Protecting Children and Adolescents From Tobacco and Nicotine.

This technical report provides the evidence base for the accompanying tobacco clinical report and policy statement. It builds on, strengthens, and expands AAP recommendations from the previous version in 2015. Tobacco use remains the leading preventable cause of disease and death for adults in the United States. The tobacco epidemic takes a substantial toll on children's and adolescent's health, including harms because of prenatal exposure during pregnancy, secondhand and thirdhand exposure during infancy and childhood, and/or direct use during adolescence. Tobacco and nicotine use almost always starts in childhood or adolescence. Almost 40% of children aged 3 to 11 years are regularly exposed to secondhand tobacco smoke, and rates of secondhand exposure to e-cigarette aerosol have increased over the last decade.

[1]  D. Camenga,et al.  Protecting Children and Adolescents From Tobacco and Nicotine. , 2023, Pediatrics.

[2]  K. A. Cullen,et al.  Tobacco Product Use Among Middle and High School Students — United States, 2022 , 2022, MMWR. Morbidity and mortality weekly report.

[3]  G. Matt,et al.  Differential associations of hand nicotine and urinary cotinine with children's exposure to tobacco smoke and clinical outcomes. , 2021, Environmental research.

[4]  Annette K Regan,et al.  Adverse Birth Outcomes Associated With Prepregnancy and Prenatal Electronic Cigarette Use , 2021, Obstetrics and gynecology.

[5]  M. Cabana,et al.  Interventions for Tobacco Smoking Cessation in Adults, Including Pregnant Persons: US Preventive Services Task Force Recommendation Statement. , 2021, JAMA.

[6]  J. Long,et al.  Association between electronic cigarette use and tobacco cigarette smoking initiation in adolescents: a systematic review and meta-analysis , 2020, BMC Public Health.

[7]  S. Balk,et al.  Health Disparities in Tobacco Use and Exposure: A Structural Competency Approach , 2020, Pediatrics.

[8]  K. A. Cullen,et al.  Tobacco Product Use Among Middle and High School Students — United States, 2020 , 2020, MMWR. Morbidity and mortality weekly report.

[9]  Ahmed Jamal,et al.  Tobacco Product Use Among Adults — United States, 2019 , 2020, MMWR. Morbidity and mortality weekly report.

[10]  T. Wills,et al.  E-cigarette use and respiratory disorders: an integrative review of converging evidence from epidemiological and laboratory studies , 2020, European Respiratory Journal.

[11]  T. Chamogeorgakis,et al.  Lung Transplantation for the Treatment of Vaping Induced, Irreversible, End Stage Lung Injury. , 2020, The Annals of thoracic surgery.

[12]  G. Matt,et al.  Thirdhand smoke contamination and infant nicotine exposure in a neonatal intensive care unit: An observational study. , 2020, Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco.

[13]  Brian A. King,et al.  Tobacco Product Use Among High School Students — Youth Risk Behavior Survey, United States, 2019 , 2020, MMWR supplements.

[14]  K. Wilson,et al.  The Effects of Nicotine on Development , 2020, Pediatrics.

[15]  Brian A. King,et al.  Update: Characteristics of a Nationwide Outbreak of E-cigarette, or Vaping, Product Use–Associated Lung Injury — United States, August 2019–January 2020 , 2020, MMWR. Morbidity and mortality weekly report.

[16]  M. Munafo,et al.  Is e-cigarette use in non-smoking young adults associated with later smoking? A systematic review and meta-analysis , 2019, Tobacco Control.

[17]  Christina D Diaz,et al.  Pulmonary Illness Related to E-Cigarette Use. , 2019, The New England journal of medicine.

[18]  Jing Lu,et al.  Paternal Smoking Before Conception and During Pregnancy Is Associated With an Increased Risk of Childhood Acute Lymphoblastic Leukemia: A Systematic Review and Meta-Analysis of 17 Case-Control Studies , 2019, Journal of pediatric hematology/oncology.

[19]  C. Haighton,et al.  Is adolescent e-cigarette use associated with smoking in the United Kingdom?: A systematic review with meta-analysis , 2019, Tobacco prevention & cessation.

[20]  C. Bullen,et al.  Different doses, durations and modes of delivery of nicotine replacement therapy for smoking cessation. , 2019, The Cochrane database of systematic reviews.

[21]  J. Ramirez,et al.  Maternal Smoking Before and During Pregnancy and the Risk of Sudden Unexpected Infant Death , 2019, Pediatrics.

[22]  Brian P. Jenssen,et al.  E-Cigarettes and Similar Devices , 2019, Pediatrics.

[23]  James Tsai,et al.  Exposure to Secondhand Smoke Among Nonsmokers — United States, 1988–2014 , 2018, MMWR. Morbidity and mortality weekly report.

[24]  B. Liu,et al.  Maternal smoking during pregnancy and risk of cryptorchidism: a systematic review and meta-analysis , 2018, European Journal of Pediatrics.

