This article is written for the benefit of reflux parents, based on the experiences of reflux parents. It is not meant to replace medical advice and is of a general nature only. If you have any questions or concerns, please seek advice from your medical professional.

Lifestyle changes can help reduce reflux, and an important strategy is that infants or children of any age completely avoid exposure to tobacco smoke. This includes addressing an older child’s exposure where possible.

Tobacco smoke can relax the lower oesophageal sphincter and increase the tendency for reflux to occur. For infants and children under the age of two years, second hand smoke (passive smoking) can significantly contribute to the development of reflux with complications.

Second hand smoke can also increase the likelihood of an infant or child having colic, irritability, asthma, pneumonia, croup, middle ear infections and even sudden unexpected infant death (including sudden infant death syndrome). There may also be long term effects from second hand smoke during childhood.

Information reviewed by Professor (Adj) Jeanine Young, Nursing Director, Research, Royal Children’s Hospital, Brisbane
Additional information on gastro-oesophageal reflux and management suggestions are provided in our book “Reflux Reality: A Guide for Families”.


Alaswad, B., Toubas, P. L., & Grunow, J. E. (1996). Environmental tobacco smoke exposure and gastroesophageal reflux in infants with apparent life-threatening events. The Journal of the Oklahoma State Medical Association , 7, 233-7. Available here

American Academy of Pediatrics. (1997). Environmental Tobacco Smoke: A Hazard to Children: Policy Statement. Pediatrics , 99 (4), 639-42. Available here

Gaffney, K. (2001). Infant Exposure to Environmental Tobacco Smoke. (S. Gennaro, Ed.) Journal of Nursing Scholarship , 33 (4), 343 – 7. Available here

Henry, S. M. (2004). Discerning Differences: Gastroesophageal Reflux and Gastroesophageal Reflux Disease in Infants. Advances in Neonatal Care , 4 (4), 235-247. Abstract available here

Orenstein, S. R. (1999). Consultation with the Specialist: Gastroesophageal Reflux. Pediatrics in Review , 20, 24 – 28. Available here

SIDS and Kids. National Scientific Advisory Group (NSAG) (2009, March). Information Statement: Smoking. Retrieved August 4, 2010, from SIDS and Kids: Available here

Stanciu, C., & Bennett, J. R. (1972). Smoking and Gastro-Oesophageal Reflux. British Medical Journal , 3, 793 – 5. Available here