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Updated: Jun 1, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Secondhand smoke risk in infants discharged from an NICU: potential for significant health disparities?
Angela L Stotts1, Patricia W Evans, Charles E Green
1Family and Community Medicine, University of Texas Medical School at Houston, 6431 Fannin, JJL 324, Houston, TX 77030, USA. angela.l.stotts@uth.tmc.edu
Insights
Disadvantaged families with high-risk infants are less likely to implement smoking bans, increasing secondhand smoke exposure risks. Targeted interventions are crucial for these vulnerable populations to reduce health disparities.
Area of Science:
- Neonatal care
- Public health
- Environmental health
Background:
- Secondhand smoke exposure (SHSe) poses significant risks to infants discharged from neonatal intensive care units (NICUs).
- This study investigated smoking practices in families with high-risk infants, focusing on socioeconomic factors, race, and mental health.
- Understanding these factors is crucial for developing effective interventions.
Purpose of the Study:
- To examine the relationship between sociodemographic factors and the implementation of household smoking bans.
- To identify disparities in secondhand smoke exposure among infants at high risk.
- To inform the development of targeted interventions for vulnerable families.
Main Methods:
- Data were collected from 99 families participating in The Baby's Breath Project, a hospital-based SHSe intervention trial.
- Participants included parents of high-risk infants in the NICU with a household smoker.
- Measures included sociodemographics, smoking habits, home and car smoking bans, and maternal depression.
Main Results:
- 26% of families with high-risk infants reported a household smoker, with nearly half earning less than $25,000 annually.
- Only 27.8% of low-income families had a total smoking ban, compared to nearly 60% of higher-income families (p < .01).
- African American and Caucasian families were less likely to have bans than Hispanic families (p < .05), and mothers without bans reported higher depression scores (p < .02).
Conclusions:
- Disadvantaged families exhibit lower adoption of protective behaviors against SHSe, increasing infant risk.
- These disparities contribute to tobacco-related health inequities in vulnerable populations.
- Innovative SHSe interventions are urgently needed for families with high-risk infants.
Introduction:
Secondhand smoke exposure (SHSe) threatens fragile infants discharged from a neonatal intensive care unit (NICU). Smoking practices were examined in families with a high respiratory risk infant (born at very low birth weight; ventilated > 12 hr) in a Houston, Texas, NICU. Socioeconomic status, race, and mental health status were hypothesized to be related to SHSe and household smoking bans.
Methods:
Data were collected as part of The Baby's Breath Project, a hospital-based SHSe intervention trial targeting parents with a high-risk infant in the NICU who reported a smoker in the household (N = 99). Measures of sociodemographics, smoking, home and car smoking bans, and depression were collected.
Results:
Overall, 26% of all families with a high-risk infant in the NICU reported a household smoker. Almost half of the families with a smoker reported an annual income of less than $25,000. 46.2% of families reported having a total smoking ban in place in both their homes and cars. Only 27.8% families earning less than $25,000 reported having a total smoking ban in place relative to almost 60% of families earning more (p < .01). African American and Caucasian families were less likely to have a smoking ban compared with Hispanics (p < .05). Mothers who reported no smoking ban were more depressed than those who had a household smoking ban (p < .02).
Conclusions:
The most disadvantaged families were least likely to have protective health behaviors in place to reduce SHSe and, consequently, are most at-risk for tobacco exposure and subsequent tobacco-related health disparities. Innovative SHSe interventions for this vulnerable population are sorely needed.
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