Smoking is a leading preventable cause of death in developed countries, tobacco smoke, consisting in more than 4000 components, with more than 40 carcinogens (1,2,3). Second-hand smoke (SHS) is the mixture of side stream smoke given off by a burning tobacco product and mainstream smoke exhaled by a smoker (4.5). Parental smoking has been linked with increased rates of sudden infant death syndrome, otitis media, chronic middle ear effusion, acute respiratory infections, asthma, and decreased lung growth ?(3,6). There is no safe level for Second-hand smoke exposure, as even low levels are associated with harmful effects (7). Second-hand smoke becomes farther harmful indoors, as polluted air more carcinogens than the smoke that goes through the cigarette filter, inhaled by the active smoker (8). Physicians have to educate parents by discussing the significance of decreasing childhood exposure to secondhand smoke (7). WHO estimates report that 40% of children worldwide are exposed to tobacco smoke in their homes in spite of the accumulated evidence of harm to children from tobacco smoke exposure (8,9). In the Kingdom of Saudi Arabia, the prevalence of smoking among adult ranges from 11.6-52.3% (10).