[25]  I. Agaku,et al.  Racial/Ethnic Disparities in Tobacco Product Use Among Middle and High School Students — United States, 2014–2017 , 2018, MMWR. Morbidity and mortality weekly report.

[26]  U. Lindemann,et al.  Fact sheets , 2018, A Practical Guide to Bio-inspired Design.

[27]  Eyal Oren,et al.  The State of US Health, 1990-2016: Burden of Diseases, Injuries, and Risk Factors Among US States , 2018, JAMA.

[28]  Danielle E. Ramo,et al.  Adolescent Exposure to Toxic Volatile Organic Chemicals From E-Cigarettes , 2018, Pediatrics.

[29]  Li Zhang,et al.  Maternal Smoking and Attention-Deficit/Hyperactivity Disorder in Offspring: A Meta-analysis , 2018, Pediatrics.

[30]  J. Winickoff,et al.  Guidance for the Clinical Management of Thirdhand Smoke Exposure in the Child Health Care Setting. , 2017, Journal of clinical outcomes management : JCOM.

[31]  S. Russell,et al.  Transgender Youth Substance Use Disparities: Results From a Population-Based Sample. , 2017, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[32]  Laura A. Gibson,et al.  Association Between Initial Use of e-Cigarettes and Subsequent Cigarette Smoking Among Adolescents and Young Adults: A Systematic Review and Meta-analysis , 2017, JAMA pediatrics.

[33]  R. Auer,et al.  Heat-Not-Burn Tobacco Cigarettes: Smoke by Any Other Name , 2017, JAMA internal medicine.

[34]  N. Benowitz,et al.  Cardiovascular effects of electronic cigarettes , 2017, Nature Reviews Cardiology.

[35]  L. Siqueira Nicotine and Tobacco as Substances of Abuse in Children and Adolescents , 2017, Pediatrics.

[36]  M. Gissler,et al.  Maternal Smoking and the Risk of Cancer in Early Life – A Meta-Analysis , 2016, PloS one.

[37]  Saida R Sharapova,et al.  Cigarette Smoking Among Inmates by Race/Ethnicity: Impact of Excluding African American Young Adult Men From National Prevalence Estimates. , 2016, Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco.

[38]  R. Courtney,et al.  The Health Consequences of Smoking-50 Years of Progress: A Report of the Surgeon General, 2014Us Department of Health and Human Services Atlanta, GA: Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for: Critique , 2015 .

[39]  Zhen Wang,et al.  Effects of secondhand smoke exposure on asthma morbidity and health care utilization in children: a systematic review and meta-analysis. , 2015, Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology.

[40]  Xin Xu,et al.  Annual healthcare spending attributable to cigarette smoking: an update. , 2015, American journal of preventive medicine.

[41]  M. Goniewicz,et al.  Electronic cigarettes are a source of thirdhand exposure to nicotine. , 2015, Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco.

[42]  H. Nagaraja,et al.  Secondhand smoke exposure and endothelial stress in children and adolescents. , 2015, Academic pediatrics.

[43]  F. Virant Cotinine in Children Admitted for Asthma and Readmission , 2014, Pediatrics.

[44]  J. Skripak Persistent Effects of Maternal Smoking During Pregnancy on Lung Function and Asthma in Adolescents , 2014, Pediatrics.

[45]  A. Lewis,et al.  Exposure to nitrosamines in thirdhand tobacco smoke increases cancer risk in non-smokers. , 2014, Environment international.

[46]  Thomas R. Kirchner,et al.  Tobacco retail outlet advertising practices and proximity to schools, parks and public housing affect Synar underage sales violations in Washington, DC , 2014, Tobacco Control.

[47]  S. Hecht,et al.  Thirdhand tobacco smoke: a tobacco-specific lung carcinogen on surfaces in smokers' homes. , 2014, Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco.

[48]  Ruoling Chen,et al.  Is exposure to secondhand smoke associated with cognitive parameters of children and adolescents?--a systematic literature review. , 2013, Annals of epidemiology.

[49]  S. Weng,et al.  Estimating Overweight Risk in Childhood From Predictors During Infancy , 2013, Pediatrics.

[50]  J. Balmes,et al.  Thirdhand cigarette smoke in an experimental chamber: evidence of surface deposition of nicotine, nitrosamines and polycyclic aromatic hydrocarbons and de novo formation of NNK , 2013, Tobacco Control.

[51]  R. Rosenfeld,et al.  The diagnosis and management of acute otitis media. , 2013, Pediatrics.

[52]  Prabhat Jha,et al.  21st-century hazards of smoking and benefits of cessation in the United States. , 2013, The New England journal of medicine.

[53]  K. Wilson,et al.  Secondhand tobacco smoke exposure and severity of influenza in hospitalized children. , 2013, The Journal of pediatrics.

[54]  H. Mansvelder,et al.  Short- and long-term consequences of nicotine exposure during adolescence for prefrontal cortex neuronal network function. , 2012, Cold Spring Harbor Perspectives in Medicine.

