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Duko B, Bedaso A, Dachew BA, Newnham E, Gebremedhin AT, Tessema G, Einarsdottir K, Alati R, Pereira G. The effect of maternal prenatal tobacco smoking on offspring academic achievement: A systematic review and meta-analysis. Addict Behav 2024; 153:107985. [PMID: 38367506 DOI: 10.1016/j.addbeh.2024.107985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 02/12/2024] [Accepted: 02/12/2024] [Indexed: 02/19/2024]
Abstract
BACKGROUND Previous epidemiological studies examining the prospective association between maternal prenatal tobacco smoking and offspring academic achievement have reported conflicting results. Therefore, this systematic review and meta-analysis was conducted to examine the magnitude and consistency of association reported by those studies. METHODS This systematic review and meta-analysis was guided by the PRISMA protocol. Relevant epidemiological studies on the topic were extracted from four main databases (PubMed/Medline, Embase, PsycINFO, and Scopus). The Newcastle-Ottawa Scale (NOS) was used to appraise the methodological quality of the included studies. We conducted a narrative assessment of the studies that did not report effect estimates. Inverse variance-weighted random effect meta-analysis was used to combine studies reporting effect sizes to estimate pooled adjusted odds ratio with 95% confidence intervals (95% CI). The review was prospectively registered in PROSPERO (CRD42022350901). RESULTS Nineteen observational studies, published between 1973 and 2021 with a total of 1.25 million study participants were included in the final review. Of these, fifteen studies (79 %) reported reduced academic achievement in offspring exposed to maternal prenatal tobacco smoking. The eight primary studies (sample size = 723,877) included in the meta-analysis together suggested a 49 % higher risk of reduced academic achievement in offspring exposed to maternal prenatal tobacco smoking when compared to non-exposed offspring (Pooled odds ratio = 1.49, 95 % CI:1.17-1.91). CONCLUSION Our review found a positive association between maternal prenatal tobacco smoking and offspring reduced academic achievement. However, variation in the adjustment of potential confounders and significant heterogeneity across included studies limited more conclusive inference. Mechanistic studies to identify causal pathways and specific academic impacts are needed to inform targeted developmental programs to assist child learning and academic performance.
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Affiliation(s)
- Bereket Duko
- Curtin School of Population Health, Curtin University, Kent Street, Bentley, WA 6102, Australia; Australian Centre for Precision Health, Clinical and Health Sciences, University of South Australia, Adelaide, SA 5000, Australia; South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia.
| | - Asres Bedaso
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council, New South Wales, Australia
| | - Berihun Assefa Dachew
- Curtin School of Population Health, Curtin University, Kent Street, Bentley, WA 6102, Australia
| | - Elizabeth Newnham
- Curtin School of Population Health, Curtin University, Kent Street, Bentley, WA 6102, Australia; enAble Institute, Curtin University, Kent Street, Bentley, WA 6102, Australia; FXB Center for Health and Human Rights, Harvard University, Boston, MA, USA
| | | | - Gizachew Tessema
- Curtin School of Population Health, Curtin University, Kent Street, Bentley, WA 6102, Australia; enAble Institute, Curtin University, Kent Street, Bentley, WA 6102, Australia
| | - Kristjana Einarsdottir
- Curtin School of Population Health, Curtin University, Kent Street, Bentley, WA 6102, Australia; School of Health Sciences, University of Iceland, Vatnsmýrarvegur 16, 101 Reykjavík, Iceland
| | - Rosa Alati
- Curtin School of Population Health, Curtin University, Kent Street, Bentley, WA 6102, Australia; enAble Institute, Curtin University, Kent Street, Bentley, WA 6102, Australia; Institute for Social Sciences Research, The University of Queensland, 80 Meier's Rd, Indooroopilly, Qld 4068 Australia
| | - Gavin Pereira
- Curtin School of Population Health, Curtin University, Kent Street, Bentley, WA 6102, Australia; enAble Institute, Curtin University, Kent Street, Bentley, WA 6102, Australia; Centre for Fertility and Health (CeFH), Norwegian Institute of Public Health, Oslo, Norway
