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XI No.11 - Sunday November 4 - Saturday November 17, 2012


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Doctor's Consultation  by Dr. Iain Corness

 

Should we ban smoking in cars?

I read an interesting article the other day from the Royal College of Paediatrics and Child Health (English spelling prevails as the college is very British), where their president Dr Hilary Cass said, “Levels of tobacco smoke in a car can be even higher than in a smoky bar and the effect on children can be serious, with second-hand smoke strongly linked to chest infections, asthma, ear problems and cot deaths. The (British) Government’s recent advertising campaign has tried to expose just how damaging smoke in a confined space is for children. But we’ve long campaigned on this issue and are calling on Government to go the extra mile and make it illegal. You can’t smoke in public places anymore. It’s illegal to inflict your smoke on colleagues at work. So why should you be allowed to inflict it on children?”

I think most of the readers of this column know my position on smoking, as I am very much against it, but being a pragmatist, I do not try and push the message too hard with adult smokers. They have heard all the statistics and have made up their own minds. I am not going to do a Joan of Arc over it.

However, it has been known for many years that children in smoking households suffer from more respiratory problems than the children from non-smoking households. “Thorax” the International Journal of Respiratory Medicine stated 12 years ago that “Previous reviews in this series have shown that parental smoking is associated with an increased incidence of acute lower respiratory illnesses, including wheezing illnesses, in the first one or two years of life, but does not increase the risk of sensitization to common aero-allergens, an important risk factor for asthma of later onset. Prevalence surveys of school children suggest that wheeze and diagnosed asthma are more common among children of smoking parents, with a greater increase in risk for more severe definitions of wheeze.”

I think you should just accept that at face value, do your own ‘googling’ if you like, but undoubtedly cigarette smoke and children is not a good mix. With the details that levels of cigarette smoke in closed cars is higher than in smoky bars, this should ring some warning bells.

As I said at the beginning of this article, I do not try and push the message to adult smokers, so please do not give me a barrage of ‘hate mail’. However, if this item about kids and smoking has hit a nerve, here is the truth on stopping smoking. The success rate really hangs on commitment. Leaving aside hypnosis and acupuncture, about which I know very little, but the good books tell me do not enjoy high success rates, let’s look at the other methods. Nicotine Replacement Therapy (NRT) gums and sprays make Nicotine available for you in measured doses - much like cigarettes do. You get the craving, you chew the gum. You get the craving, you squirt the spray.

Patches are slightly different. They deliver the Nicotine slowly over a 12 or 24 hour period, supposed to stop the craving before it happens. But often do not. After stabilizing on the NRT it is time to bring the dosage down, which is the next hurdle at which many fall. The end result can be cigarette smoking plus NRT - a potentially fatal combination. In fact, I strongly believe that NRT should only be done under close medical supervision. Too much nicotine can kill too!

So what is the best way? It’s called Cold Turkey. The proof is in the numbers. There has been enough research done and the prime factor is that the quitter has to be committed to the concept of becoming a non-smoker. Doing it (quitting) for somebody else, because you lost a bet, because you are being nagged into it by your wife, girlfriend, boyfriend is doomed to failure, I am afraid. This is something which requires your total commitment. 100 percent all the way.

Cold Turkey demands you stop immediately. Go through any withdrawals. Come out the other side as a non-smoker and you can stay that way for the rest of your life (and your children’s lives).


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Should we ban smoking in cars?

 

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