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Published on: October 22, 2020
Early childhood exposure to secondhand smoke and behavioural problems in preschoolers
Tzu Tsun Luk1, Man Ping Wang2, Yi Nam Suen3
1School of Nursing, The University of Hong Kong, Pok Fu Lam, Hong Kong.
Insights
Secondhand smoke exposure in early childhood, measured by cotinine levels, is linked to increased conduct problems and hyperactivity in preschoolers. This finding highlights the risks of environmental tobacco smoke for child behavioral health.
Area of Science:
- Environmental Health
- Pediatrics
- Developmental Psychology
Background:
- Limited evidence exists on behavioral abnormalities in children exposed to secondhand smoke.
- Secondhand smoke exposure is a significant environmental risk factor for child health.
- Biomarkers like cotinine are crucial for quantifying exposure levels.
Purpose of the Study:
- To investigate the association between secondhand smoke exposure and behavioral problems in preschoolers.
- To examine the relationship between infant/toddler cotinine concentration and preschooler behavioral outcomes.
- To assess behavioral health in children not exposed to maternal smoking during gestation but exposed to secondhand smoke.
Main Methods:
- Prospective cohort study of 301 non-smoking mothers and their children (≤18 months).
- Salivary cotinine levels measured at baseline as a biomarker for secondhand smoke exposure.
- Child behavioral health assessed at 3-year follow-up using the Strengths and Difficulties Questionnaire (SDQ).
- Multivariable linear regressions adjusted for covariates.
Main Results:
- Higher cotinine concentrations in early childhood were significantly associated with increased conduct problems (b=0.90).
- Higher cotinine concentrations were also linked to greater hyperactivity/inattention (b=1.12).
- These associations remained significant after adjusting for multiple confounding factors.
Conclusions:
- Secondhand smoke exposure in early childhood is associated with adverse behavioral outcomes in preschoolers.
- Cotinine levels serve as a reliable indicator of secondhand smoke exposure and its impact.
- Findings support the role of environmental tobacco smoke in the development of child behavioral problems.
Abstract:
Evidence on behavioural abnormalities in children exposed to secondhand smoke is limited. This study examined the relation between infant/ toddler cotinine concentration, a biomarker of secondhand smoke exposure, and behavioural problems in preschoolers who were unexposed to maternal smoking during gestation. A prospective cohort of 301 non-smoking mothers with their young children aged ≤18 months visiting postnatal primary care clinics in Hong Kong was enrolled in 2012 and followed by telephone survey 3 years afterwards. Saliva was collected at baseline for cotinine assay. Child behavioural health at 3-year follow-up was assessed by the parent-reported Strengths and Difficulties Questionnaire (SDQ). We conducted multivariable linear regressions to compute regression coefficients (b) of SDQ scores in relation to salivary cotinine level. Mean ± SD age of children at follow-up was 3.7 ± 0.5 years and 50.8% were boys. After adjusting for age, sex, birthweight, household income, housing type, maternal education and depressive symptoms, greater cotinine concentrations during early childhood were associated with greater conduct problems (b = 0.90, 95% CI 0.03-1.76) and hyperactivity/ inattention (b = 1.12, 95% CI 0.07-2.17) at preschool age. This study corroborates previous findings on the potential role of secondhand smoke in development of child behavioural problems.
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