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Merianos AL, Jacobs W, Olaniyan AC, Smith ML, Mahabee‐Gittens EM. Tobacco Smoke Exposure, School Engagement, School Success, and Afterschool Activity Participation Among US Children. THE JOURNAL OF SCHOOL HEALTH 2022; 92:1202-1213. [PMID: 35989183 PMCID: PMC9669117 DOI: 10.1111/josh.13240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 07/21/2022] [Accepted: 08/01/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Tobacco smoke exposure (TSE), defined as secondhand smoke (SHS) and thirdhand smoke (THS), is associated with negative health consequences. This study's objective was to assess the associations between home TSE status and school engagement, school success, and afterschool activity participation among school-aged children. METHODS We conducted a secondary analysis of 2018-2019 National Survey of Children's Health cross-sectional data. Children ages 6-11 years (N = 17,466) were categorized into home TSE groups: no home TSE; THS exposure only; and SHS and THS exposure. Weighted logistic and Poisson regression models were built. RESULTS Compared to children with no home TSE, children with home THS exposure only and SHS and THS exposure were at decreased odds of being engaged in school (AOR = 0.69, 95%CI = 0.57, 0.83; AOR = 0.63, 95%CI = 0.41, 0.97, respectively), and at increased odds of having ≥1 school-to-home contact about child problems in school (AOR = 1.83, 95%CI = 1.50, 2.23; AOR = 1.58, 95%CI = 1.05, 2.37, respectively). Children with THS exposure only were at increased odds of missing ≥1 school day (AOR = 1.43, 95%CI = 1.13, 1.81). Children with THS exposure only (ARR = 0.90, 95%CI = 0.83, 0.96) and SHS and THS exposure (ARR = 0.74, 95%CI = 0.61, 0.89) were at reduced likelihood of participating in a higher number of afterschool activities. CONCLUSIONS Children exposed to home tobacco smoke are at unique risk for poorer school engagement and success.
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Affiliation(s)
- Ashley L. Merianos
- University of Cincinnati, School of Human ServicesPO Box 210068CincinnatiOH45221‐0068
| | - Wura Jacobs
- Department of KinesiologyCalifornia State University Stanislaus, One University CircleTurlockCA95382
| | - Afolakemi C. Olaniyan
- University of Cincinnati, School of Human ServicesPO Box 210068CincinnatiOH45221‐0068
| | - Matthew Lee Smith
- School of Public Health, Texas A&M University212 Adriance Lab RoadCollege StationTX77843
| | - E. Melinda Mahabee‐Gittens
- Cincinnati Children's Hospital Medical Center, Division of Emergency MedicineCollege of Medicine, University of Cincinnati3333 Burnet Avenue, MLC 2008, 3333 Burnet AvenueCincinnatiOH45229
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Agaku I, Tsafa T, Nikitara K, Odani S. Familial secondhand smoke: Tobacco use and adoption of smoke-free home and car rules among US parents. POPULATION MEDICINE 2021. [DOI: 10.18332/popmed/140059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Rashidi M, Mohammadpoorasl A, Sahebihagh MH. Environmental Tobacco Smoke and Educational Self-Regulation and Achievement in First Grade High School Students. J Med Life 2020; 13:229-234. [PMID: 32742519 PMCID: PMC7378345 DOI: 10.25122/jml-2020-0020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Environmental tobacco smoke, containing many toxic gases, suggests inevitable contact of humans with the damaging factors of cigarettes. On average, approximately 40% of children, 35% of women and 32% of men worldwide are exposed to environmental tobacco smoke. This study aims at investigating the relationship between environmental tobacco smoke in adolescents and their educational self-regulation and achievement. In this study, 770 students aged between 13 and 15 were selected and studied using the multistage sampling method. The tools used in this study consisted of four questionnaires, demographic characteristics, environmental tobacco smoke, educational self-regulation, and educational achievement. The validity and reliability of tools have been approved, and the data were analyzed using SPSS v22. The results indicated a significant inverse relationship between environmental tobacco smoke and students' educational self-regulation and achievement (p-value > 0.001). Given the relationship between exposure to environmental tobacco smoke and educational self-regulation and achievement, it is essential to keep children away from tobacco smoke. Family health and education policy-makers are recommended to design and operate fundamental schemes in order to deal with environmental tobacco smoke.
