March 24, 2015

Is exposure to secondhand smoke child abuse?

No one would argue that exposing children to secondhand smoke is bad, but should it be considered child abuse?

Taryn Lindhorst, a UW associate professor of social work, says no. In an opinion piece published online in the Annals of Family Medicine earlier this month, Lindhorst argues that treating children’s exposure to secondhand smoke as child abuse and reporting parents to authorities takes a punitive approach to addiction and harms both children and families.

“Removing kids from their families, their siblings, their extended families, is very traumatic for kids,” she said in a recent interview. “You would potentially be causing as much harm as you are relieving.”

Lindhorst wrote the piece in response to one written by Adam Goldstein, director of tobacco intervention programs at the University of North Carolina School of Medicine, also published in the Annals of Family Medicine. Citing a case in which a 7-year-old girl developed pneumonia after ongoing exposure to her parents’ smoking, Goldstein said society has a responsibility to protect children from secondhand smoke, just as it does from other harmful situations.

“Purposeful and recurrent exposure of children to secondhand smoke by a parent is as abusive as many other commonly accepted physical and emotional traumas of children, like drunk driving or leaving children in a hot car unattended, ” Goldstein said in a statement.

“We have cared for too many children hospitalized with asthma and pneumonia, caused in large part to their repeated exposure to secondhand smoke.”

But Lindhorst said smoking should instead be treated as an addiction. A punitive approach would disproportionately affect women, people of color and poor families, she said — almost twice as many adults living under the poverty line smoke as those living above it, and smoking is more prevalent among people who suffered abuse or other trauma as children.

“The parents who are smoking today are likely the traumatized children of yesterday,” writes Lindhorst, the Carol LaMare Associate Professor of Social Work.

“This understanding, if truly embraced, would help us to address one of the root causes of smoking and provide support for smokers to change behaviors that are themselves the result of trauma.”

Instead of removing children from their homes, Lindhorst said, clinicians should offer parents support and resources to help them quit smoking.

“Unfortunately, very few parents who smoke are receiving these kinds of interventions from pediatric care providers,” she writes. “Until we know that parents have received adequate collaborative treatment, we should not resort to further sanctions by treating their behavior as a form of child abuse.”