Passive smoking increases children's pain during medical procedures

A new study demonstrates that passive exposure to cigarette smoke increases how much pain children perceive during an invasive medical procedure. Investigators conducted the study in 100 children who underwent venous catheterization at a clinic in Turkey. Fifty of the children (mean age, 7.3 years) had been exposed to passive smoking and 50 (mean age, 7.7 years) had not. The fathers of the passive-smoking group all smoked in the child’s house, as did 2 of the mothers.

During peripheral venous catheterization, the children’s facial expressions were photographed as the needle was inserted. Investigators then evaluated these photographs using the Wong-Baker faces pain rating scale. The evaluation showed that children who were passively exposed to smoke perceived significantly more pain during the procedure than those who had not been exposed. Neither age nor gender significantly affected pain perception (Topaloglu N, et al. Acta Paediatr. 2013;102[11]:e493-e496).

COMMENTARY  If this is a cause-and-effect relationship, I wonder what the cause is and what made these researchers and others think of this idea. Perhaps nicotine, as a stimulant, acts to promote anxiety and a more acute response to the painful stimulus. In any case, here’s one more reason for parents and guardians to protect their children from smoke. -Michael Burke, MD

MS FREEDMAN is a freelance medical editor and writer in New Jersey. DR BURKE, section editor for Journal Club, is chairman of the Department of Pediatrics at Saint Agnes Hospital, Baltimore, Maryland. He is a contributing editor for Contemporary Pediatrics. The author and editor have nothing to disclose in regard to affiliations with or financial interests in any organizations that may have an interest in any part of this article.