Table 5.11

Studies of secondhand smoke exposure and children’s growth

StudyDesign/populationExposure categoriesSource of exposureOutcomeFindingsComments
Rona et al. 1981 Longitudinal (1,800)
Children aged 5–11 years from England and Scotland who participated in the National Study of Health and Growth United
  • Children with no smokers in the home
  • One smoker in the home
  • Two or more smokers in the home
  • Parental secondhand smoke exposure at home
  • There was a strong inverse association between height and the number of household smokers (p <0.001 in England and p <0.01 in Scotland)
  • After adjusting for confounding variables such as maternal smoking during pregnancy, paternal social class, maternal and paternal heights, and the number of siblings, a significant trend remained only in the English sample (p <0.01)
Source exposure data were obtained from parental self-reports through questionnaires; children’s heights were measured across all 28 study areas; persons identified regarding exposures smoked ≥5 cigarettes/day at home; secondhand smoke at home seems to affect the growth of children
Rantakallio 1983 Longitudinal (12,068)
Finnish children (mothers enrolled during pregnancy and children followed until 14 years of age)
  • Maternal smoking
  • Paternal smoking (exposures were not clearly defined)
  • Mother
  • Father
Height at 14 years of age
  • Children of smokers were shorter at 14 years of age compared with children of nonsmokers
  • Regression coefficient:
     −0.034 (maternal smoking, p = 0.056)
     −0.032 (paternal smoking, p = 0.072)
Source exposure data were self-reported (questionnaire); children of smokers were shorter than children of nonsmokers
Rona et al. 1985 Editorial prospective (5,000–6,000)
Primary school children (aged 5–11 years) from England and Scotland United Kingdom
  • Prenatal and secondhand smoke exposures from parental smoking
Height (in mm)
  • Children of mothers who smoked during pregnancy and whose parents smoked at home had significantly reduced (p <0.01) heights by 2 mm for children aged 5–11 years
Chinn and Rona 1991 Observational study (11,224)
English and Scottish inner-city and representative children aged 5–11 years
United Kingdom
  • Number of cigarettes smoked by parents at home (recorded as a continuous variable) = 0, 1–4, 5–14, 15–24, 25–34, and ≥35
  • Secondhand smoke
Height, respiratory illness (wheeze)
  • There were no regression coefficients of height standard deviation scores on involuntary smoking; controlling for confounders was significantly different from zero
  • Significant usual coughs were observed in English inner-city boys and girls (p <0.01 and p <0.05, respectively)
  • Persistent wheeze was significant for Scottish boys (p <0.05)
Source exposure data were from maternal self-reports (questionnaires); heights were measured by Holtian stadiometer, and respiratory symptoms were gathered from maternal reports; overall risk of respiratory conditions resulting from secondhand smoke is small but not negligible
Eskenazi and Bergmann 1995 Longitudinal cohort (2,622)
Children (aged 5 years ± 6 months) enrolled in Child Health and Development Studies between 1964 and 1967 in the San Francisco East Bay area
United States
  • Nonsmokers exposed to secondhand smoke (cotinine levels 2–10 ng/mL)
  • Unexposed nonsmokers
  • Serum cotinine levels of smokers:
     0–79 ng/mL
     80–163 ng/mL
     164–569 ng/mL
  • Maternal secondhand smoke exposure during pregnancy and prenatal maternal smoking
  • Serum cotinine sample during pregnancy
  • Children of smokers and those of nonsmokers in unadjusted analyses were 0.1, 0.2, and 0.5 centimeters shorter for each smoker’s cotinine tertile, respectively
  • Only the adjusted heights of children of mothers who smoked prenatally and postnatally were significantly different from those of nonsmokers (p <0.05), but when birth weight and gestational length were added to the model, the finding was no longer significant
Source exposure data were from maternal self-reports of smoking status; secondhand smoke exposure was measured using cotinine as a biomarker; self-reported smoking status and serum cotinine levels showed good agreement in height measurements collected by trained personnel; children whose mothers were heavy smokers during pregnancy were shorter at 5 years of age compared with children of nonsmokers; this effect appears to be attributable to in utero exposure rather than to postnatal secondhand smoke exposure

NR = Data were not reported.

mm = Millimeters.

ng/mL = Nanograms per milliliter.

From: 5, Reproductive and Developmental Effects 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).

NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.