Introduction & Objective: Exposure to the environmental Tobacco smoke is associated with detrimental effects on pulmonary function in the children. This study investigated the relation between airway complications in children receiving general anesthesia with the passive inhalation of smoke and those who were not.

Materials & Methods: 223 children scheduled to receive general anesthesia care were enrolled in this case-control study. The anesthesiologist and the residents, unaware of the smoke exposure history, recorded the occurrence of airway complications. A history of passive smoking was assessed by measuring the numbers of cigarettes smoked by their parents per day. The data was analyzed by c2statistical test.

Results: Respiratory complications occurred in 54.3% of the patients who were exposed to smoke and 32.4% of those who were not and the difference was statistically significant. Respiratory complications in daughters exposed to tobacco smoke was seen in 57.5% and in boys 51.2% (P=0.012). Respiratory events in children exposed to tobacco smoke was seen in 76.7% children with mother without education, 46.5% children of mothers with low educated level, and 12.5% children of mother with high educational level (P=0.002). This correlation was seen between respiratory events and educational level of fathers (P=0.006). Moreover, our study showed positive correlation between the number of cigarettes smoked per day with respiratory complications during general anesthesia (P<0.05).

Conclusion: There is a strong association between passive inhalation of tobacco smoke and respiratory complications in children receiving general anesthesia. The relationship was greatest for the daughters and those whose parents had a lower level of education. Passive smoking should be regarded as a risk factor for the children undergoing general anesthesia.