Table 6.12

Studies of cough prevalence associated with parental smoking

Odds ratio for smoking (95% confidence interval)
StudyPopulation age (years)/locationDefinition of coughPrevalence in unexposed (%)Either parent (unadjusted)Either parent (adjusted)One parent only vs. neitherBoth parents vs. neitherMother only vs. neitherFather only vs. neitherConfounders adjusted for
Norman-Taylor and Dickinson 1972 5
United Kingdom
Recent recurrence3.10.89 (0.44–1.80)NR*0.62 (0.25–1.46)1.4 (0.61–3.2)NRNRNR
Colley 1974 6–14
United Kingdom
Usually, in winter14.71.47 (1.17–1.85)NR1.25 (0.94–1.66)1.66 (1.28–2.16)NRNRNR
Lebowitz and Burrows 1976 0–15
United States
Persistent4.82.28 (1.20–4.32)NRNRNRNRNRNR
Schilling et al. 1977 7–18
United States
Cough and/or phlegm, usually (definition unclear)12.81.22 (0.82–1.82)NR1.06 (0.68–1.63)1.99 (1.06–3.73)1.1 (0.56–2.15)1.04 (0.64–1.69)NR
Bland et al. 1978 11–12
United Kingdom
Day or night19.41.56 (1.36–1.79)1.36 (1.12–1.64)1.2 (0.96–1.49)1.57 (1.25–1.94)NRNRActive smoking, gender
Weiss et al. 1980 5–9
United States
Cough and phlegm1.71.88 (0.24–15.0)NR1.64 (0.18–15.0)2.09 (0.25–17.8)NRNRNR
Dodge 1982 8–12
United States
NR14.12.03 (1.35–3.06)NR1.84 (1.15–2.95)2.29 (1.41–3.73)NRNRNR
Ekwo et al. 1983 6–12
United States
With colds301.40 (1.09–1.80)NR1.33 (1.0–1.78)1.50 (1.10–2.04)1.38 (0.87–2.17)1.32 (0.96–1.80)NR
Schenker et al. 1983 5–14
United States
Chronic6.31.21 (0.95–1.54)NR1.12 (0.84–1.49)1.35 (1.0–1.83)NRNRNR
Charlton 1984 8–19
United Kingdom
Frequent recurrences221.47 (1.31–1.66)NR1.36 (1.19–1.56)1.64 (1.41–1.91)1.36 (1.15–1.62)1.34 (1.13–1.59)NR
United Kingdom
Frequent recurrences33.51.60 (1.33–1.96)NRNRNRNRNRNR
United Kingdom
Frequent recurrences17.51.50 (1.26–1.79)NRNRNRNRNRNR
United Kingdom
Frequent recurrences8.51.12 (0.83–1.52)NRNRNRNRNRNR
Ware et al. 1984 6–9
United States
Persistent7.7NR1.19 (1.02–1.39)1.09 (0.91–1.30)1.38 (1.16–1.63)0.99 (0.75–1.29)1.13 (0.94–1.36)Age, gender, city
Burchfiel et al. 1986 0–19
United States
NR8.5NR1.0 (0.78–1.27)0.93 (0.67–1.30)1.27 (0.89–1.81)0.78 (0.37–1.64)0.97 (0.67–1.41)Age, gender, parental education
Goren and Goldsmith 1986 2nd and 5th graders
With sputum61.17 (0.77–1.78)NRNRNR1.22 (0.72–2.07)1.15 (0.73–1.81)NR
Park and Kim 1986 0–14
In the past 2 weeks53.04 (2.09–4.43)NR3.2 (2.11–4.85)3.0 (2.05–4.38)NRNRNR
Strachan and Elton 1986 7–8
United Kingdom
Night49.11.7 (0.85–3.44)NRNRNRNRNRNR
Andrae et al. 1988 6 months 16 years
Exercise induced5.11.39 (1.10–1.76)NRNRNRNRNRNR
Somerville et al. 1988 5–11
United Kingdom
Usually in the morning41.24 (1.0–1.53)1.24 (0.94–1.65)NRNRNRNRAge, gender, birth weight, obesity, socioeconomic status (SES), mother’s age, number of siblings
United Kingdom
Usually day/night81.46 (1.27–1.68)1.26 (1.02–1.56)NRNRNRNRAge, gender, birth weight, obesity, SES, mother’s age, number of siblings
Strachan 1988 7
United Kingdom
At night in the past month91.91 (1.29–2.82)NR1.64 (1.05–2.56)2.45 (1.5–4.02)NRNRNR
Hosein et al. 1989 7–17
United States
Persistent0.9NR2.02 (0.68–6.03)1.84 (0.55–6.18)2.23 (0.69–7.19)NRNRGender, active smoking
Stern et al. 1989a 7–12
With phlegm5.3NRNRNRNR0.98 (0.60–1.62)0.85 (0.52–1.39)NR
Stern et al. 1989b 7–12
Persistent8NRNRNRNR1.45§ (1.13–1.87)NRNR
Dijkstra et al. 1990 6–12
Persistent4.6NR2.46 (1.07–5.64)NRNRNRNRAge, parental education
Chinn and Rona 1991 5–11
United Kingdom
UsuallyNRNR1.25 (1.13–1.38)NRNRNRNRAge, gender, country, birth weight, obesity, SES, mother’s age, number of siblings, ethnicity, gas cooking
Forastiere et al. 1992 7–11
With phlegm5.51.3 (NR)1.3 (0.9–1.9)NR1.7 (1.1–2.5)1.2 (0.7–2.0)1.0 (0.7–1.6)Age, gender, area, SES
Night3.41.8 (NR)1.8 (1.2–2.7)NR2.5 (1.6–3.9)1.5 (0.8–2.8)1.2 (0.8–2.0)Age, gender, area, SES
Bråbäck et al. 1995 10–12
