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Air pollution from pulp and paper factories may have a greater effect on children who are exposed to tobacco smoke than other children. It is already well-known that tobacco smoke adversely affects children’s breathing and that they should not smoke or be exposed to smoke in their homes.  This study shows that the situation for these children may be worsened by exposure to pollution from pulp and paper mills.  In this study, 61% of middle school children either smoked or had smokers in their homes.  This is a significant public health problem.  Also, a large number of students reported wheezing. Wheezing and asthma may have negative medical, behavioral, and educational consequences for children.  This research highlights the possible harmful health effects of tobacco smoke in combination with pulp and paper mill pollution exposure in students.

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