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Affiliation(s)
- Mina Rashidi
- Student Research Committee, Department of Community Health Nursing, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Asghar Mohammadpoorasl
- Health and Environment Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Hasan Sahebihagh
- Tabriz Health Services Management Research Center, Department of Community Health Nursing, Tabriz University of Medical Sciences, Tabriz, Iran
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Bell K, Corbacho B, Ronaldson S, Richardson G, Torgerson D, Robling M. The impact of pre and perinatal lifestyle factors on child long term health and social outcomes: a systematic review. HEALTH ECONOMICS REVIEW 2018; 8:2. [PMID: 29368151 PMCID: PMC5783983 DOI: 10.1186/s13561-018-0186-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 01/11/2018] [Indexed: 05/22/2023]
Abstract
To understand the full extent of the impact of a trial, it is important to consider the long-term consequences of outcomes beyond the trial follow-up period, especially for early year's interventions. A systematic review of the literature associated with the long-term consequences of four key outcomes from the Building Blocks trial, specifically, low birth weight, smoking during pregnancy, interval to subsequent pregnancy and A&E attendance or inpatient admission was conducted. These factors were guided by the funders, the Department of Health, as being of particular interest in the UK context. Relevant studies were identified from a number of sources including large databases, reference checking and citation searching. The search yielded 3665 papers, 43 of which were considered appropriate for inclusion. Of these, 29 were relating to smoking during pregnancy, 13 to low birth weight, 0 to A&E attendances during early childhood and 1 to short (< 2 years) interval to subsequent pregnancy. Consistent associations were found between maternal smoking during pregnancy and the effects this has on children's health, educational attainment and likelihood of engaging in problem behaviour and criminal activity in later life. Low birth weight was also found to impact on children's long-term health and cognitive development. Subsequent pregnancies within two years of the previous birth were linked with increased likelihood of pre-term birth and neonatal death. Only minimal evidence was identified regarding the consequences of a short interval to second pregnancy and of child A&E and outpatient attendances. Given that these outcomes have been identified by the UK Department of Health as of particular interest for UK benefit, investment of research in these areas is recommended to establish a clearer picture of both short and long-term consequences.
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Affiliation(s)
- Kerry Bell
- York Trials Unit, Department of Health Sciences, University of York, ARRC Building, York, YO10 5DD UK
| | - Belen Corbacho
- York Trials Unit, Department of Health Sciences, University of York, ARRC Building, York, YO10 5DD UK
| | - Sarah Ronaldson
- York Trials Unit, Department of Health Sciences, University of York, ARRC Building, York, YO10 5DD UK
| | - Gerry Richardson
- Centre for Health Economics, University of York, York, YO10 5DD UK
| | - David Torgerson
- York Trials Unit, Department of Health Sciences, University of York, ARRC Building, York, YO10 5DD UK
| | - Michael Robling
- Centre for Trials Research, Cardiff University, Cardiff, CF14 4YS Wales
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Yeramaneni S, Dietrich KN, Yolton K, Parsons PJ, Aldous KM, Haynes EN. Secondhand Tobacco Smoke Exposure and Neuromotor Function in Rural Children. J Pediatr 2015; 167:253-9.e1. [PMID: 25882879 PMCID: PMC4516634 DOI: 10.1016/j.jpeds.2015.03.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Revised: 01/26/2015] [Accepted: 03/06/2015] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To investigate the relationship between secondhand tobacco smoke (SHS) exposure and neuromotor function in children. STUDY DESIGN We studied 404 children aged 7-9 years who were exposed to SHS and other environmental neurotoxicants. Parents reported smoking habits, and serum cotinine levels were measured in children to determine SHS exposure. The Halstead-Reitan Finger Oscillation Test, Purdue Grooved Pegboard Test-Kiddie version, and Bruininks-Oseretsky Test of Motor Proficiency 2-Short Form were used to assess neuromotor function. Multivariable regression models that accounted for potential confounders were used to evaluate the associations. RESULTS Approximately 50% of the children were exposed to SHS based on serum cotinine measures. Exposure to SHS was significantly associated with motor impairment in children, including diminished visuomotor coordination (P = .01), fine motor integration (P = .01), balance (P = .02), and strength (P = .04) after adjusting for exposures to lead and manganese, age, sex, body mass index, measures of parental cognitive abilities, parental education, and quality of home environment. CONCLUSION SHS is a neurotoxicant that may be associated with impaired childhood neuromotor function.
