Wzorzec-przegl d lekarski-XX-2001

ORIGINAL PAPERS
Sylwia KA£UCKA
Consequences of passive smoking in home
environment
Nastêpstwa biernego tytoniu palenia w œrodowisku
domowym
The First Department of Family Medicine
Medical University of Lodz
Head: Przemys³aw Kardas MD, PhD
Additional key words:
cigarette smoking
passive smoker
COPD
home environment
Dodatkowe s³owa kluczowe:
palenie papierosów
bierny palacz
POChP
œrodowisko domowe
The study was financially support
by the Medical University in Lodz,
project number 502-18-561
The results of the study were published
in Przeglad Lekarski 2007/64/10 in English
and Polish version.
Address for correspondence:
The First Department of Family Medicine
Medical University
Narutowicza Str 96/C
90-141 Lodz,
Phone: (+48 42) 678 72 10
Fax: (+48 42) 678 52 57
email: [email protected]
Przegl¹d Lekarski 2007 / 64 / 10
Passive smoking means cigarette
smoke inhaling by people other than
smokers. Passive smoker inhales tobacco smoke coming not only from
side-stream, but also smoke exhaled
by the smoker. Long-term tobacco
smoke inhaling increases the risk of
appearance of smoke related diseases
(for example COPD, heart diseases),
including the most dangerous types of
cancer, which only few smokers realize. The aim of this study was to check
whether tobacco smoke inhaling in
home environment from childhood to
adulthood has an influence on respiratory system of adults. The study included adults. In the study two types
of participants division were used.
Among 1481 persons two groups were
separated. Group 1 contains people,
who have never lived in home environment with active smokers, altogether
465 persons. Group 2 contains people
who from birth have been exposed to
cigarette smoke inhaling (altogether
1016 persons). With help of the author’s questionnaire the information
concerning demographic features and
smoking habit were gathered. The patients underwent doctor’s examination. They had a spirometric test and a
chest radiogram. Statistically significant differences appear among persons with higher education who belong to two different groups. The
number of children who have lived in
smoke free rooms during childhood
and adolescence and finished studies
is bigger than the number of active
smokers’ children (p<0.001). Over 90%
of never smokers have inhaled cigarette smoke since childhood in home
environment. Chronic obstructive pulmonary disease has been diagnosed
at 47.5% of active smokers, 48.3% of
ex-smokers and up to 44.7% of passive smokers. Cigarette smoking and
smoke inhaling for more than twenty
years has a significant influence on the
appearance of COPD. No statistically
significant differences were noted
among the three groups of participants. (p>0.05).Cigarette smoke inhaling at childhood and adolescence
Bierne palenie oznacza inhalowanie dymu tytoniowego innych palaczy.
Bierny palacz wdycha dym tytoniowy
pochodz¹cy nie tylko ze strumienia
bocznego, ale i dym wydychany przez
palacza. Ta wieloletnia inhalacja tytoniu zwiêksza ryzyko wyst¹pienia chorób odtytoniowych (np. POChP, choroby serca) w tym najgroŸniejszych nowotworów, z czego rzadko, który bierny palacz zdaje sobie sprawy. Celem
niniejszej pracy by³o sprawdzenie czy
inhalowanie dymu tytoniowego w œrodowisku domowym od dzieciñstwa do
dojrza³oœci ma wp³yw na uk³ad oddechowy w wieku doros³ym. Badaniem
objêto osoby pe³noletnie. W pracy zastosowano dwa podzia³y badanych
osób. Wœród 1481 osób wyodrêbniono dwie grupy. Do grupy 1 nale¿¹ osoby, w które w œrodowisku domowy nie
przebywa³y nigdy z osobami pal¹cymi
papierosy, ³¹cznie 465 osób. W grupie
2 znalaz³y siê osoby, które od urodzenia by³y nara¿one na inhalacje dymu
tytoniowego (³¹cznie 1016 osób). Za
pomoc¹ autorskiego kwestionariusza
uzyskano informacje na temat cech
demograficznych i na³ogu palenia papierosów. Pacjenci zostali poddani
badaniu lekarskiemu. Wykonano u
nich badanie spirometryczne oraz radiogram klatki piersiowej. Ró¿nice
istotne statystycznie wystêpuj¹ miêdzy
osobami z wy¿szym wykszta³ceniem
nale¿¹cymi do dwóch ró¿nych grup.
