Higher Use of Tobacco Increases the Risk of Child Malnutrition

Higher Use of Tobacco Increases the Risk of Child Malnutrition

Tobacco use kills more than 5 million people per year. It is responsible for 1 in 10 adult deaths. Among the five greatest risk factors for mortality, it is the single most preventable cause of death. Eleven per cent of deaths from ischaemic heart disease, the world’s leading killer, are attributable to tobacco use. More than 70% of deaths from lung, trachea and bronchus cancers are attributable to tobacco use. If current patterns continue, tobacco use will kill more than 8 million people per year by 2030.

The illicit tobacco market may account for as much as one in every 10 cigarettes consumed globally, according to studies, including information supplied by the global customs community. The European Commission estimates that illicit trade in cigarettes costs the EU and their Member States over €10 billion annually in lost tax and customs revenue. In response to the threat posed by illicit tobacco trade, the international community negotiated and adopted in November 2012 the Protocol to Eliminate Illicit Trade in Tobacco Products, the first protocol to the WHO FCTC. From many angles, the illicit trade of tobacco products is a major global concern, including health, legal and economic, governance and corruption and also poses serious challenges to child health and nutrition.

The following picture provides the information about the prevalence of tobacco use among adults and adolescents across the globe. We can see from the picture that 15-30 percent of tobacco use lies across North and South America, Central Asia and Australia. Lessthan 10 percent of tobacco use among adults and adolescents lies in the region ofSub-Saharan Africa, India and China.

Tobacco use and poverty are inextricably linked. Many studies have shown that in the poorest households in some low- and middle-income countries, more than 10% of total household expenditure is on tobacco. This means that these families have less money to spend on such basic items as food, education and health care. In addition to its direct health effects, tobacco use leads to increased health-care costs. It contributes to higher malnutrition and illiteracy rates, since money that could have been used for food and education is spent on tobacco. The role of tobacco use in exacerbating poverty and hindering economic development needs to be fully recognized.

One study in Bangladesh investigated the relation between parental tobacco use and malnutrition in children below 5 year and compared the expenditures in foods in households with and without tobacco use. The study concluded that prevalence of parental tobacco use was 69.9 percent and using the new World Health Organization child growth standards, prevalence of stunting (low height for age), underweight (low weight for age) and wasting (low weight for height)were 46 %, 37.6 % and 12.3 %, respectively.  Another study was taken in Vietnam, which provided evidence of association between environmental tobacco smoking and childhood pneumonia in developed or developing countries. The result of the study shows the prevalence of environmental tobacco smoking was 70.5 percent. It was estimated that 28.7 percent of childhood pneumonia in this community is attributable to environmental tobacco smoking.

Parental smoking has been incriminated as having amajor adverse influence on the respiratory health ofyoung children. Fergusson et al found thatonly maternal, and not paternal, smoking was influential. The findings of a study suggest that maternal smoking influences the incidence of respiratory illnessesin children mainly through a congenital effect, and only to a lesser extent through passiveexposure after birth. Evidencefromseveralsourcessuggeststhatinfectionofthelowerrespiratorytractinearlychildhood mayimpairlungfunctioninadultlife andleadto respiratorysymptoms.Lower respiratory tract infections are more common among infants with low-birth weight and in later childhood these infants have a higher prevalence of cough and worsening function than infants with normal birth weight. 

Another study from India held to investigate the association between tobacco and alcohol use and child health. The study shows that compared to children from households that do not consume either tobacco or alcohol, children who come from households that smoke and chew tobacco as well as drink alcohol were less likely to be completely immunized (52% versus 30%); more likely to have an episode of Acute Respiratory Infection (16% versus 21%); less likely to seek care if sick with Acute Respiratory Infection (68% versus 57%); and more likely to be severely stunted (17% versus 27%) and severely underweight (13% versus 22%).

Tobacco also greatly increases the risk of tuberculosis and mostly affects young adults, in their most reproductive years. However, all age groups are at risk. Over 95 % of cases and deaths are in developing countries. About half a million children age (0-14 year)fell ill with TB and 74, 000 HIV-negative children died from the disease in 2012.  More than 20 percent of TB cases world-wide are attributable to TB. There are inherent relations between tuberculosis and malnutrition among children is widely accepted across the globe, particularly in low and middle-income countries.

Therefore, raising awareness on the harm to people’s health caused by the use of tobacco and tobacco products, among families which indirectly opens door for ill health of children, wider use of tobacco products among youth and low-income groups due to the increased accessibility and affordability.

About the Author
Arvind Singh is a young child rights activist and social researcher at Matri Sudha- A Charitable Trust, a non-profit in Delhi. He mainly works on child health and nutrition through grass-root intervention, research and advocacy. His work on malnutrition in Delhi made various government departments and child rights commissions to work coordinately on the issue.


 Association of environmental tobacco smoking exposure with an increased risk of hospital admissions for pneumonia in children under 5 years of age in Vietnam- http://thorax.bmj.com/content/64/6/484.short
 Household tobacco and alcohol use, and child health: an exploratory study from India - http://www.cghr.org/wordpress/wp-content/uploads/Household-tobacco-and-alcohol-use-and-child-death-in-India-2004.pdf

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