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Affiliation(s)
- Samrat Yeramaneni
- Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, Ohio,Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Kim N. Dietrich
- Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Kimberly Yolton
- General and Community Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Patrick J. Parsons
- Division of Environmental Health Sciences, Wadsworth Center, New York State Department of Health, Albany, New York,Department of Environmental Health Sciences, School of Public Health, University at Albany, Albany, New York
| | - Kenneth M. Aldous
- Division of Environmental Health Sciences, Wadsworth Center, New York State Department of Health, Albany, New York,Department of Environmental Health Sciences, School of Public Health, University at Albany, Albany, New York
| | - Erin N. Haynes
- Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, Ohio
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Omoloja A, Tyc VL. Tobacco and the pediatric chronic kidney disease population. Pediatr Nephrol 2015; 30:235-43. [PMID: 24890336 DOI: 10.1007/s00467-014-2804-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Revised: 02/27/2014] [Accepted: 02/28/2014] [Indexed: 01/18/2023]
Abstract
Tobacco use and exposure are preventable causes of morbidity and mortality. Whereas the impact of this public health issue is well described in adults with kidney disease, its role in the pediatric chronic kidney disease (CKD) population is largely unknown. This review discusses the prevalence of tobacco use and exposure in children with CKD, updates the reader on how tobacco affects the kidney, and presents intervention strategies relevant to this patient population.
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Affiliation(s)
- Abiodun Omoloja
- Department of Pediatrics, One Children's Plaza, Wright State University, Dayton, OH, 45404, USA,
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Adolescent obesity as a risk factor for high-level nicotine addiction in young women. J Adolesc Health 2011; 49:511-7. [PMID: 22018566 DOI: 10.1016/j.jadohealth.2011.04.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2010] [Revised: 04/01/2011] [Accepted: 04/01/2011] [Indexed: 11/23/2022]
Abstract
PURPOSE Obesity and cigarette smoking are two of the most frequent and preventable causes of disease and death in the United States; both are often established during youth. We hypothesized that obese, adolescent girls would be at higher risk for nicotine addiction in young adulthood, and that particular individual and social factors would mediate this association. METHODS Students surveyed in the National Longitudinal Study of Adolescent Health (Add Health), a nationally representative school-based and in-home survey conducted in three waves, comprised the sample. More than 4,000 respondents were used for the multivariate linear and logistic regression analyses used to determine the association between obesity and level of nicotine addiction. Potential mediation effects of the association were also examined. RESULTS Obesity doubled the risk of the highest level of nicotine addiction after controlling for demographic factors, parent and friend smoking, and baseline smoking (OR, 2.12; 95% CI, 1.22-3.68). Family smoking was the strongest predictor of nicotine addiction (OR, 4.72; 95% CI, 2.89-7.72). Grade point average was a partial mediator of this relationship (OR, .48; 95% CI, .32-.74). CONCLUSIONS Obese, adolescent females are at increased risk for high-level nicotine addiction in young adulthood as compared with their nonobese peers. Grade point average partially mediates the association, and may represent a confluence of factors including increased absenteeism, social marginalization, biases, and lack of confidence in academic ability. Obese, adolescent females may require targeted interventions to address their risk of subsequent high-level nicotine addiction, especially if risk factors such as parental smoking and poor school performance are present.
