Only 10% let smoke by their children

By Valeria Shapira
Of the Writing of the NATION

Those are not indeed smoke of the neighbor that a boy in his house breathes. In spite of the recommendations against the tobacco, the parents smoke in front of their small noses and only 10% of them leave the habit to smoke by order of pediatra, according to estimations of the Respiratory Center of the Hospital of Children Ricardo Gutiérrez, who in good condition takes care of of neumonología 9000 annual consultations external.

"When we consulted the parents to them if they smoke, they always respond that only they do it in the balcony. But we know that, actually, this is not asi ': they smoke in all the house - doctor Carlos Macri warns, head of the mentioned center -. On the other hand, pediatras not always include the subject of the tabaquismo in the routine interrogation."

The respiratory affection is the second cause of disease and death in minors of four years, only surpassed by the accidents. And it is verified that the environmental pollution and the smoke of the tobacco are included between their main causes. Already in 1976, the prestigious Pediatrics magazine, official organ of the North American Academy of Pediatría, noticed about the relation between the passive tabaquismo (nonsmokers who inhale the smoke of the cigarette) and the sudden death in suckling babies. More ahead, when it was managed to dosar a metabolito of the nicotine in tinkles and the saliva of the nonsmokers - the cotinina -, it was observed that this substance has an average life of 15 to 40 hours in the adults and of 37 to 160 hours in the children.

Unlike which usually one is believed, the lungs of a boy are not those of an adult in miniature. In the first place, because when being born the development of these organs is incomplete. When it drinks leaves the maternal belly, each one of its lungs contains about 20,000 alveolar coats (those that allow the carbonic oxygen interchange and anhídrido during the breathing), but to the 8 years of life the number of coats ascends to 300 thousands. The lungs are included in the list of organs that undergo more abrupt changes in the beginning of the extrauterine life: they change his content of amniotic liquid to face the challenge to fill of air - that is not free of polluting agents -, and to become the future guide of the respiratory apparatus.

"the diseases, the virus and the bacteria morphologically are based with more facility in lands money changers or evolutionary process, like the lungs of the boys, who finalize their growth around the 8 years. The inverse process (of involución) happens after the 65 years. If to these factors one adds the environmental pollution and the passive tabaquismo to them the panorama it aggravates, and for that reason it is considered that the main groups of risk of respiratory diseases are the small children and the old ones ", explains doctor Macri.

A boy inhales, in rest, about 4500 daily liters of air, number that rises to 20,000 liters between which they practice some sport. "If that air is contaminated can cause serious damages in its respiratory apparatus", he adds.

Diverse investigations compiled by this specialist along with their colleague Alexander Teper will be published next by Inter-American the McGrwHill publishing house in the book "respiratory Diseases in children", whose chapters referred to the environmental contamination and the tabaquismo correspond to doctors Gustavo Aristizabal Duke, of Colombia, and Claudius Linares, of the Respiratory Center of the Hospital of Children Ricardo Gutiérrez.

Some of those investigations indicate that the exhibition to the smoke of the cigarette generates in the children a greater risk of acute infections (like neumonías), diminution of the pulmonary growth and the functions of the lung, and predisposition to an increase of episodes of asthma or accentuation of its symptoms, among other complications.

Also it is verified that the low weight when being born can be related to the tabaquismo in the embarrassed woman, since it increases the carboxihemoglobina (compound that contaminates the blood) and is related to the vasoconstricción of the placenta and the uterus, and to the increase of the maternal and fetal cardiac frequency.

The increase of the spontaneous abortions is a problem that also undergo with greater assiduity the women than they consume cigarettes.

The statistics of the World-wide Organization of the Health indicate that it is smoked more and more in the underdeveloped countries, whereas the tobacco consumption descends in the countries of the First World.

Data gathered by doctor Lencina notice that more of 80% of the adult smokers it began in the habit before the 21 years. In our country, the total of smokers calculates in 12 million. With respect to Latin America, the statistics indicate that the addict ones to the tobacco begin to smoke between the 14 and 17 years. On the other hand, an aggravating one exists: the recidiva between the young people whom they try to leave the tobacco is from 75% to 90%, compared with 65% of the failure in the adults.

In that context, it notices Macri, "the tabaquismo is fundamentally a pediátrico problem. Not only by the questions related to the risks of the passive smoker, but because its use is every greater time in the childhood and adolescence, ages in which the habits difficult settle to modify. Therefore, it is necessary to make prevention, with pedagogical resources, since one has demonstrated that the drastic, punitorios or coercive methods fail ".

Pediatras - doctor Macri- stresses must have an active participation in the prevention, since when being in contact with the enemy with the probable futures smokers and their parents - possibly real smokers can to take part in direct form, or avoiding the beginning of the addiction or collaborating in the abandonment of this one.

"If the single fact to mention the risk for the own health and the one of its children during reiterated medical consultations generates the abandonment of the habit in a 10% of the parents smokers, we must insist so that the question you smoke? he integrates myself to the medical interrogation of routine ", affirms the specialist.