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If dad smokes outside the house, is baby protected?
Q: I just had my first baby, a girl who's now 1 month old. Both my husband and I were smokers, but I quit during pregnancy so my baby would be healthy. I feel so much better that I know I won't go back to it. But my husband still smokes. I'm worried about how it might affect our baby. He says the baby won't be exposed to any smoke if he smokes only outside the house. Is this true?
A: Patricia, congratulations on your new baby and having quit smoking! Many parents, like you, have found that focusing on the health of their child has helped them quit smoking successfully.

As you know, secondhand smoke is very dangerous. It contains nearly 4,000 toxic chemicals, including carbon monoxide and cyanide. Secondhand smoke is most dangerous for babies because of their small size, their increased rate of breathing and the fact that their bodies are growing and developing rapidly. Exposure to secondhand smoke greatly increases a baby's chance of getting colds, ear infections, bronchitis, pneumonia and asthma. It also increases a baby's chance of dying of SIDS.

A recent study found that children exposed to secondhand smoke experienced learning delays. Other studies have found that secondhand smoke increases a child's chance of developing heart disease and lung and breast cancers later in life. Remember, too, that children learn from what they see their parents doing. That means that children of smokers are more likely to become smokers themselves.

Your husband is right that smoking only outdoors can help reduce your baby's exposure to secondhand smoke. But it doesn't completely eliminate the exposure. A recent study from Sweden found that while children whose parents smoked indoors had 15 times the level of cotinine (a chemical from cigarette smoke) as children of non-smokers, the children of parents who said they smoked only outdoors still showed levels of cotinine twice as high as children of non-smokers. This indicated that either the parents were not consistent about smoking only outdoors, or they brought smoke back to their children on their breath, hair or clothes.

In all, it's safest for your husband to quit smoking. This will improve your baby's health, yours and your husband's. You can give your husband encouragement and moral support for his effort to quit. In addition, outside help is available including motivational information, behavioral counseling, medications and support groups. For information on quitting smoking, have your husband contact his doctor and visit the National Cancer Institute website on quitting smoking, www.smokefree.gov.

Karen Sokal-Gutierrez M.D., M.P.H. Pediatrician