Tobacco's toll: Implications for the pediatrician

The disease of tobacco addiction, which is pervasive in the United States, begins in childhood and adolescence. Twenty-five percent of the population regularly uses tobacco, despite evidence that such use is the leading preve ntable cause of death in the United States. Tobacco use reportedly kills 2. 5 times as many people each year as alcohol and drug abuse combined. Accord ing to 1998 data from the World Health Organization, there were 1.1 billion smokers worldwide and 10 000 tobacco-related deaths per day. Furthermore, in the United States, 43% of children aged 2 to 11 years are exposed to env ironmental tobacco smoke, which has been implicated in sudden infant death syndrome, low birth weight, asthma, middle ear disease, pneumonia, cough, a nd upper respiratory infection. Pediatricians play a crucial role in reduci ng both tobacco use (by children, adolescents, and their parents) and expos ure to tobacco smoke and should rank this among their highest health preven tion priorities.