TY - JOUR
T1 - Association between environmental tobacco smoke exposure across the first four years of life and manifestation of externalizing behavior problems in school-aged children
AU - Gatzke-Kopp, Lisa
AU - Willoughby, Michael T.
AU - Warkentien, Siri
AU - Petrie, Daniel
AU - Mills-Koonce, Roger
AU - Blair, Clancy
N1 - Funding Information:
The authors have declared that they have no competing or potential conflicts of interest. Funding for this project was provided by the National Institute of Health Office of the Director UG3 OD023332; UH3 OD023332-01 and the Eunice Kennedy Shriver National Institute of Child Health and Human Development P01 HD039667.Key points Children’s cotinine levels across the first four years of life predict later externalizing symptoms, even among children whose mothers did not smoke during pregnancy. Findings have important implications for risks associated with postnatal exposure that extend beyond the well-documented respiratory and immunological consequences. Assessing cotinine directly from children captures exposure from sources that may extend beyond the parents and accounts for factors that might exacerbate or mitigate children’s exposure, such as whether parents smoke indoors. Findings have implications for policy, such as incorporating routine screening for cotinine as is commonly done for lead. Results provide important characterization of the timing and magnitude of environmental smoke exposure that can inform studies examining genetic pathways of the development of externalizing problems. Children’s cotinine levels across the first four years of life predict later externalizing symptoms, even among children whose mothers did not smoke during pregnancy. Findings have important implications for risks associated with postnatal exposure that extend beyond the well-documented respiratory and immunological consequences. Assessing cotinine directly from children captures exposure from sources that may extend beyond the parents and accounts for factors that might exacerbate or mitigate children’s exposure, such as whether parents smoke indoors. Findings have implications for policy, such as incorporating routine screening for cotinine as is commonly done for lead. Results provide important characterization of the timing and magnitude of environmental smoke exposure that can inform studies examining genetic pathways of the development of externalizing problems.
Publisher Copyright:
© 2019 Association for Child and Adolescent Mental Health
PY - 2020/11/1
Y1 - 2020/11/1
N2 - Background: Extensive literature in human and animal models has documented an association between maternal smoking during pregnancy and externalizing behavior in offspring. It remains unclear; however, the extent to which postnatal environmental smoke exposure is associated with behavioral development, particularly for children whose mothers did not smoke during pregnancy. The present study examined whether magnitude of exposure to environmental smoke across the first four years of life demonstrated a linear association with later externalizing symptoms. Methods: Exposure was quantified through salivary cotinine measured when children were 6, 15, 24, and 48 months of age, providing a more accurate quantification of realized exposure than can be estimated from parental report of cigarettes smoked. Data were available for n = 1,096 (50% male; 44% African American) children recruited for the Family Life Project, a study of child development in areas of rural poverty. Results: Analyses indicate a linear association between cotinine and children’s symptoms of hyperactivity and conduct problems. This association remained significant after controlling for family poverty level, parental education, parental history of ADHD, hostility, depression, caregiver IQ, and obstetric complications. Furthermore, this association was unchanged when excluding mothers who smoked during pregnancy from the model. Conclusions: Findings are consistent with animal models demonstrating an effect of environmental exposure to nicotine on ongoing brain development in regions related to hyperactivity and impulsivity, and highlight the importance of mitigating children’s exposure to environmental smoke, including sources that extend beyond the parents.
AB - Background: Extensive literature in human and animal models has documented an association between maternal smoking during pregnancy and externalizing behavior in offspring. It remains unclear; however, the extent to which postnatal environmental smoke exposure is associated with behavioral development, particularly for children whose mothers did not smoke during pregnancy. The present study examined whether magnitude of exposure to environmental smoke across the first four years of life demonstrated a linear association with later externalizing symptoms. Methods: Exposure was quantified through salivary cotinine measured when children were 6, 15, 24, and 48 months of age, providing a more accurate quantification of realized exposure than can be estimated from parental report of cigarettes smoked. Data were available for n = 1,096 (50% male; 44% African American) children recruited for the Family Life Project, a study of child development in areas of rural poverty. Results: Analyses indicate a linear association between cotinine and children’s symptoms of hyperactivity and conduct problems. This association remained significant after controlling for family poverty level, parental education, parental history of ADHD, hostility, depression, caregiver IQ, and obstetric complications. Furthermore, this association was unchanged when excluding mothers who smoked during pregnancy from the model. Conclusions: Findings are consistent with animal models demonstrating an effect of environmental exposure to nicotine on ongoing brain development in regions related to hyperactivity and impulsivity, and highlight the importance of mitigating children’s exposure to environmental smoke, including sources that extend beyond the parents.
UR - http://www.scopus.com/inward/record.url?scp=85076315574&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85076315574&partnerID=8YFLogxK
U2 - 10.1111/jcpp.13157
DO - 10.1111/jcpp.13157
M3 - Article
C2 - 31797389
AN - SCOPUS:85076315574
SN - 0021-9630
VL - 61
SP - 1243
EP - 1252
JO - Journal of Child Psychology and Psychiatry and Allied Disciplines
JF - Journal of Child Psychology and Psychiatry and Allied Disciplines
IS - 11
ER -
