Cigarette smoking is a form of child abuse, says one of the nation's leading child abuse experts, and it's high time we recognize it as such.

"More young children are killed by parental smoking than by all unintentional injuries combined," says James Garbarino, an internationally recognized expert on child protection and the director of Cornell University's Family Life Development Center. These deaths include almost 3,000 annually due to low birth weight, 2,000 due to Sudden Infant Death Syndrome and another 1,300 attributed to respiratory infection, asthma and burns, according to researchers in the Archives of Pediatrics and Adolescent Medicine (July 1997 edition).

Children of smokers also are more likely to become smokers themselves and, thus, be exposed to the numerous adverse, direct effects of smoking. Coupled with the recent tobacco settlement that finally dispenses with any pretense about the harmlessness of smoking, the pediatric findings should cause us to consider where smoking fits into larger issues of child protection, said Garbarino, author of Raising Children in a Socially Toxic Environment (1995, Jossey-Bass Publishers) and Understanding Abusive Families (in press, Jossey-Bass Publishers).

"Let's call it what it is: Parental smoking is child abuse," he stressed.

Before any parental act qualifies as child abuse or neglect and thus falls within the jurisdiction of the State, it must meet three conditions. First, there must be a basis in scientific knowledge or professional expertise that a particular practice is harmful or dangerous to children. Second, there must be a public debate stimulated by child advocates to use the new knowledge as a basis for challenging what has been regarded as normal and acceptable child rearing. Third, community values must adapt by accepting a new standard of care for children.

The history of protecting children in cars is a good example. Forty years ago no standards, Garbarino said. An injured child was simply the victim of an "accident." Thirty years ago, data showed that two-thirds of all injuries and 90 percent of all fatalities to children riding in cars could be prevented if children were placed in the rear, in a car seat. Thus, an injured child became the victim of a "preventable accident."

Twenty years ago it became common practice for responsible parents to offer this protection to children. An injured child became the victim of unfortunate parental laxity. Ten years ago numerous states passed legislation expanding the legal classification of neglect to include transporting a child in an automobile unprotected. An injured child became the victim of negligence.

"This is the way things work in child protection. What was once normal becomes first unwise, then only acceptable and, finally, illegal," Garbarino said. "Child abuse and neglect is a matter of a constantly negotiated settlement between science and professional expertise on the one hand and community values and culture on the other. There is always a time and place to change the definition, to raise the standard of care."

When it comes to parental smoking, the time and place are here and now, Garbarino said. It's time to use the anti-smoking consensus to move on behalf of the next generation and ban smoking in the presence of children as part of society's efforts to protect children, he said.

What would this mean? First, that state legislatures recognize that the verdict on smoking is in, once and for all. Smoking would join other behaviors that once were permitted but now are legally unacceptable, Garbarino said -- like maiming children to use them as beggars, beating children bloody to enforce discipline and locking children in closets as punishment. The publicity associated with such action would send an important message to parents and add further incentive for them to quit smoking. Prenatal care groups would be empowered to take a strong, supportive stance to smoking cessation efforts with every soon-to-be mother. Private groups, such as the National Committee to Prevent Child Abuse and the Ad Council, could add the "smoking is abuse" theme to their prevention messages. Citizens would be encouraged to communicate directly with smoking parents as they have been about parents who hit their children in public or who leave them alone unsupervised.

As in other forms of child maltreatment, the first recourse would be prevention messages, then the provision of public support to change parental behavior. The last resort would be coercive intervention to motivate parents to change and to protect children from harm.

"Would it make a difference? We know from decades of research on child abuse and neglect that it takes time and effort to make a difference in the treatment received by children at the hands of their parents," Garbarino said. "A strong public effort to recognize the abusive nature of parental smoking would force the professional community to come out of the closet on this issue. It is not uncommon for child protection professionals and child advocates at professional meetings on child abuse to 'light up' during coffee breaks. Given what we now know about pediatric second-hand smoke, this is tantamount to reaching in one's pocket to pull out some child pornography.

"Let's end the charade that second-hand smoke is not harmful to kids. It's time to recognize parental smoking as child abuse," Garbarino concluded.