Liczba dzieci, które mieszka³y w pomieszczeniach wolnych od dymu tytoniowego w okresie dzieciñstwa i okresu m³odzieñczego zdoby³y wy¿sze wykszta³cenie jest wiêksza, ni¿ liczba
dzieci rodziców pal¹cych papierosy
(p<0,001). Ponad 90% osób nigdy niepal¹cych papierosów od dzieciñstwa
wdycha³a dym papierosowy w œrodowisku domowym. Przewlek³¹ obturacyjna chorobê p³uc rozpoznano u
47,5% aktualnych palaczy, 48,3% by³ych palaczy i u a¿ 44,7% biernych palaczy papierosów. Palenie papierosów
i inhalowanie dymu tytoniowego przez
ponad 20 lat ma istotny wp³yw na wystêpowanie POChP. Nie odnotowano
ró¿nic istotnych statystycznie miêdzy
637
should be taken seriously because it causes development
of chronic diseases like COPD. GOLD 2006 standards convince that at every stage of COPD development the effects
of this disease may be partly reversed if one stops smoking cigarettes. That is why a child should not be exposed
to cigarette smoke at any stage of its life. Permanent inhalation of tobacco smoke since early childhood in home environment influences equal occurrence of COPD at passive, ex- and active smokers. Reduction of tobacco consumption, better care concerning passive smokers, increasing consciousness of parents smoking in home environment may protect their children from serious health
consequences in the future.
Introduction
Passive smoking means cigarette smoke inhaling by people other than smokers.
The passive smoker inhales a great amount of toxic substances from cigarette smoke, that are freed by lighting a cigarette, a
pipe or a cigar. Non-smokers as well as active smokers are exposed to harmful influence of passive smoke inhaling in smokefilled places.
Tobacco smoke contains over 4.000
chemical substances, among them 40 carcinogenic compounds. Smoke inhaled by a
passive smoker is less condensed than
smoke inhaled by a smoker, but it contains
35 times more carbon dioxide and 4 times
more nicotine and 69 carcinogens. It is called a “side-stream of tobacco smoke”. Passive smoker inhales tobacco smoke coming
not only from “side-stream”, but also from
the “main stream” exhaled by the smoker
[12]. Long-term tobacco smoke inhaling increases the risk of appearance of smoke
related diseases (for example COPD, heart
diseases), including the most dangerous
types of cancer, which only few smokers
realize.
The side-stream of tobacco smoke contains also allergenic substances, causing
lacrimation, nose mucosal membrane irritation, coughing and allergies. It is easy to
notice when after a few hours spent in one
room with smoking persons we start to sneeze, cough, feel eye irritation or headache.
Passive smoking is such a serious problem that English scientists called it “second
hand smoker”. Epidemiological studies carried out in the USA showed that every year
passive smoking causes 150.000 deaths
because of cancer, about 180.000 deaths
because of cardiovascular diseases and
85.000 deaths because of respiratory system diseases. Negative results of passive
smoking were noticed also in Europe, where every year almost 80.000 people die [13].
In the report prepared by three prestigious
European scientific institutes it was underlined that passive smoking causes diseases
and deaths at the same extent as active
smoking.
