The Indian Journal of Pediatrics

, Volume 66, Issue 6, pp 817–824 | Cite as

Smoking and children

  • Dilip R. Patel
Basic and Behavioural Sciences


Tobacco use by children and adolescents is a major health threat. A number of carcinogens and other harmful compounds have been identified in tobacco smoke. The major component, nicotine, is highly addictive. In India, approximately 5500 children and adolescents start using tobacco products daily, some as young as 10 years old. The majority of users have first tried tobacco prior to age 18. Children and adolescents are exposed to the harmful effects of nicotine from smoking or second hand smoke from others; and from use of smokeless tobacco. There is increased prevalence of respiratory disease, ear and sinus infections, asthma, oral disease, and many long-term complications such as cardiovascular disease and cancers due to tobacco use. Prevention and treatment strategies include behavioural approaches and pharmacotherapy. There is an increased urgency especially, for countries like India to address the problem of tobacco use by children and adolescents as the tobacco industry faces legal and public opinion obstacles in Western countries like United States. The medical practitioner can play an important role by implementing the preventive and treatment strategies in his or her practice.

Key words

Nicotine Smoking Smokeless tobacco 


  1. 1.
    Miller NS, Cocores JA. Nicotine dependence: Diagnosis, chemistry, and pharma-cologic treatments.Pediatrics in Review 1993; 14: 275.PubMedCrossRefGoogle Scholar
  2. 2.
    National Institute on Drug Abuse, National Institutes of Health, United States; Cigarettes and other nicotine products, NIDA Infofax,, accessed 7/19/1999Google Scholar
  3. 3.
    National Cancer Institute, USA : Environmental tobacco smoke,www.nci.nih. gov, accessed 7/19/1999.Google Scholar
  4. 4.
    Holbrook JH. Nicotine addiction. In: Fauci AS, Braunwald E, Isselbacher KJet al (eds).Harrison’s Principles of Internal Medicine, 14th edn. Mc-Graw Hill, New Delhi 1998; pp 2516.Google Scholar
  5. 5.
    Epps RP, Lunn WR, Manley MW. Tobacco, youth, and sports.Adolescent Medicine 1998; 9:483.PubMedGoogle Scholar
  6. 6.
    Becker AB, Manfreda J, Ferguson ACet al. Breast-feeding and environmental tobacco smoke exposure.Arch Pediatr Adolesce Med 1999; 153:689.Google Scholar
  7. 7.
    Benowitz NL.The Use of Biologic Fluid Samples in Assessing Tobacco Smoke Consumption. National Institute of Drug Abuse (USA) Research Monograph 1983; 48: 6–26.Google Scholar
  8. 8.
    Narayan KMV, Chadha SL, Hanson RLet al. Prevalence and patterns of smoking in Delhi: cross-sectional study.Brit Med J (International) 1994; 312:1576.Google Scholar
  9. 9.
    Gupta PC, Ball K. India: Tobacco Tragedy.Lancet 1990; 335 :594.CrossRefGoogle Scholar
  10. 10.
    Vaidya SG. Young tobacco users.World Health, 1995; 48 (4):30.Google Scholar
  11. 11.
    Meijer B, Branski D, Knol Ket al. Cigarette smoking habits among school children.Chest 1996; 110: 921.PubMedCrossRefGoogle Scholar
  12. 12.
    Kessler DA, Natanblut SL, Wilkenfeld JP,et al. Nicotine addiction: A pediatric disease.J Pediatrics 1997; 130:518.CrossRefGoogle Scholar
  13. 13.
    Editorial. Exporting tobacco addiction from the USA.Lancet 1998; 351:1597.Google Scholar
  14. 14.
    Food and Drug Administration (USA) Press Office : Children and tobacco : The Problem and the Facts.http://waisgate., accessed 7/19/1999.Google Scholar
  15. 15.
    Centers for Disease Control and Prevention United States: Youth Risk Behavior Surveillance United States 1997.MMWR, 1998; 47 (SS-3) : 1–89.Google Scholar
  16. 16.
    Monitoring the Future Study. Trends in lifetime prevalence of use of various drugs for eighth, tenth, and twelfth graders, United States. University of Michigan, Ann Arbor, Michigan,, accessed 7/23/1999.Google Scholar
  17. 17.
    American Academy of Pediatrics Policy Statement: Environmental Tobacco Smoke : A hazard to children.Pediatrics 1997; 99: 639.CrossRefGoogle Scholar
  18. 18.
    Epps RP, Manley MW, Glynn TJ. Tobacco use among adolescents: strategies for prevention.pediatric Clin N Amer 1995; 42 ; 389.Google Scholar
  19. 19.
    Epps RP, Manley MW.Clinical Interventions to Prevent Tobacco Use by Chidren and Adolescents. Washington DC, USA, US Department of Health and Human Services, National Cancer Insti-tute; 1996.Google Scholar
  20. 20.
    Klein JD. Incorporating effective smoking prevention and cessation counselling into practice.pediatric Annals 1995; 24 (12): 646.PubMedGoogle Scholar
  21. 21.
    Heymen RB. Tobacco prevention and cessation strategies.Adolescent Health Update, 1997; 9 (3), American Academy of Pediatrics, Elk Grove Village, IL, USA.Google Scholar
  22. 22.
    Hymowitz N. A survey of pediatric office-based interventions on smoking.NEJM 1995; 92: 657.Google Scholar
  23. 23.
    Burnett KF, Young PC. Ask, advise, assist: Pediatricians and passive smoke exposure.Clinical Pediatrics 1999; 38:339.PubMedCrossRefGoogle Scholar
  24. 24.
    Hughes JR, Goldstein MG, Hurt RD, Shiffman S. Recent advances in the pharmacotherapy of smoking.JAMA 1999; 281: 72.PubMedCrossRefGoogle Scholar

Copyright information

© Dr. K C Chaudhuri Foundation 1999

Authors and Affiliations

  1. 1.Department of PediatricsMichigan State University Kalamazoo Centre for Medical StudiesKalamazooUS

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