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. 2022 Aug 10:10:881299.
doi: 10.3389/fpubh.2022.881299. eCollection 2022.

The association between neurodevelopmental and behavioral problems and tobacco smoke exposure among 3-17 years old children

Yu Gao  1 , Tong Wang  1 , Zhizhen Duan  1 , Yuepu Pu  1 , Juan Zhang  1
Affiliations

The association between neurodevelopmental and behavioral problems and tobacco smoke exposure among 3-17 years old children

Yu Gao et al. Front Public Health. .

Abstract

Children being exposed to tobacco smoke can lead to poor developmental and behavioral problems. We aimed to explore the correlation between neurodevelopmental and behavioral problems (NBPs) and tobacco smoke exposure (TSE) among children aged 3-17 years. In this study, data were obtained from the 2018-2019 U.S. National Survey of Children's Health (NSCH). Children in the range of 3-17 years old were taken as the research subjects, and their parents were surveyed through questionnaires. TSE status was defined as one of three groups: no tobacco smoke exposure (no TSE), someone smoking but not inside the house (no home TSE), and someone smoking inside the house (home TSE). NBPs mainly included behavioral or conduct problems, intellectual disability, learning disability, speech or other language disorders, and developmental delay. We used the sampling weights provided by the NSCH to weight the data in order to obtain an unbiased population estimate. One-way ANOVA and Chi-square tests were performed to examine the difference of each variable. Logistic regression analysis and stratified analysis were carried out to investigate the association between NBPs and TSE. A total of 48,783 children were included in this study, with an average age of 10.1 years. In total 17.9% of all the participants were preschool children, 35.1% were school-age children, and 47.0% were school-age adolescents. More than 85.0% of children lived with no TSE. Over 90.0% of children were healthy in each NBP. Children living with home TSE and no home TSE showed significant adjusted odds ratios (aORs) compared with no TSE in four NBPs besides intellectual disability. The stratified analysis found aORs were higher for NBPs in preschool children compared to the school-age children and school-age adolescents. Male children living with home TSE showed higher aORs in moderate/severe NBP conditions. Our study indicated it is necessary to protect the health of young children from TSE by intervention measures.

Keywords: age; children; gender; neurodevelopmental and behavioral problems; stratified analysis; tobacco smoke exposure.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Multiple logistic regression analysis of TSE and NBPs. After adjusted for child age, gender, race, health status, premature birth and low birth weight, children who lived with/without home TSE (home TSE/no home TSE) compared to children who lived with no TSE (no TSE, reference) in mild (A) and moderate/severe (B) condition of NBPs.
Figure 2
Figure 2
Multiple logistic regression analysis of TSE and NBPs by age stratified analysis. After adjusted for child age, gender, race, health status, premature birth and low birth weight, three groups of children (preschool children, school-age children and school-age adolescents) who lived with/without home TSE (home TSE/no home TSE) compared to children who lived with no TSE (no TSE, reference) in mild (A) and moderate/severe (B) condition of NBPs.
Figure 3
Figure 3
Multiple logistic regression analysis of TSE and NBPs by gender stratified analysis. After adjusted for child age, gender, race, health status, premature birth and low birth weight, two groups of children (male and female) who lived with/without home TSE (home TSE/no home TSE) compared to children who lived with no TSE (no TSE, reference) in mild (A) and moderate/severe (B) condition of NBPs.
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