In the year 2007 the European Commission accepted The Green Book called “Towards a Europe free from tobacco smoke”,
which contains wide consultations at all le638
trzema grupami badanych (p>0,05). Nale¿y powa¿nie braæ
pod uwagê wdychanie dymu tytoniowego w okresie dzieciñstwa i dojrzewania, gdy¿ wp³ywa na rozwój chorób przewlek³ych w tym POChP. Standardy GOLD 2006, przekonuj¹,
i¿ na ka¿dym etapie rozwoju POChP mo¿na czêœciowo odwróciæ skutki tej choroby, jeœli zaprzestanie siê palenia papierosów. Dlatego w ka¿dym momencie ¿ycia dziecka nale¿y uwolniæ go od wdychania dymu tytoniowego w œrodowisku domowym. D³ugotrwa³a inhalacja dymu tytoniowego od
najm³odszych lat w œrodowisku domowym wp³ywa na wystêpowanie w takim samym stopniu POChP u biernych palaczy, ex-palaczy i aktywnych palaczy papierosów. Redukcja konsumpcji tytoniu w danym kraju, wiêksza dba³oœæ o
biernych palaczy, zwiêkszanie œwiadomoœci rodziców pal¹cych papierosy w œrodowiskach domowych mo¿e uchroniæ ich dzieci przed powa¿nymi skutkami zdrowotnymi w
przysz³oœci.
(FEV1/FVC < 70%), and value of FEV1 (forced expiratory volume in the first second) after broncholytic drug
inhalation amounts to > or < 80% of the proper value,
then the result indicates the COPD [1,2]. The chest radiogram was used to exclude other respiratory system
diseases, among them cancer.
Statistic analysis
For measurable features there were calculated
means with standard bias and for quality variables there
was given the percentage of their particular categories
in tested samples. In order to compare average values
there was used a test for two independent trials or a
Cochran-Cox test. For evaluation of differences in the
frequency of particular features value (category) appearance in groups there was used chi-square test or independence test chi-square with the Yates’ correction
for two fractions from big samples.
vels: political and public, national and regional, medical services and environment protection, as well as economic in order to protect citizens from negative results of passive smoking [9].
The aim of this study was to check whether tobacco smoke inhaling in home environment from childhood to adulthood has an
influence on respiratory system of adults.
Materials and Methods
The study included adults, patients of the primary
medical care doctors. The factor that qualified them for
the study was living from birth with an active smoker.
The participants lived in the same urban district, in apartments with central heating. The study excluded persons
who were exposed to gases, dust or other irritating substances at work.
In the study two types of participants division were
used. Among 1481 persons two groups were separated.
Group 1 contains people, who have never lived in home
environment with active smokers, altogether 465 persons.
Group 2 contains people who from birth have been exposed to cigarette smoke inhaling (altogether 1016 persons). The study does not deal with children.
The second division concerned smoking habit.
Three groups have been distinguished: group A – active
cigarette smokers, group B – former cigarette smokers
(a person who has not smoked at least for two years and
does not live in the presence of smoke) and group C –
never-smokers.
With help of the author’s questionnaire the information concerning demographic features and smoking habit were gathered. The patients underwent doctor’s examination. They had a spirometric test and a chest radiogram.
According to ERS (European Respiratory Society)
and PTFP (Polish Physio-Pulmonary Society) a spirometric test is the basic respiratory system function test.
The Ratio of FEV1 (forced expiratory volume in the first
second) to FVC (forced vital capacity) is lower than 70%
Results
Data received on the basis of the author’s questionnaire
In the survey 1481 persons took part,
777 women (52.5% of participants) and 704
men (47.5% of participants). Regarding
home environment the participants were divided into two groups. Altogether to the survey there were enrolled 465 persons who
have never been exposed to cigarette smoke inhaling at home (group 1) and 1016 persons who have inhaled cigarette smoke since birth (group 2).
In the following tables there was applied
a division into: group 1 – persons who in
their home environment do not stay with
active smokers and group 2 – persons who
in their home environment stay with active
smokers (Table I-III).
The number of persons (1016), who since their childhood have been exposed to
cigarette smoke inhaling in their home environment was twice bigger than the number
Table I
Characteristics of participants.
