How to Reduce Effects of Third-hand Smoke and Child Concussions

How to Reduce Effects of Third-hand Smoke and Child Concussions

Whether the risk is at home or on the field, these expert tips will help your children avoid urgent care.

Q: I know there’s second-hand smoke if you’re in a room with a smoker, but what is third-hand smoke? Is it a real thing? —Joy B., Atlanta, GA

A: Yes, third-hand smoke is a real—terrible—thing. It is the toxic residue that collects on clothes, rug, drapes or furniture when those things are exposed to smoke from any tobacco product. Think about it. If you’re a non-smoker and you’ve stood next to someone who smokes (but isn’t smoking at the time) and you can smell the cigarette on their skin and clothes, you’re inhaling third-hand smoke.

University of Cincinnati researchers recently completed a study finding that tobacco smoke exposure (TSE), whether second- or third-hand, poses a health risk to anyone who comes in contact. However, the researchers pointed out that infants and children are particularly vulnerable to the double whammy of second- and third-hand smoke if they live with folks who smoke in the home. And even if kids live in a house with smokers who never light up at home, their health is damaged by constant exposure to third-hand smoke residue the smokers have on them. That residue, added the researchers, contains particles of toxins that are smaller than the residue in second-hand smoke, and may pose even more of a health risk because third-hand smoke has “multiple exposure routes and has a much longer duration of exposure.”

Adolescents are also at increased risk for health problems because of second- and third-hand TSE: They’re three and a half times more likely to end up in an emergency department or urgent care center than kids who live in homes with no tobacco exposure. They are also at increased risk of shortness of breath, wheezing, acute respiratory infections, pneumonia, ear problems and asthma. And they reported that it was hard to exercise. So yes, third-hand smoke is a real and very toxic health problem. If you know someone who uses tobacco, offer to help them quit and suggest they check out ways to quit smoking on

Q: My son who’s in the 8th grade had a slight concussion playing football last week. He seems to be fine now, but his doc and coach say he can’t play again for three to four weeks even though they let him go back to school on the Tuesday after his Saturday injury. Does that make any sense? —Joel B., Sacramento, CA

A: They are doing it right by following the new CDC protocols for kids and concussions. Your son needs to avoid all sports activities because kids his age take a lot longer to get back to 100 percent after a concussion than grown-ups do. In fact, according to the American Osteopathic Association, children experience concussion symptoms three to four times longer than older teens and adults.

Depending on the degree of your son’s head injury, he may have as many as 19 steps to clear before his doc clears him to get back to any sports. He should be excused from gym classes for a few weeks, and make sure he’s not playing pick-up basketball games after school. Also, look out for any mood changes and physical illness—they could be signs that he’s struggling to recover.

As for why he is allowed to go back to school—well, that’s based on a new principle called “active recovery,” which promotes faster clearing of symptoms such as dizziness and visual-focusing, balancing and spatial-orientation problems. It helps the brain re-establish or establish new neurologic pathways to regain full function, as long as his symptoms don't return or worsen. This is not unlike the NFL guidelines, just four times longer.

Medically reviewed in July 2018.

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