Environmental tobacco smoke interacts with the respiratory mucosa by irritation and/or inflammation. Environmental tobacco smoke seems also modulate humoral and cellular immune activity. Thus, environmental tobacco smoke, in all children, increases the risk of superior and inferior airway infections, modifies the growth and the natural evolution of the respiratory function, increases the occurrence of asthma and exacerbates the symptoms of asthma, and creates or exacerbates a bronchial hyperresponsiveness. In atopic children (defined by the presence of at least one positive allergy skin test), environmental tobacco smoke increases the risk of respiratory allergy and exacerbates the symptoms of respiratory allergy. Parental environmental tobacco smoke is a universal toxic which must be avoided in both allergic and non-allergic children.
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