Charakterystyka osób bior¹cych udzia³ w badaniu.
c2=26,551
p=0,000000
Group
Groups
1
Gender
n
2
Total
%
n
%
n
%
Wom en
198
42.6
579
57.0
777
52.5
M en
267
57.4
437
43.0
704
47.5
Total
465
100.0
1016
100.0
1481
100.0
Przegl¹d Lekarski 2007 / 64 / 10
S. Ka³ucka et al.
of persons (465), whose home environment
was free from smoke (p=0.00000).
Average age of the participants was 52.5
years. In the first group there are slightly
older persons, both men and women, in
comparison to the second group
(p<0.00000).
Statistically significant differences appear among persons with higher education
who belong to two different groups. The
number of children who have lived in smoke free rooms during childhood and adolescence and finished studies is bigger than
the number of active smokers’ children
(p<0.00).
In further study results there was applied a division into: cigarette smokers (A),
former cigarette smokers (B) and never
smokers (C) (Table IV-VI).
In the study active smokers (965) dominate over ex-smokers (317) and never
smokers (199). There were no statistically
significant differences between active smokers and ex-smokers both in the group of
women and men (p>0.05). The level of statistical relevance was noted between groups of active smokers and never smokers
and between former smokers and never
smokers (p<0.0000).
The biggest percentage of highly educated persons was noted in the group C
(26.6%) in the environment of non-smokers,
in comparison to former (19.2%) or active
(19.3%) smokers. Definitely most of the
smokers had secondary, vocational and elementary education.
Over 90% of never smokers have inhaled cigarette smoke since childhood in home
environment.
Results concerning respiratory system
damage on the example of COPD.
Chronic obstructive pulmonary disease
has been diagnosed at 47.5% of active
smokers, 48.3% of ex-smokers and up to
44,7% of passive smokers.
Cigarette smoking and smoke inhaling
for more than twenty years has a significant
influence on the appearance of COPD. No
statistically significant differences were noted among the three groups of participants.
(p>0.05) (Table VII-1A).
COPD was diagnosed more often at
active men smokers than women smokers
(p<0.0112). In groups 1 and 2 there were
no statistically significant differences in the
occurrence of COPD among women and
men (p>0.05) (Table VII-2A).
Considering the results, participants
from group 2 smoke shorter (average 33.2
years) than persons who have not been
exposed to cigarette smoke inhaling at
home (average 29.1 years). In both groups
women smoke on average 4 years shorter
than men (p<0.000) (Table VII-1B).
COPD occurred more often at former
men smokers than women (p<0.0054). There were no statistically significant differences in COPD occurrence between women
and men ex-smokers in group 2 (p>0.05)
(Table VII-2B).
Considering the results women smoked
on average for 24 years, both those who
spent their childhood in the environment of
smokers and those whose home was smoke free (p>0.05). Also among men there was
Przegl¹d Lekarski 2007 / 64 / 10
Table II
Age of participants in two different home environments.
Wiek badanych osób w dwóch ró¿nych œrodowiskach domowych.
Group
Groups
1
Gender
2
M ean
SD
M ean
Wom en
53.3
14.0
M en
57.4
14.9
Total
56.5
14.6
Wom en v s M en
p
Total
Group 1 v s 2
SD
M ean
SD
50.7
14.8
51.9
14.7
0.0308
50.7
15.4
53.2
15.5
0.0000
50.7
15.0
52.5
15.1
0.0000
0.0028
p>0.05
p>0.05
-
Table III
Level of education among the participants in both groups.
Poziom wykszta³cenia wœród badanych w dwóch grupach.