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Heinonen K, Räikkönen K, Pesonen AK, Andersson S, Kajantie E, Eriksson JG, Wolke D, Lano A. Longitudinal study of smoking cessation before pregnancy and children's cognitive abilities at 56 months of age. Early Hum Dev 2011; 87:353-9. [PMID: 21397413 DOI: 10.1016/j.earlhumdev.2011.02.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2010] [Revised: 01/30/2011] [Accepted: 02/03/2011] [Indexed: 10/18/2022]
Abstract
BACKGROUND An inverse relationship exists between the rates of maternal smoking during pregnancy and children's cognitive abilities. The effect of maternal cessation of smoking before pregnancy on child's cognitive development is less clear. AIMS To study whether maternal cessation of smoking before pregnancy is associated with children's cognitive abilities. STUDY DESIGN AND SUBJECTS The original cohort included all 1535 live-born infants admitted to the neonatal wards during 1 year and 658 randomly recruited non-admitted infants. The present study sample comprised 1019 (68.2%) children of the original sample born at term and free of any major impairment followed up to 56 months. OUTCOME MEASURES Child's general reasoning, visual-motor integration, verbal competence, and language comprehension at 56 months of age. RESULTS The results showed that children whose mothers smoked >10 cigarettes per day before pregnancy but none during pregnancy, fared 12.07 (95% confidence interval [CI]: 4.07 to 20.08) and 11.23 (95% CI: 2.81 to 19.66) age-standardized points poorer in general reasoning and in language comprehension tests, respectively, than children of never-smokers. All results were adjusted for the sex, gestational age-adjusted birth weight, multiple/singleton pregnancy, birth order, preeclampsia, maternal diabetes, admission to neonatal ward, 5-minute Apgar score (<7), breastfeeding, parental level of education, maternal age, BMI at the end of pregnancy and single parenting. CONCLUSIONS Heavy smoking before pregnancy is associated with children's lower cognitive abilities even if the mother has quit smoking before pregnancy. Identification and intervention of heavy smoking women of fertile age would potentially improve not only their odds to become pregnant but also benefit the offspring's cognitive functioning.
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Affiliation(s)
- Kati Heinonen
- Institute of Behavioral Science, University of Helsinki, Helsinki, Finland.
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Sobotova L, Liu YH, Burakoff A, Sevcikova L, Weitzman M. Household exposure to secondhand smoke is associated with decreased physical and mental health of mothers in the USA. Matern Child Health J 2011; 15:128-37. [PMID: 20012677 DOI: 10.1007/s10995-009-0549-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Secondhand smoke is one of the most common toxic environmental exposures to children, and maternal health problems also have substantial negative effects on children. We are unaware of any studies examining the association of living with smokers and maternal health. To investigate whether non-smoking mothers who live with smokers have worse physical and mental health than non-smoking mothers who live in homes without smokers. Nationally representative data from the 2000-2004 Medical Expenditure Panel Survey were used. The health of non-smoking mothers with children <18 years (n = 18,810) was assessed, comparing those living with one or more smokers (n = 3,344) to those living in households with no adult smokers (n = 14,836). Associations between maternal health, household smoking, and maternal age, race/ethnicity, and marital, educational, poverty and employment status were examined in bivariable and multivariable analyses using SUDAAN software to adjust for the complex sampling design. Scores on the Medical Outcomes Short Form-12 (SF-12) Physical Component Scale (PCS) and Mental Component Scale (MCS) were used to assess maternal health. About 79.2% of mothers in the USA are non-smokers and 17.4% of them live with ≥1 adult smokers: 14.2% with 1 and 3.2% with ≥2 smokers. Among non-smoking mothers, the mean MCS score is 50.5 and mean PCS is 52.9. The presence of an adult smoker and increasing number of smokers in the home are both negatively associated with MCS and PCS scores in bivariable analyses (P < 0.001 for each). Non-smoking mothers with at least one smoker in the household had an 11% (95% CI = 0.80-0.99) lower odds of scoring at or above the mean MCS score and a 19% (95% CI = 0.73-0.90) lower odds of scoring at or above the mean PCS score compared to non-smoking mothers with no smokers in the household. There is an evidence of a dose response relationship with increasing number of smokers in the household for PCS (P < 0.001). These findings demonstrate a previously unrecognized child health risk: living with smokers is independently associated with worse physical and mental health among non-smoking mothers.