[55]  S. Weng,et al.  Systematic review and meta-analyses of risk factors for childhood overweight identifiable during infancy , 2012, Archives of Disease in Childhood.

[56]  J. Difranza,et al.  Systematic literature review assessing tobacco smoke exposure as a risk factor for serious respiratory syncytial virus disease among infants and young children , 2012, BMC Pediatrics.

[57]  A. Hofman,et al.  Fetal exposure to maternal and paternal smoking and the risks of wheezing in preschool children: the Generation R Study. , 2012, Chest.

[58]  T. Ino,et al.  Relationship between body mass index of offspring and maternal smoking during pregnancy , 2012, International Journal of Obesity.

[59]  D. Cook,et al.  Prenatal and Passive Smoke Exposure and Incidence of Asthma and Wheeze: Systematic Review and Meta-analysis , 2012, Pediatrics.

[60]  Bo Yang,et al.  Deterioration of endothelial function and carotid intima-media thickness in Tibetan male adolescents exposed to second-hand smoke , 2012, Journal of the renin-angiotensin-aldosterone system : JRAAS.

[61]  D. Cook,et al.  Parental smoking and the risk of middle ear disease in children: a systematic review and meta-analysis. , 2012, Archives of pediatrics & adolescent medicine.

[62]  E. Kandel,et al.  Molecular Mechanism for a Gateway Drug: Epigenetic Changes Initiated by Nicotine Prime Gene Expression by Cocaine , 2011, Science Translational Medicine.

[63]  Steven Lane,et al.  Household Tobacco Smoke and Admission Weight Predict Severe Bronchiolitis in Infants Independent of Deprivation: Prospective Cohort Study , 2011, PloS one.

[64]  S. Hecht,et al.  Metabolites of a Tobacco-Specific Lung Carcinogen in Children Exposed to Secondhand or Thirdhand Tobacco Smoke in Their Homes , 2011, Cancer Epidemiology, Biomarkers & Prevention.

[65]  D. Cook,et al.  Parental and household smoking and the increased risk of bronchitis, bronchiolitis and other lower respiratory infections in infancy: systematic review and meta-analysis , 2011, Respiratory research.

[66]  B. Rosner,et al.  In utero smoke exposure and impaired response to inhaled corticosteroids in children with asthma. , 2010, The Journal of allergy and clinical immunology.

[67]  T. Pechacek,et al.  Vital signs: nonsmokers' exposure to secondhand smoke --- United States, 1999-2008. , 2010, MMWR. Morbidity and mortality weekly report.

[68]  L. Lehtonen,et al.  Prenatal smoking exposure and the risk of psychiatric morbidity into young adulthood. , 2010, Archives of general psychiatry.

[69]  J. Viikari,et al.  Arterial Intima-Media Thickness, Endothelial Function, and Apolipoproteins in Adolescents Frequently Exposed to Tobacco Smoke , 2010, Circulation. Cardiovascular quality and outcomes.

[70]  Gail M. Williams,et al.  Is smoking in pregnancy an independent predictor of academic difficulties at 14years of age? A birth cohort study. , 2010, Early human development.

[71]  Office on Smoking How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General , 2010 .

[72]  K. Ariyoshi,et al.  Association of environmental tobacco smoking exposure with an increased risk of hospital admissions for pneumonia in children under 5 years of age in Vietnam , 2009, Thorax.

[73]  Marlene R. Miller,et al.  Toward Transparent Clinical Policies , 2008, Pediatrics.

[74]  G. Foster,et al.  National Health and Nutrition Examination Survey , 2005 .

[75]  R. Shiffman,et al.  Classifying Recommendations for Clinical Practice Guidelines , 2004, Pediatrics.

[76]  Office on Smoking The Health Consequences of Smoking: A Report of the Surgeon General , 2004 .

[77]  C. Agostoni,et al.  Earlier smoking habits are associated with higher serum lipids and lower milk fat and polyunsaturated fatty acid content in the first 6 months of lactation , 2003, European Journal of Clinical Nutrition.

[78]  B. Horta,et al.  Maternal smoking and the risk of early weaning: a meta-analysis. , 2001, American journal of public health.

[79]  N. Rigotti,et al.  Initial symptoms of nicotine dependence in adolescents , 2000, Tobacco control.

[80]  J. Deanfield,et al.  Passive smoking and impaired endothelium-dependent arterial dilatation in healthy young adults. , 1996, The New England journal of medicine.

[81]  R Doll,et al.  Mortality in relation to smoking: 40 years' observations on male British doctors , 1994, BMJ.

[82]  F. Vio,et al.  Smoking during pregnancy and lactation and its effects on breast-milk volume. , 1991, The American journal of clinical nutrition.

[83]  J. Palca Nicotine addiction , 1988, Nature.

[84]  April Tantillo Infant Mortality , 1923, Nature.