Group
Education
1
Group 1 v s 2
2
n
%
Total
n
%
n
%
c2
p
Incom plete elem entary
5
1.1
8
0.8
13
0.9
0.304
p>0.05
Elem entary
81
17.4
162
15.9
243
16.4
0.506
p>0.05
Vocational
94
20.2
227
22.3
321
21.7
0.850
p>0.05
Secondary
180
38.7
424
41.7
604
40.8
1.207
p>0.05
Incom plete higher
12
2.6
56
5.5
68
4.6
6.257
0.012370
Higher
93
20.0
139
13.7
232
15.7
9.641
0.001903
465
100.0
1016
100.0
1481
100.0
Total
-
Table IV
Cigarette smoking and gender of the participants.
Palenie papierosów a p³eæ badanych.
Groups
Gender
Activ e sm okers (A)
p
Ex-sm okers (B)
Non sm okers (C)
n
%
n
%
n
%
Wom en
467
48.4
152
47.9
158
79.4
M en
498
51.6
165
52.1
41
20.6
Total
965
100.0
317
100.0
199
100.0
(A) v s (B) (A) v s (C) (B) v s (C)
p>0.05
0.000000 0.000000
-
Table V
Level of education of the participants and cigarette smoking.
Wykszta³cenie wœród badanych a palenie papierosów.
Groups
Education
Activ e sm okers
(A)
n
Incom plete elem entary
%
p
Ex-sm okers
(B)
n
%
Non-sm okers
(C)
n
(A) v s (B) (A) v s (C) (B) v s (C)
%
5
0.5
5
1.6
3
1.5
p>0.05
p>0.05
p>0.05
Elem entary
180
15.6
39
12.3
24
12.1
p>0.05
p>0.05
p>0.05
Vocational
223
23.1
66
20.8
32
16.1
p>0.05
0.006284
p>0.05
Secondary
371
38.4
146
46.1
87
43.7
0.016564
p>0.05
p>0.05
Incom plete higher
47
4.9
7
2.2
14
7.0
0.040615
p>0.05
0.006911
Higher
139
14.4
54
17.0
39
19.6
p>0.05
p>0.05
p>0.05
965
100.0
317
100.0
199
100.0
Total
no statistically significant difference in the
years of smoking in both home environments. Women in both groups were smoking definitely shorter than men, on average 8 years (p<0.000).
-
Discusion
Since scientific research showed increase of smoke related diseases morbidity at
passive tobacco smokers, prohibition of
smoking is widely introduced in public pla639
Table VI
Groups of the participants according to home environment.
Badani wg grup palenia w œrodowisku zamieszkania.
Groups
Sm oking in hom e
env ironm ent
Activ e sm okers
(A)
p
Ex-sm okers
(B)
Non-sm okers
(C)
n
(A) v s (B) (A) v s (C) (B) v s (C)
n
%
n
%
%
No
240
24.9
206
65.0
19
9.6
Yes
725
75.1
111
35.0
180
90.4
Total
965
100.0
317
100.0
199
100.0
0.000000 0.000002 0.000000
-
Table VII
Occurrence of COPD and smoking cigarettes.
Wystêpowanie POChP a palenie papierosów.
Groups
C O PD
Activ e sm okers
(A)
p
Ex-sm okers
(B)
Non-sm okers
(C)
(A) v s (B) (A) v s (C) (B) v s (C)
n
%
n
%
n
%
No
507
52.5
164
51.7
110
55.3
Yes
458
47.5
153
48.3
89
44.7
Total
965
100.0
317
100.0
199
100.0
p>0.05
p>0.05
p>0.05
-
Przewlek³¹ obturacyjna chorobê p³uc rozpoznano u 47,5% aktualnych palaczy, 48,31% by³ych palaczy i u a¿ 44,7%
biernych palaczy papierosów. Palenie papierosów i inhalowanie dymu tytoniowego przez ponad 20 lat ma istotny
wp³yw na wystêpowanie POChP. Nie odnotowano ró¿nic istotnych statystycznie miêdzy trzema grupami badanych
(p>0,05).
Table VII-1A
COPD and active smokers, gender participants and home environment.