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Affiliation(s)
- L Sobotova
- Institute of Hygiene, Faculty of Medicine, Comenius University, Bratislava, Slovakia, Europe
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Ho SY, Lai HK, Wang MP, Lam TH. Exposure to secondhand smoke and academic performance in non-smoking adolescents. J Pediatr 2010; 157:1012-1017.e1. [PMID: 20638075 DOI: 10.1016/j.jpeds.2010.06.013] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2010] [Revised: 03/24/2010] [Accepted: 06/08/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To study the association between exposure to secondhand smoke (SHS) and academic performance in non-smoking adolescents. STUDY DESIGN A questionnaire survey of 23 052 non-smoking students aged 11 to 20 years was conducted. Information on academic performance, number of days of SHS exposure per week at home and outside the home, number of smokers at home and their relationship with the student, and sociodemographic characteristics was recorded. RESULTS Students exposed to SHS at home 1 to 4 and 5 to 7 days per week were 14% (95% confidence interval, 5%-25%) and 28% (15%-41%) more likely, respectively, to report poor academic performance compared with students who were not exposed to SHS. Living with one, two, and ≥ 3 smokers, compared with no smoker, was also associated with 10% (0.1%-20%), 43% (23%-65%) and 87% (54%-127%), respectively, higher odds of poor academic performance (P for trend <.001). The greatest excess risks were observed with SHS exposure from co-residing non-relatives, followed by siblings, visitors, co-residing grandparents and relatives, and parents. CONCLUSION SHS exposure is associated linearly with poor academic performance in non-smoking adolescents, and the effect of SHS exposure at home is stronger from smokers other than the parents.
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Affiliation(s)
- Sai-Yin Ho
- School of Public Health, The University of Hong Kong, Pokfulam, Hong Kong
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Minnes S, Singer LT, Kirchner HL, Short E, Lewis B, Satayathum S, Queh D. The effects of prenatal cocaine exposure on problem behavior in children 4-10 years. Neurotoxicol Teratol 2010; 32:443-51. [PMID: 20227491 DOI: 10.1016/j.ntt.2010.03.005] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2010] [Accepted: 03/05/2010] [Indexed: 11/25/2022]
Abstract
BACKGROUND Children prenatally exposed to cocaine may be at increased risk for behavioral problems due to disruptions of monaminergically regulated arousal systems and/or environmental conditions. OBJECTIVE To assess behavioral outcomes of cocaine (CE) and non-cocaine-exposed (NCE) children, 4 through 10 years old, controlling for other prenatal drug exposures and environmental factors. METHODS Low socioeconomic status (SES), primarily African American children (n=381 (193 (CE), 188 (NCE)) were recruited from birth. Generalized Estimating Equation (GEE) analyses were used to assess the predictive relationship of prenatal cocaine exposure to odds of caregiver reported clinically elevated behavioral problems at 4, 6, 9 and 10y ears of age, controlling for confounders. RESULTS Prenatal cocaine exposure was associated with increased rates of caregiver reported delinquency (OR=1.93, CI: 1.09-3.42, p<0.02). A significant prenatal cocaine exposure by sex interaction was found for delinquency indicating that only females were affected (OR=3.57, CI: 1.67-7.60, p<0.001). There was no effect of cocaine on increased odds of other CBCL subscales. Higher prenatal tobacco exposure was associated with increased odds of externalizing symptoms at 4, 9 and 10 years of age. For CE children, those in foster or adoptive care were rated as having more behavior problems than those in biologic mother or relative care. Greater caregiver psychological distress was associated with increased behavioral problems. There were no independent effects of elevated blood lead level on increased behavior problems after control for prenatal drug exposure and other environmental conditions. CONCLUSION Prenatal cocaine and tobacco exposure were associated with greater externalizing behavior after control for multiple prenatal drug exposures, other environmental and caregiving factors and lead exposure from 4 through 10 years of age. Greater caregiver psychological distress negatively affected caregiver ratings of all CBCL domains. Since cocaine and tobacco use during pregnancy and maternal psychological distress have the potential to be altered through prenatal educational, drug treatment and mental health interventions, they warrant attention in efforts to reduce rates of problem behaviors in children.
