Passive Smoke Exposure and Its Effects on Cognition, Sleep, and Health Outcomes in Overweight and Obese Children

Abstract

Background: Passive smoke exposure (PSE) may be a risk factor for childhood overweight and obesity and is associated with worse neurocognitive development, cognition, and sleep in children. The purpose of the study is to examine the effects of PSE on adiposity, cognition, and sleep in overweight and obese children using an objective measure of PSE.

Methods: Overweight or obese children (n = 222) aged 7-11 (9.4 ± 1.1 years; 58% black; 58% female; 85% obese) were recruited from schools near Augusta, Georgia, over the course of the school year from 2003-2006 for a clinical trial, with data analyzed in 2009-2010. Passive smoke exposure was measured with plasma cotinine. Health, cognitive, and sleep measures and parent report of smoke exposure were obtained.

Results: Overweight and obese children with PSE had greater overall and central adiposity than nonexposed overweight and obese children (p < 0.03). However, PSE was unrelated to prediabetes, insulin resistance, or visceral fat. PSE was linked to poorer cognitive scores (p < 0.04) independent of adiposity, but was not related to sleep-disordered breathing.

Conclusions: PSE is associated with fatness and poorer cognition in children. Tailored interventions that target multiple health risk factors including nutrition, physical activity, and tobacco use in children and families are needed to prevent adverse health outcomes related to tobacco use and obesity.

Figure 1.

Smoke exposure and obesity measures. Means and standard error bars are shown. Panel A shows waist circumference, Panel B shows BMI z-score, and Panel C shows percent body fat via dual-energy x-ray absorptiometry. Asterisks indicate that children exposed to tobacco smoke were more obese compared to those that were not exposed. *p < 0.05. **p < 0.01.

Figure 2.

Smoke exposure and cognitive performance. Means and standard error bars are shown. Asterisks indicate that children exposed to tobacco smoke scored poorly on cognitive tests compared to those that were not exposed. *p < 0.05. **p < 0.01.