Abstract
BackgroundThe effect of secondhand smoke (SHS) exposure on child psychological problems remained inconclusive in previous studies. The aim of this study is to explore the association between SHS exposure and psychological symptoms in children.MethodsThis population-based cross-sectional survey used cluster random probability sampling and recruited children aged 6–13 years in 26 primary schools in Shanghai, China, in 2014. Duration of SHS exposure in children were categorized as none, < 1 h/day, 1–2 h/day, ≥3 h/day. Psychological symptoms were assessed by the parental version of the Strengths and Difficulties Questionnaire (SDQ). We used logistic regression to estimate the adjusted associations of SHS exposure with total SDQ and its specific domains. Multiple imputation was used for handling missing data.ResultsA total of 17,571 children completed this survey, with a response rate of 99.7%. SDQ scores were available for 15,344 participants, of whom 20.9% were not exposed to SHS, 63.0% exposed for < 1 h/day, 10.4% for 1–2 h/day, and 5.7% for ≥3 h/day. Compared to children not exposed to SHS, SHS exposure was positively associated with total SDQ score: OR 1.42, 95% confidence interval (CI) 1.22 to 1.66 for SHS exposure < 1 h/day, OR 2.14, 95% CI 1.76 to 2.62 for 1–2 h/day and OR 2.53, 95% CI 2.01 to 3.18 for ≥3 h/day after adjusting for sex, age, mode of birth, family socio-economic status and place of birth. These associations did not vary by sex.ConclusionSHS exposure is an independent risk factor for psychological problems among children. Nonetheless, our study is unable to distinguish between fetal and child exposure to SHS.
Highlights
The effect of secondhand smoke (SHS) exposure on child psychological problems remained inconclusive in previous studies
Of these 17,571, 15,344 participants had parentreported Strengths and Difficulties Questionnaire (SDQ) scores measured at 6~13 ages and 10.9% had a psychological problem
SHS exposure was higher in children born in Shanghai than those born in other places across China
Summary
The effect of secondhand smoke (SHS) exposure on child psychological problems remained inconclusive in previous studies. The aim of this study is to explore the association between SHS exposure and psychological symptoms in children. Wang et al BMC Public Health (2019) 19:923 be involved in the association between SHS exposure and mental health disorders and it is well established dopamine is an important neurotransmitter that controls many aspects of emotional, conduct and cognitive function. [7] Evidence from animal studies suggest that exposure to SHS increases dopamine release in brain areas such as caudate-putamen, nucleus accumbens and olfactory tubercle. Some previous studies have showed positive associations between SHS exposure and mental health disorders. Evidence from the Chinese context could be valuable We examined this issue in a large population-based crosssectional survey, ‘the Shanghai Child Health, Education and lifestyle Evaluation (SCHEDULE) study’.
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