By Ed Edelson
Tuesday, November 4, 2008 12:00 AM
TUESDAY, Nov. 4 (HealthDay News) -- Children who live with adult smokers are more likely to be underfed and undernourished, a new study finds.
The same is true for adult members of smoking households, but children feel the impact the most, said study author Dr. Michael Weitzman, chairman of pediatrics at New York University School of Medicine.
"We know that there are long-term consequences of food insecurity for children. They are more likely to do poorly in school, to have iron deficiency and anemia, and to have behavioral and social problems," Weitzman said.
"Food insecurity" is a concept that was developed by the U.S. Department of Agriculture in the 1990s to study malnutrition in developed countries such as the United States. "It is a standardized scale measuring how many times a household cannot give children the food they want, how many meals they skip, how often they go to bed hungry," Weitzman said.
Looking at data on 8,817 households gathered in national surveys by the U.S. Centers for Disease Control and Prevention, Weitzman and his colleagues found that 15 percent of adults and 11 percent of children reported food insecurity within the past year, with 6 percent of adults and 1 percent of children experiencing severe food insecurity. This meant they went to bed hungry, because there wasn't enough food in the house.
The study found that 23 percent of households with children had at least one smoker, with the incidence higher -- 32 percent -- in low-income households. In those households with a smoker, 17 percent of children were food insecure, compared to 8.7 percent of those children in nonsmoking households. Severe food insecurity was reported for 3.2 percent of children in smoking households, compared to 0.9 percent of those living in households with no smokers.
Because families with at least one smoker spend an estimated 2 percent to 20 percent of their income on tobacco, it's quite likely that smokers' habits drain the money needed to provide adequate food, according to background information with the study.
Parents feel the food pinch themselves, Weitzman said. "They cut back on feeding themselves before they cut back on the children's food," he said. "And parents tend to feed the youngest children better."
The findings were published in the November issue of theArchives of Pediatric & Adolescent Medicine.
The problem is likely to grow worse, given the current condition of the economy, Weitzman said. "If the economic downturn persists, both food insecurity and adults smoking are likely to increase," he said, because smoking "is one of the hardest addictions to give up."
One sure way to reduce smoking -- raising the taxes on cigarettes -- has its own dangers, because it's likely to cut even more into the family food budget, Weitzman said.
Two other strategies should be considered, said John F. Banzhaf III, executive director and chief counsel of Action on Smoking and Health, a Washington, D.C.-based advocacy organization.
"The first would be to persuade or even require physicians to report, as the law already requires in suspected child abuse, instances where parents smoke at home in the presence of children, especially children who already have asthma, sinusitis or other conditions which make them especially sensitive and susceptible," Banzhaf said.
A more aggressive tactic would be to take steps against doctors who do not warn people about the dangers of smoking or provide effective smoking cessation treatment, he said. "One journal article has even gone so far as to suggest that the best, and perhaps the only, way to motivate most of them would be to begin bringing malpractice actions where medical problems results," he added.
The U.S. National Library of Medicine details the many problems caused by smoking.
SOURCES: Michael Weitzman, M.D., chairman of pediatrics, New York University School of Medicine, New York City; John F. Banzhaf III, executive director and chief counsel, Action on Smoking and Health, Washington, D.C.; November 2008,Archives of Pediatric & Adolescent Medicine