By Michael Roizen, M.D., And Mehmet Oz, M.D.

Thirdhand smoke: myth or reality; new CDC guidelines for childhood concussions

Q: I know there's secondhand smoke if you're in a room with a smoker, but what is thirdhand smoke? Is it a real thing? - Joy B., Atlanta

A: Yes, thirdhand smoke is a real (and 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 nonsmoker and you've stood next to someone who smokes (but isn't smoking at the time) and you can smell the cigarette on that person's skin and clothes, you're inhaling thirdhand smoke.

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

Adolescents are at increased risk for health problems because of second- and thirdhand 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, Joy, thirdhand smoke is a real and very toxic health problem. If you know someone who uses tobacco, offer to help him or her quit and suggest that he or she check out

Q: My son, who's in the eighth 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

A: They are doing it right by following the new Centers for Disease Control and Prevention 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. One example: New England Patriots tight end Ron Gronkowski cleared the NFL's five-step protocol in less than two weeks after suffering a concussion. That let him play in the Super Bowl against the Philadelphia Eagles. But for kids, it's different. 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, it's just four times longer.

© 2018 Michael Roizen, M.D. and Mehmet Oz, M.D.
Distributed by King Features Syndicate, Inc.

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