Abstract
INTRODUCTIONSecondhand smoke (SHS) exposure is linked to a series of serious health problems. Children may be particularly vulnerable to the effects of SHS exposure at home. This study aimed to determine the association between SHS exposure at home and cognitive performance in school children.METHODSA multistage sampling was performed across rural primary schools in Kuala Krai, Kelantan, Malaysia. Data were collected using self-administered questionnaires and the children aged 10–11 years (n=312) were subjected to cognitive tests including digit span, letter-number sequencing, coding, and symbol search. Cognitive performance was tested using subscales derived from the Wechsler Intelligence Scale for Children.RESULTSThe prevalence of SHS exposure at home was 55.8%, where 11.9% of children lived with one smoker, while 43.9% of children lived with ≥2 smokers. There was a significant difference in the mean score of the combined cognitive tests between SHS-exposed and non-exposed children after adjustment for sex, parental educational level, family income and academic performance [Pillai’s Trace=0.084, F statistic (df)=6.803 (4302), p<0.001].CONCLUSIONSMore than half of the primary school children in rural Kuala Krai were exposed to SHS from at least one smoker at home. There was a significant association between SHS exposure at home and cognitive performance.
Highlights
Secondhand smoke (SHS) exposure is linked to a series of serious health problems
A total of 312 respondents were included in the study, 53.5% were females and 92.6% were of Malay ethnicity
We found that 52.6% of the respondents lived in wooden houses, whereas 47.4% lived in brick houses
Summary
Secondhand smoke (SHS) exposure is linked to a series of serious health problems. This study aimed to determine the association between SHS exposure at home and cognitive performance in school children. According to the National Health and Morbidity Survey, the overall prevalence of current smokers aged ≥15 years was 22.8% in 2015, reflecting 43% of the males and 1.4% of the females[2]. The Global Adult Tobacco Survey 2011 of Malaysia reported that approximately 27.9% of non-smoking adults were exposed to SHS at home[3]. The National Health and Morbidity Survey 2019 reported that 31% of Malaysians were exposed to SHS at home, compared with 27% at work[4]. A Morbidity and Mortality Weekly Report of US reported that 25.2% of non-smokers aged ≥3 years had serum cotinine levels of 0.05–10
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