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Affiliation(s)
- Sonia Minnes
- Case Western Reserve University, The Mandel School of Applied Social Science, Cleveland, Ohio 44106, USA.
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Collins BN, Ibrahim JK, Hovell M, Tolley NM, Nair US, Jaffe K, Zanis D, Audrain-McGovern J. Residential smoking restrictions are not associated with reduced child SHS exposure in a baseline sample of low-income, urban African Americans. Health (London) 2010; 2:1264-1271. [PMID: 23875066 DOI: 10.4236/health.2010.211188] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Second hand smoke exposure (SHSe) relates to many chronic and acute illnesses. Low income African American (AA) maternal smokers and their children have disproportionately higher tobacco-use and child SHSe-related morbidity and mortality than other populations. While public health officials promote residential smoking restrictions to reduce SHSe and promote smoking cessation, little is known about the impact of restrictions in changing smoking behavior and SHSe in this population. Thus, the purpose of this study was to examine associations between residential smoking restrictions, maternal smoking, and young children's SHSe in the context of other factors known to influence low income AA mothers' smoking behavior. For this study, we used cross-sectional, baseline data from 307 AA maternal smokers' pre-treatment interviews completed as part of a subsequent behavioral counseling trial to reduce their young (< 4 years old) children's SHSe. Residential smoking restriction was dichotomized as 0 = no restrictions and 1 = some restrictions. Child urine cotinine provided a biomarker of SHSe. Mothers reported cigarettes/day smoked, cigarettes/day exposed to child, and intention to quit. Multivariate regressions modeled effects of restriction as the primary predictor of smoking and exposure outcomes. Maternal smoking patterns such as cigarettes per day (β = 0.52, p < 0.001) and years smoked (β = -0.11; p = 0.03) along with presence of additional smokers in the home (β = 0.10; p = 0.04), but not residential restriction (β = -0.09, p = 0.10), predicted reported SHSe. Restriction did not relate to baby cotinine or maternal intention to quit. Thus, residential smoking restrictions may contribute to efforts to reduce children's SHSe and promote maternal smoking change; but alone, may not constitute a sufficient intervention to protect children. Multi-level intervention approaches that include SHSe-reduction residential smoking policies plus support and cessation assistance for smokers may be a necessary approach to smoke-free home adoption and adherence.
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Bell K, McNaughton D, Salmon A. Medicine, morality and mothering: public health discourses on foetal alcohol exposure, smoking around children and childhood overnutrition. CRITICAL PUBLIC HEALTH 2009. [DOI: 10.1080/09581590802385664] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Park J, Kang MG, Ryu SY, You JW, Moon KR. Predictors of failure in medical students. KOREAN JOURNAL OF MEDICAL EDUCATION 2009; 21:143-151. [PMID: 25813112 DOI: 10.3946/kjme.2009.21.2.143] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2008] [Accepted: 02/18/2009] [Indexed: 06/04/2023]
Abstract
PURPOSE This study aimed to identify the predictors of failure in medical students. METHODS We conducted a 10-year follow-up survey of 231 medical students. The students' general characteristics, study-related factors, health-related behavior, and self-perceived health were examined using questionnaires that were given late in the first year of a premedical course. We evaluated the failure incidence of students using school records from the second year of a premedical course to the fourth year of medical school. The statistical analyses that were used were chi2-test, student t-test, and multiple logistic regression analysis. RESULTS Sixty-five students experienced failure. Thirty-seven (56.9%) had 1 failure, 11 (16.9%) had 2 failures, 8 (12.3%) had 3 failures, 4 (6.2%) had 4 failures, and 5 (7.7%) had 5 failures. From the results of multiple logistic regression, the rates of failure were significantly higher for those whose grade point average (GPA) in the first year of a premedical course was below 2.5 (Relative Risk [RR]=6.52, 95% Confidence Interval [CI]: 1.42~29.8), who smoked more than 1 pack of cigarettes per day (RR=7.37, 95% CI: 1.23~44.07), who drank more (RR=1.16, 95% CI: 1.02~1.33), and exercised less (RR=0.997, 95% CI: 0.995~0.999). CONCLUSION It was demonstrated that the incidence of failure in medical students was reflected in their academic records in the first year of a premedical course and by unhealthy lifestyles. This study suggests that students who have poor academic marks and unhealthy lifestyles in the first year of a premedical course should be properly guided to reduce the incidence of failure.
