoke while pregnant, and that many children with asthma live in households where one or both parents smoke.

"It is very prevalent, but it's a secret because it's not something parents are proud to admit," says Nancy Sander, president and founder of Allergy and Asthma Network/Mothers of Asthmatics, Inc. "I speak all over the country to parents of children with asthma, and there are always a number of people with smoker's cough or reeking of cigarette smoke."

Asthma affects more than 10 million adults and close to 5 million children in the United States, according to the Asthma and Allergy Foundation of America. More children are hospitalized each year for problems related to asthma than any other chronic childhood condition.

Although exact figures on the number asthmatic children living with smokers are not available, surveys indicate that more than 40 percent of all children 2 months to 11 years of age live in homes with at least one smoker, according to the American Academy of Pediatrics.

In addition to contact with family pets, exposure to cigarette smoke is one of the most obvious ways to aggravate the condition in children. Lesley Brabyn, the founder and executive director of the Asthma Education and Resource Center, points out that a single exposure to smoke can cause inflammation to a child's airways for up to seven weeks.

"Smoking in the home is clearly related to an increase in respiratory infections and wheezing illnesses in the first few years of life," says Mary Klinnert, a pediatric psychologist at the National Jewish Medical and Research Center. "And if children have asthma, smoking is clearly related to triggering asthma attacks and keeping the lungs flamed."

So why don't parents just quit smoking? As Joanne Tone discovered, kicking the habit can be an arduous task, regardless of the incentives.

"These are not horrible people, but they feel horrible," Sander says. "It's not just the physical addiction. Smoking is part of the family. It's how they identify themselves."

Parents who are unable to quit may try to limit their child's exposure, but this is not a viable remedy because the smoke lingers in their hair and clothes.

"Have you ever stood next to someone who smokes?" Brabyn asks. "Smokers don't realize that they are like poison oak bush next to a child with asthma."

Some parents choose to downplay the seriousness of their child's asthma and the hazards posed by smoking altogether. Klinnert is leading a study on the prevention of childhood asthma funded by the National Institutes of Health. She has found that mothers who smoke are less likely to work with nurses who visit homes to deal with a variety of issues related to asthma.

"There's a denial and a defensiveness, and I'm sure there's guilt," Klinnert says. "It's as if they just don't want to think about the whole issue."

Joanne Tone managed to quit smoking two years ago, "out of sheer determination," after battling her addiction for decades. She understands the struggles faced by many parents of children with asthma.

"All in all, it's a really lousy thing to do to your children or anyone you love," she says. "But people do it anyway because cigarettes are so powerfully addictive, and they convince themselves that somehow it's okay."

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