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Sidestream Villain

“You are smoking too much nowadays,” she said.

“Work stress, dear. I promise you that the day our child is born, I would stop smoking. It’s just three more months,” he said, putting on his headset to go back to his online meeting.

“Sooner the better,” she said softly, putting the coffee cup next to his computer.

It did turn out to be much sooner than expected. She went into labour at 33 weeks, delivering a pre-term baby. The baby was shifted to the newborn ICU, needing ventilatory support; and that’s how I was called in to do an echocardiogram to rule out any “by-birth” (congenital) heart disease. The echo showed a hole between the atria (atrial septal defect).

Moot question

“Doctor, none of us have any heart disease. We both are healthy. Why did our child get it,” the father asked.

It is said that “a cigarette is a stick with a fire at one end and a fool at the other”. As the smoker inhales, the tip of the burning cigarette glows, increasing the temperature to a very high degree; the products of the burning tobacco travels down his windpipe down to his lungs. We call it the mainstream smoke. In contrast, 85% of the smoke produced by a cigarette is generated while it is passively burning: the sidestream smoke. Surprisingly, the sidestream smoke emits toxic chemicals such as 2-napthylamine, N-nitroso-diethyamine, 4-aminobiphenyl and carbon monoxide, in concentrations higher than the mainstream smoke, making it more dangerous.

Despite being inhaled by the passive smoker in less concentrations, the sidestream smoke with its smaller particle size, higher condensate and the lower burning temperature produce an overall effect far more toxic than the mainstream smoke.

Try dipping your face in a bucket of water and you would feel instantly suffocated; your heart would race faster. But as a professional diver takes a deep dive, his heart rate actually slows down in an effort to conserve oxygen supply.

This “diver’s reflex” is naturally present in aquatic mammals such as dolphins.

The human foetus in the womb is submerged in a bag of water. Not permitted to breathe, its only source of nutrition is the placenta plugged in through the connecting umbilical cord.

If for some reason the oxygen supply falls short, the foetal heart rate drops and the “diver’s reflex” kicks in to ration oxygen supply. The reason why during every antenatal visit, the gynaecologist carefully listens and records the baby’s heart beat is to ensure that the baby is unstressed.

Once a child is born and starts breathing, it shifts itself from the “diver’s reflex” response to the air-breathing response. Normally the transition is seamless and fast.

Placenta is an organ that carefully filters, processes and curates what passes through it for the benefit of the baby. But some complex chemicals fool the system, and one of them is nicotine.

Crafty nicotine

The crafty nicotine molecule wriggles past the placenta and goes straight to the baby’s growing organs, brain and heart.

New data indicate that it is concentrated in the foetal brain stem, a vital area sitting right below the brain hemisphere that controls the heart rate and breathing. Inhibition of this area could result in poor respiratory effort of the newborn. Sidestream nicotine is generated by the smoking father and unintentionally inhaled by the mother.

It’s time those on the “non-burning” end becomes more responsible and kinder to the rest of the family. For the sake of the next generation.

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Printable version | Jun 20, 2021 12:28:16 PM |

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