POChP a aktywni palacze, p³eæ badanych i œrodowisko zamieszkania.
Groups
Gender
1
n
2
%
n
Total
%
n
%
Wom en
37
41.1
165
43.8
202
43.3
M en
79
52.7
177
50.9
256
51.4
Wom en v s M en c 2
3.008
3.656
6.421
p
p>0.05
p>0.05
0.011278
Table VII-1B
COPD and ex-smokers, gender participants and home environment.
POChP a byli palacze, p³eæ badanych i œrodowisko zamieszania.
Groups
Gender
1
2
Total
n
%
n
%
n
%
Wom en
43
45.7
18
31.0
61
40.1
M en
69
61.6
23
43.4
92
55.8
Wom en v s M en c 2
5.183
1.817
7.737
p
0.022809
p>0.05
0.005410
Table VII-2A
The number of years smoking cigarettes among smokers, gender participants in two groups.
Liczba lat palenia papierosów wœród aktywnych palaczy, p³eæ badanych w dwóch grupach.
Groups
Gender
p
2
Total
Group 1 v s 2
M ean
SD d
M ean
SD d
M ean
SD d
Wom en
30.5
14.8
27.0
14.1
27.7
14.3
0.0367
M en
34.8
16.3
31.5
15.1
32.4
15.5
0.0294
Total
33.2
15.9
29.1
14.7
30.1
15.1
0.0003
Wom en v s M en
640
1
0.0418
0.0000
0.0000
-
Przegl¹d Lekarski 2007 / 64 / 10
ces (hospitals, offices, stations, restaurants)
and in working areas, in order to protect nonsmokers in most countries. The importance
of home environment is often neglected by
parents who for many years expose their
children to toxic smoke inhaling.
Despite higher awareness and knowledge concerning health consequences of tobacco smoking and passive inhalation in
Poland there is still a big percentage of smoking addicts. Nowadays in Poland still 43%
of men and 22% of women smoke regularly
on average 20 cigarettes a day. Although in
our country smoking prohibition has been
enforced in public places, in a couple of cities even at bus and tram stops, at children
playgrounds and in parks, smoking at home
is still unpunished. The range of the problem
is showed in this study, where there were
twice more persons whose parents smoked
at home (Table I).
The consequences of passive smoking
are observed at every stage of human life.
Tobacco smoke inhalation may cause miscarriages, intrauterine fetus necrosis, lowering
of vital forces of newborns. The child should
not have any contact with tobacco smoke,
since it is more sensitive to toxins present in
smoke than adults. Smoking parents do not
always realize how fatal it is for health of a
child and future adult. Children – passive
smokers, more often fall for infections of respiratory system, otitis media, sinusitis and
they suffer from unconventional symptoms
like coughing, hoarseness and running nose.
Passive smoking impairs the function of immune system and lowers general condition
of a young organism. It influences the child’s
intellectual capabilities (reading, logical thinking, comprehension) and can retard its intellectual development. Children who have
been exposed to smoke inhaling at home,
did not acquire higher education as often as
children who could enjoy smoke free home
environment (Table III, V).
Passive smoking means child’s contact
not only with tobacco smoke but also with
its remnants that cumulate and stay in the
room. Smoke does not know boundaries,
smoke-filled air circulates constantly. Airing
may remove unpleasant smell but it does
not eliminate all toxic chemical substances
from surroundings and human organism.
Harmful substances cumulate in a young
organism. Hair tests of mothers who smoked in the presence of their children showed that continue (metabolite of nicotine)
stayed longer in hair of children than mothers [8].
Toxic compounds of tobacco smoke cause damage of ciliary epithelium, one of the
most important and essential defense mechanisms of respiratory system [7]. Inefficient ciliary apparatus does not clean airways thoroughly and inflammatory processes evoked by harmful substances in smoke are not suppressed. Inflammation causes also bigger amount of goblet cells contributing to hypersecretion of bronchial secretion. These are the reasons for morning
coughs of children, frequent non-specific
infections, asthma, multiorgan allergy. It was
indicated that infants in smoking families
have respiratory system infections twice
more often than infants in non-smoking faS. Ka³ucka et al.
