Marsha, your list of smoking references that deal with interferring with the
upper respiratory control remind me of a story that my supervising teacher (way
back when I was a biology/human anatomy student teacher before kids) told his
classes about smoking. He talked about how so many folks look at the lung cancer
statistics and then tell about their Uncle George who smoked a carton of
cigarettes every day from age 6 and lived to be 100, and then add that it won't
happen to them. His response was that cancer may or may not hit every smoker,
but that one thing that WILL happen to every smoker is that the smoke (nicotine?
sorry, it has been more than a few years!) paralyzes the cilia (hair-like
projections) that line the airways and are responsible for moving mucous up and
out. This just leaves coughing as the major way to clear mucous. He talked about
how many times smokers will take a cough suppressant at night to stop the
coughing and how folks had "drowned" in their sleep because the cough
suppressant knocked out their other defense for accumulating mucous.

I don't have any references for this, and honestly don't know whether this is in
the literature or not, but IF it is, perhaps this kind of mechanism is at work
when the smoke hits the infant's airways as well? Perhaps the combination of
mounting mucous and paralyzed cilia are enough to trigger an apnea spell in an
otherwise prone baby?

He also mentioned that as soon as someone quits smoking, the cilia rejuvenate,
at least up to a point.

His mother died of lung cancer from smoking, and the other chilling tale he used
to tell was about going to see his mom in a lung cancer ward. He described the
poor souls who had throat /mouth cancer and had had tracheotomies, leaving a
small straw-like tube in their necks. These folks were puffing away on the
cigarettes placed in the tubes--a graphic illustration of just how addictive
they can be.

As I recall, his students sat spell-bound through this lecture. It would be
interesting to see how many of them are smokers....

Melissa Vickers, IBCLC
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