Night8.4NRNRNRNR2.09Δ (1.51–2.90)NRGender, atopy, dampness, overcrowding
Night6.7NRNRNRNR1.10Δ (0.62–1.93)NRGender, atopy, dampness, overcrowding
Night7.4NRNRNRNR2.27Δ (1.55–3.32)NRGender, atopy, dampness, overcrowding
Cuijpers et al. 1995 6–12
Chronic12.6NR1.10 (0.67–1.8)NRNRNRNRNR
Goren and Hellmann 1995 2nd and 5th graders
With sputum8.11.25 (1.06–1.49)NR1.12 (0.93–1.36)1.51 (1.22–1.87)1.42Δ (1.17–1.73)1.25 (1.05–1.48)Age, gender, dampness, father’s education, dog, unvented geyser
Moyes et al. 1995 6–7
New Zealand
Night300.91 (0.77–1.08)NRNRNRNRNRNR
New Zealand
Night241.78 (1.50–2.11)NRNRNRNRNRNR
Ninan et al. 1995 8–13
United Kingdom
Isolated, persistent, nocturnalNR1.61 (0.70–3.70)NRNRNRNRNRNR
Volkmer et al. 1995 4–5
DryNRNot significantNot significantNRNRNRNRNR
Wright et al. 1996 6
United States
Persistent27.41.44** (1.07–1.94)NRNRNRNRNRNR
United States
Persistent, without wheeze11.81.67,** (1.10–2.54)1.93,** (1.09–3.45)NRNRNRNRGender, hay fever, lower respiratory infection in the first year
Zejda et al. 1996 7–9
Chronic31.9NR1.3 (1.02–1.71)NRNRNRNRCrowding
Austin and Russell 1997 12 and 14
United Kingdom
Chronic7.21.58 (1.11–2.27)NRNRNR1.93 (1.30–2.85)NRNR
Dales et al. 1997 NR
Recorded night cough863.25 (1.16–9.09)NRNRNRNRNRNR
Forsberg et al. 1997 6–12
Dry cough at night apart from colds in the past year8–19NR1.3 (1.2–1.5)NRNRNRNRAge, gender, area, fitted carpets, pets, mold, stove use, parental asthma, early day care
Chen et al. 1998 6–17
Night5.51.97 (1.10–3.52)NR2.01 (1.04–3.88)1.91 (0.84–4.33)NRNRNone
Lam et al. 1998 12–15
Hong Kong
Saw a physician for cough in the past 3 months7.3NRNR1.19 (0.94–1.51)NR0.73 (0.32–1.70)1.31†† (1.03–1.65)Age, gender, area, housing type
Lewis et al. 1998 8–11
Dry night cough that lasted >2 weeks in the past 12 months without a cold19.1NR1.0 (0.81–1.23)NRNRNRNRAge, gender, PM10‡‡, SO2§§, gas heating, maternal allergy
Peters et al. 1998 8–13
Hong Kong
Physician consultation for cough in the past 3 months12.51.18 (1.06–1.32)NR1.15 (1.01–1.32)1.33 (1.08–1.64)NRNRAge, gender, housing type, area, father’s education
Withers et al. 1998 14–16
United Kingdom
Current12.4NR1.47 (1.11–1.95)NRNRp >0.05p >0.05Maternal hay fever, child’s eczema and hay fever, active smoking, single parent
Burr et al. 1999 12–14
United Kingdom
Cough without colds in the past 12 months25.51.49 (1.41–1.57)1.29ΔΔ (1.24–1.35)NRNRNRNRGender, area, pets, cooking and heating fuel, housing type, active smoking
Lam et al. 1999 8–13
Hong Kong
Cough for 3 months4.8NR1.29¶¶ (0.93–1.78)NRNRNRNRAge, gender, area, active smoking
Shamssain and Shamsian 1999 6–7
United Kingdom
Nighttime cough in the past 12 monthsNRNRNR1.04 (NR)1.10 (NR)1.05 (0.85–1.29)NRNone
Qian et al. 2000 5–14
Often, with or without colds41–84NR1.30 (1.05–1.61)NRNRNRNRAge, gender, ventilation, family history, mother’s education, coal use, area

NR = Data were not reported.

Not included in the meta-analysis.

Overall prevalence.


Mother smoked vs. did not smoke during pregnancy and infancy.


Mother currently smoked vs. did not smoke.

Father currently smoked vs. did not smoke.


Reference group = Children without cough or wheeze.


Father smoked vs. neither parent smoked where only 2.5% of the mothers smoked.


PM10= Particulate matter (levels of particles [particulate pollution] with an aerodynamic diameter of less than 10 micrometers).


SO2= Sulfur dioxide.


Derived from pooled results of all household smokers.


Analyses excluded active smokers.

From: 6, Respiratory Effects in Children from Exposure to Secondhand Smoke

Cover of The Health Consequences of Involuntary Exposure to Tobacco Smoke
The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General.
Office on Smoking and Health (US).

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