"Toddlers were more exposed," Bauer said. "Toddlers are like fish in a fish bowl. They're strapped pretty closely to their parental units, which exposes them to more smoke than adolescents who live in the same set of circumstances."
"Toddlers also breathe more rapidly, so they inhale more," added one of Bauer's co-authors, Dr. Judith Groner, a pediatrician and ambulatory care physician at Nationwide.
The youngest children also had higher levels of an inflammatory marker called soluble intracellular adhesion molecules, and there was an inverse relationship between EPC levels and exposure to smoke in both age groups, though again, the effect of secondhand smoke was more pronounced in the younger children.
These findings are similar to what has been found in adult smokers, according to the study authors. EPC levels haven't yet been studied in adults exposed to secondhand smoke.
"Based on markers of vascular stress, toddlers are hit harder," said Bauer. "To what extent this is reversible if exposure is stopped isn't known. In adults, there is evidence that when active smokers quit smoking that the risk of heart disease is lower, but some research suggests that cardiovascular disease may be imprinted in early life, so we don't know if this is reversible or not."
"This study suggests that if you have a toddler, make sure they're out of harm's way," he added.
Dr. Devang Doshi, director of pediatric pulmonology, allergy and immunology at Beaumont Hospital in Royal Oak, Mich., said, "This study gives us more insight into the bad effects of secondhand smoke exposure from a respiratory and cardiac standpoint."
"A lot of people don't realize that when you smoke in the house, children are continuously exposed. It's always in the house; the smoke doesn't just go away," he added.
Doshi said his first advice to parents is to quit s
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