Table VII-2B
The number of years smoking cigarettes among ex-smokers, gender participants in two groups.
Liczba lat palenia papierosów wœród by³ych palaczy, p³eæ badanych w dwóch grupach.
Groups
Gender
1
p
2
Total
Group 1 v s 2
M ean
SD
M ean
SD
M ean
SD
Wom en
24.2
12.0
24.6
12.2
24.4
12.0
p>0.05
M en
32.0
13.7
31.6
13.1
31.9
13.4
p>0.05
Total
28.5
13.5
27.9
13.1
28.3
13.3
p>0.05
Wom en v s M en
0.0000
0.0000
milies, also the risk of hospitalization and
pneumonia is 50% higher [11].
We often do not connect our present
health condition with negative habits of our
parents in home environment. Long-term
negative results of passive smoking may be
noticed after several dozen years when there appears accelerated development of arteriosclerosis (risk of heart attack is 25%
higher at passive smokers than at persons
never exposed to smoke), serious respiratory system infections or COPD [10]. It is a
result of impairing and/or damaging of cells
by tobacco smoke toxins. Inflammatory process existing in lungs for years stimulates
constant migration of phagocytes which release large amounts of active oxygen species [3] and intensify existing inflammatory
process in lungs even more [4]. Lack of airways cleaning, hypersection, excess of proteolytic compounds successively destroy
lung tissue [4].Balance between oxidants
and antioxidants is disturbed which consequently leads to the development of chronic
obstructive pulmonary disease COPD. Children who have been exposed to tobacco
smoke at home since early childhood even
after 20 years may feel consequences of
passive nicotinism [5]. COPD is a chronic
disease, in which causative action in more
than 90% is tobacco smoke. The disease
develops asymptomatically and first symptoms appear after 10 years of smoking, at
40 years of age and more. In the examined
participants there were no differences in the
occurrence of COPD at active, ex- and never smokers. But never smokers have in-
Przegl¹d Lekarski 2007 / 64 / 10
0.0000
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haled smoke for 20 years in their home environment and negative results of passive inhalation at childhood appear at adulthood as
COPD (Table VII).
Repairing processes and changes which
take place in pulmonary parenchyma and
other organs are restrained because organism needs time to free itself from toxic and
carcinogenic compounds. They stay in the
organism because in the past cascades of
irreversible processes were activated. Toxicity of passive smoking is confirmed by the
latest research concerning breast cancer of
passive women smokers. Long lasting and
regular passive smoking increases the risk
of breast cancer by 27% and at premenopausal period by 68% [6]. Similar phenomenon is shown in documented retrospective
research concerning connection between
passive smoking at developmental age and
occurrence of lung cancer at adulthood.
A nicotinism-prevention campaign is an
example of reduction of negative results
among passive smokers. In the United States cigarette smokers are discriminated for
20 years. Prohibition of smoking in public
places, like restaurants, pubs in England,
Ireland or Netherlands did not cause their
bankruptcy but cleared them from cigarette
smoke.
Cigarette smoke inhaling at childhood
and adolescence should be taken seriously
because it causes development of chronic
diseases like COPD. GOLD 2006 standards
convince that at every stage of COPD development the effects of this disease may be
partly reversed if one stops smoking ciga-
rettes. That is why a child should not be
exposed to cigarette smoke at any stage of
its life.
Conclusions
1. Permanent inhalation of tobacco
smoke since early childhood in home environment influences equal occurrence of
COPD at passive, ex- and active smokers.
2. Reduction of tobacco consumption,
better care concerning passive smokers, increasing consciousness of parents smoking
in home environment may protect their children from serious health consequences in
the future.
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