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J Obstet Gynecol Neonatal Nurs. 2010 Jan-Feb;39(1):111-7. doi: 10.1111/j.1552-6909.2009.01093.x.

Contribution of tobacco smoke exposure to learning disabilities.

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School of Nursing and Health Studies, Georgetown University, Washington, DC, USA.



To investigate the contribution of exposure to prenatal tobacco smoke (PTS) and environmental tobacco smoke (ETS) to parent-reported learning disabilities.


A nationally representative, cross-sectional survey conducted in the United States, the National Health and Nutrition Examination Survey (NHANES) 1999 to 2002, was used to explore the association between reported learning disability and exposure to PTS and ETS.


Data were analyzed from 5,420 children ages 4 to 15 years old.


Secondary data analysis was conducted using logistic regression controlling for a number of potential confounders and covariates.


Overall, 10.6% of children had a parent-reported learning disability (LD), exceeding previous estimates. Exposure to PTS (odds ratio [OR] = 1.6) and ETS (OR = 1.6) were significantly associated with increased odds for LD in children, with a greater odds noted (OR = 2.6) when exposed to PTS and ETS.


Exposure to tobacco smoke significantly increases the odds for children to have a learning disability. Overall, results indicate that if tobacco exposure is causally associated to LD, eliminating exposures could prevent an estimated 750,000 of parent-reported learning disabilities in the United States. Results underscore the need for diligence in the promotion of smoking prevention and cessation efforts.

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