Too Young to Smoke and Too Helpless to Stop

by Dr. Nileema Conlon Vaswani in

As England prepares itself for the smoking ban, let us spare a thought for our youngest smokers. I do not mean your 13-year-old who might try to sneak the odd fag; I mean our babies who, even before they are born, have already suffered the effects of cigarette smoke. For them, smoking is not a choice that they have made; yet, they pay for this choice with their health. They are our youngest group of passive smokers.

All of us have heard or seen the words "From July 1st, if it's an enclosed public place, it's against the law to smoke." If it's your home or another private place, one is still legally allowed to smoke. And if it's the womb, there is nothing in the power of this high profile smoking ban to make the home of a foetus a smoke-free zone.

This week, researchers have found heightened levels of cotanine, a byproduct of nicotine, in the urine of babies whose parents smoke. Mothers who smoked had the strongest impact on levels of cotanine but fathers who smoked also contributed to an increase in cotanine levels in their babies.

Besides discouraging the parents from smoking, there is nothing that the law can do at present to protect these babies. The same holds true for children whose parents smoke around them. Although smoking has been linked to cot deaths and respiratory conditions in children, there is nothing in the law that protects these children.

It seems ironic that a smoking ban that will protect much of our adult population from passive smoke cannot protect our babies whose parents smoke or even some young children in their own homes. To make smoking when pregnant or around young children illegal would be a severe blow to the liberty of adults. But consider what moral position you might adopt if you knew that a woman was feeding her children tobacco sweets. Also think about whether it would be morally permissible for a woman to eat these sweets when she was pregnant.

Although these examples may seem odd, it is difficult to identify a moral difference between feeding children tobacco sweets on the one hand, and feeding them unhealthy meals. Last week, health professionals called for childhood obesity to be classified as a form of abuse, a proposal that would allow Social Services powers to remove children from parental care on grounds of child protection. Our article on this issue argued that parents, the media and the supermarkets influence the eating culture of children and, therefore, in cases of obesity, shared in the responsibility. To blame parents alone would be morally wrong. In the case of smoking, however, unborn children and young children do not smoke because of external influences; they smoke via their parents. Yet, health professionals and the law take a softer approach in these cases than they do with the parents of obese children.

One of the reasons why the two types of cases might be treated differently is that obesity is a visible condition. What we can see tends to affect us more. The sight of a child who eats a lot, gradually becomes plump, then overweight and finally obese is a clear visible progression. While it may seem implausible to argue that what we can see has a greater moral bearing on us, the moral distance between a problem and us is influenced by this factor. A bomb blast that kills one person on a street next to where one lives tends to assume greater moral significance than does a bomb blast that kills 50 in a country that is no more than a shape on a map.

The harm that comes from smoking around a young child or when pregnant is not easy to see. Even if a baby develops respiratory problems after birth, it is not easy to link its problems to smoking. The time lapse between the stimulus and effect (smoking and result of smoking) might be too long for us to make a moral link between the two in the way that it is easier to link intake of food and obesity.

This article does not suggest that smoking when pregnant or around young children be classified as abuse. It asks, however, why health professionals are targeting childhood obesity as a form of abuse and not taking the same approach to smoking when pregnant or around young children. Moreover, at a time when the State is working hard to protect adult non-smokers from the effects of passive smoke, it is unfortunate that the youngest and most vulnerable of our population are not receiving the same protection.