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Anatomy of nicotine addiction
Source Mayo Clinic
November 15, 2012 is the
Great American Smokeout
Meena Carr (right) and Westlyn Bruno are members of a committee that was successful in making Washington-Beech, a public housing development in Roslindale, smoke-free. (Ernesto Arroyo Photo)
But it was the plight of her grandson who had asthma that triggered Carr to take action. “You wouldn’t understand until your child wakes you up in the middle of the night saying ‘I can’t breathe,’ ” she said.
The family never attributed his multiple visits to the emergency room to exposure to tobacco — especially since no one in the household smoked at the time.
But the neighbors did. That’s when Carr said she realized that closing the front door does not provide a protective barrier from another person’s smoke.
Carr, a non-smoker, did not sit idly by. She and a small group of residents decided that the new Washington-Beech Housing Development under construction in Roslindale would be smoke-free.
They solicited the assistance of the Committee for Boston Public Housing (CBPH) whose mission is to “improve the quality of life for Boston’s public housing residents.” The CBPH did a survey and discovered that buildings that had a higher rate of kids with asthma also had a higher number of smokers.
That was not unusual. According to a report cited by the Boston Public Health Commission, more than 23 percent of residents in Boston public housing had asthma compared to 15 percent of residents in non-public housing.
Armed with that information, the group began a campaign to educate the residents of the perils of smoking — not only for the smoker, but for innocent bystanders. Especially children.
Renee D. Boynton-Jarrett, M.D.
Boston Medical Center
The residents listened and responded. When a grant was given to build the new Washington Beech, more than 80 percent of the residents — even the smokers — agreed to make the complex a no-smoking residence.
That is also the goal of the Boston Public Health Commission. They are launching the Boston Smoke-Free Homes campaign and are asking property owners to register their apartments and rental homes as smoke-free (www.bostonsmokefreehomes.org). Boston Mayor Thomas M. Menino took this pledge one step further and has made all developments in the Boston Housing Authority (BHA) smoke-free in 2012.
It is well known that second-hand smoke — the combination of the burning end of a tobacco product and the smoke breathed out by smokers — can cause heart disease and lung cancer in non-smokers. According to the Centers for Disease Control and Prevention (CDC), second-hand smoke causes roughly 46,000 premature deaths each year in this country from heart disease and another 3,400 from lung cancer.
There are many perks to going smoke-free. Cost is one. A report from the Boston Tobacco Prevention and Control Program indicated that apartment turnover costs can be two to seven times greater for a unit in which the resident smoked. Insurance rates are less and the risk of fire is reduced. Furthermore, in a city like Boston, where 85 percent of the residents are non-smokers, a smoke-free apartment or home is a prime attraction.
But it’s the health concerns that are primarily driving this resolution. The 2008 Behavioral Risk Factor Surveillance System, a survey sponsored by the CDC, determined that a higher percentage of public housing residents in Boston had asthma, high blood pressure and diabetes than the general population. Moreover, 25 percent smoked compared to 13 percent of non-public housing residents.
Unfortunately, smoke doesn’t have boundaries. Second-hand smoke seeps under doors and through shared ventilation systems. That is the finding of Dr. Jonathan P. Winicoff, a pediatrician at Massachusetts General Hospital.
He and his co-researchers measured cotinine, a chemical byproduct of nicotine exposure, in the blood of 5,000 children across the country that lived in apartments or attached homes. They found that 73 percent of the children tested positive for the chemical, the highest level being found in children who lived in large multi-unit buildings.
Source: Centers for Disease Control and Prevention
Dr. Renee D. Boynton-Jarrett, a pediatrician at Boston Medical Center, explained that her major concern is the health of the child, but that is so intertwined with the health of the caregiver, that she winds up more often with two, rather than one patient. Particularly when it comes to smoking.
“Children of smokers are more likely to smoke,” she explained. “They get a level of comfort around smoking. They adopt the same behavior [as their parents] and they initiate smoking early.”
Infants and toddlers pose a different kind of problem. They don’t smoke, but they are not exempt from its hazards if they live in a house of smokers.
In children it causes severe asthma attacks, respiratory and ear infections and sudden infant death syndrome.
“Parents are aware of the impact of smoke on children,” Boynton-Jarrett said. “Some might feel guilt about their habit.”
So essential is a smoke-free environment to the health of children that the hospital has introduced into the medical record a tool to screen for smoking around children. The purpose is to determine all environments the child might inhabit that could expose him or her to second-hand smoke that a parent might overlook. Often it is places you would least expect it — day care, for example or the grandmother’s house.
But even refraining from smoking around a child may not provide full protection. Winickoff is credited with coining the term “third-hand smoke” — a toxic combination of gases and particles that lingers long after smoking.
According to a recent report in Environmental Health Perspectives, third-hand smoke consists of residual pollutants from tobacco smoke that remain in dust and on surfaces. According to Winickoff, you don’t have to see the smoke, as you do in second-hand smoke. If you smell it, it’s there.
Source: Boston Public Health Commission
More disturbing was that dust and surfaces of homes were contaminated even when smokers tried to limit exposure to smoke by turning on fans or opening windows. It was found that the remnants of smoking cling to pillows, carpets and upholstery. It even clings to toys. And that is the concern of Boynton-Jarrett. Infants and toddlers put things in their mouths.
Even smoking outdoors is not a solution — smoke clings to clothes, hair and skin. Boynton-Jarrett offers suggestions. “Wear a coat when you smoke outside to protect your clothing from the pollutants,” she said. “Wash your hands before you touch your kids.”
But one piece of advice prevails. “Try quitting,” she said.