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Affiliation(s)
- Jong Park
- Department of Preventive Medicine, College of Medicine, Chosun University, Gwangju, Korea
| | - Myung Geun Kang
- Department of Preventive Medicine, College of Medicine, Chosun University, Gwangju, Korea
| | - So Yeon Ryu
- Department of Preventive Medicine, College of Medicine, Chosun University, Gwangju, Korea
| | - Jae Won You
- Department of Orthopaedic Surgery, College of Medicine, Chosun University, Gwangju, Korea
| | - Kyung Rye Moon
- Department of Pediatrics, College of Medicine, Chosun University, Gwangju, Korea
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Mueller DT, Collins BN. Pediatric otolaryngologists' actions regarding secondhand smoke exposure: pilot data suggest an opportunity to enhance tobacco intervention. Otolaryngol Head Neck Surg 2008; 139:348-52. [PMID: 18722210 DOI: 10.1016/j.otohns.2008.05.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2007] [Revised: 12/07/2007] [Accepted: 05/05/2008] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To assess pediatric otolaryngologists' training, actions, and attitudes with respect to patients exposed to secondhand smoke. STUDY DESIGN Cross-sectional survey. SUBJECTS Pediatric otolaryngologists and senior residents. METHODS An anonymous, Web-based survey of pediatric otolaryngologists was designed to capture demographics, tobacco-specific education, actions, and attitudes. Responses were analyzed descriptively and entered into logistic regression models to determine predictors of adherence to the basic tenets of the general pediatrics secondhand smoke exposure-prevention guidelines. RESULTS One hundred-fifteen US physicians completed the survey. Descriptive analysis revealed low levels of training and low levels of tobacco-specific intervention among respondents. Logistic regression models showed that greater tobacco-specific knowledge/education and fewer perceived barriers predicted greater adherence to the basic tenets of the pediatrics guidelines. CONCLUSION Our pilot study provides preliminary evidence that can guide specific improvements in tobacco-intervention training for pediatric otolaryngologists and residents.
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Affiliation(s)
- Darryl T Mueller
- Health Behavior Research Center, Department of Public Health, Temple University, Philadelphia, PA 19122, USA
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Kieling C, Goncalves RRF, Tannock R, Castellanos FX. Neurobiology of attention deficit hyperactivity disorder. Child Adolesc Psychiatr Clin N Am 2008; 17:285-307, viii. [PMID: 18295147 DOI: 10.1016/j.chc.2007.11.012] [Citation(s) in RCA: 95] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This article addresses the current understanding of the neurobiological bases of attention deficit hyperactivity disorder (ADHD), focusing on empiric research findings that connect genetic and environmental factors to structural and functional brain abnormalities, ultimately leading to a set of age-dependent behavioral manifestations. Section one presents evidence for genetic risk factors for ADHD and discusses the role of potential environmental factors in the etiology of the disorder. Section two focuses on brain imaging studies and how they have helped generate different hypotheses regarding the pathophysiology of ADHD. Finally, the article addresses the longitudinal course of symptoms in ADHD from infancy to adulthood in an attempt to place biological findings for this complex brain disorder in the context of maturation and development.
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Affiliation(s)
- Christian Kieling
- Department of Psychiatry, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2350 - 2201A 90035-903, Porto Alegre, RS, Brazil.
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