By Jean Yaeger

Breathing in secondhand smoke isn’t healthy for children, whether the smoke comes from tobacco or marijuana.

Many of the same toxins and irritants in tobacco smoke are also present in marijuana smoke, according to the American Lung Association. Children who are exposed – at home, in the car or in other places – are indirectly inhaling any particles the smoke contains. No amount of secondhand smoke is safe. secondhand smoke (2)

What concerns doctors about secondhand smoke? “It can lead to chronic cough, mucus production and infection,” said Alice Phillips, M.D. at Cook Children’s Pediatrics Cityview. “If the child has asthma, it could trigger an asthma attack.”

It’s an increasingly common experience for Dr. Phillips to smell marijuana when patients and their families come to appointments. She detects the marijuana scent on parents and caregivers, as well as in the clothing of young children.

“In the past, I might have noticed one to two times per month, but now it is multiple times per week or even per day,” she said.

Daniel Guzman, M.D. encounters the marijuana odor on three or four patient families every shift he works in the Cook Children’s Emergency Department (ED). Dr. Guzman said he initiates conversations with those families, particularly if the child came to the ED with breathing problems. He points out his purpose is to share the medical perspective -- not invade anyone’s privacy.

“If they’re coming in for asthma issues, then I always have that conversation about smoke, whether it’s cigarette smoke or marijuana smoke that affects the lungs. We know short term that it can lead to more chronic asthma-like issues and other respiratory problems for these children,” Dr. Guzman said.


Secondhand smoke falls in the category of preventable injuries that Dr. Guzman works to reduce through education. Maintaining a smoke-free environment can be compared to proactive safety measures like car seats, gun locks and lifejackets that are meant to keep children safe.secondhand smoke

“That’s where the grassroots of all this starts. You make a change in one person, it can have a significant downstream effect, which can be life-changing,” he said. “It’s just a matter of continuing to have that conversation.”

As part of the routine exams with her teenage patients, Dr. Phillips discusses the risks of smoking, vaping and drug experimentation. Because recreational marijuana is illegal in Texas, the scent can pose a tricky situation in the pediatrician’s office. Parents aren’t always completely open when Dr. Phillips brings up the topic. She tries to communicate in ways that stick to the facts, avoid judgment, and demonstrate concern.

“I am the kids’ doctor but also their advocate,” Dr. Phillips said. “As doctors, we must walk the delicate tightrope of partnering with parents in the care for the kids.”

The American Lung Association advises:

  • No one should be around secondhand marijuana smoke.
  • Anyone exposed to secondhand marijuana smoke can have detectable levels of tetrahydrocannabinol (THC) in their systems. THC is the psychoactive or mind-altering “high” ingredient in marijuana. 
  • Don’t allow smoking at any time or place children are present.

Dr. Phillips points out that children look to the adults in their lives for guidance.

“Little eyes are always watching,” she said. “Just like we need to eat our vegetables to encourage good eating habits, we need to stay away from things which might be harmful to ourselves or potentially encourage the same habit in our kids.”

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