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Passive smoking is another reason for the increased incidence of ARI in children. There is no safe level of exposure to secondhand smoke and children are exposed to it more than adults. Not only is a child's body still developing physically, but her breathing rate is also faster than that of adults. The immature immune systems and narrow airways of infants and young children make them more susceptible. Every year, an estimated 150,000 to 300,000 children under 18 months of age get pneumonia or bronchitis from breathing secondhand tobacco smoke. Research has shown that children, who grow up in a smoky household, where one or both parents smoke, are likely to have twice the amount of respiratory and lung disorders as compared to children in non smoky households. Also, mothers who smoke may contribute to inadequate breast milk production. According to Dr.Jyotsna Mehta, Senior Gynecologist and Obstetrician at Sahani and City Hospital: In urban societies that we are dealing with, smoking has become rampant. We promote patients to quit smoking. It should be strictly avoided during the pregnancy. It must be ensured that the child does not ever become a passive smoker, whether in the womb or outside it." Unfortunately, finding an affordable solution for controlling indoor air pollution by reducing smoke exposure, reducing fuel costs, and attaining sustainability is a complex and evolving process. The WHO is preparing new indoor air quality guidelines for household fuel combustion. Introducing cleaner fuel, better ventilation by enlarging windows, and adding smoke hoods over the cooking area are interventions that can reduce pneumonia risk. Changing to full-scale cleaner household fuel could lower pneumonia incidence by 50%. The WHO has also launched a Framework Convention on Tobacco Control (WHO-FCTC) for further driving the need for clearer guidance on protection from second hand smoke. Children should be especially kept away from smoke. Smoke may not directly cause pneumonia, but it certainly leads to some ciliary dysfunction which may actually cause predisposition to the colonization of bacteria and viruses and make children more susceptible to pneumonia. The major interventions can be a switch at the household level to cleaner gaseous or liquid fuels; better combustion ventilation through high-quality biomass stoves; and strict self control on indoor smokingall in the interest of our childrens health. In the words of Dr YC Govil, Professor of Paediatrics in Chhatrapati Shahuji Maharaj Medical University (erstwhile King Georges Medical College Lucknow): The biggest intervention that can be done is education. No measure is better
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than awareness and for that people need to be educated about the havoc which tobacco and fuel smoke can wreak on innocent infants and children, exposing them to pneumonia related complications, (which may even be fatal) for no fault of theirs. Shikha Srivastava, CNS October 2011
This article is part of a Citizen News Service (CNS) series in lead up to the World Pneumonia Day, 12 November 2011. The project was managed by Abhinav Bharat Foundation and funded by the 2011 Small Grants for World Pneumonia Day Advocacy Program. We are grateful to the International Vaccine Access Center (IVAC), John Hopkins Bloomberg School of Public Health, GAVI Alliance, Global Alliance for Clean Stoves, and Best Shot Foundation for their support. We would like to thank all those who were interviewed as part of this project and who took the time to share their views.
This content is available under the Creative Commons Licence Attribution 3.0 Unported (CC BY 3.0) license
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