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Paternal smoking and increased risk of child malnutrition among families in rural Indonesia
  1. C M Best1,3,
  2. K Sun1,
  3. S de Pee2,3,
  4. M Sari2,
  5. M W Bloem1,3,
  6. R D Semba1
  1. 1
    The Johns Hopkins Medical Institutions, Baltimore, MD, USA
  2. 2
    Helen Keller International Asia Pacific, Singapore
  3. 3
    Nutrition Service, Policy, Strategy and Programme Support Division, World Food Programme, Rome, Italy
  1. Richard D Semba, MD MPH, Johns Hopkins School of Medicine, 550 N Broadway, Suite 700, Baltimore, MD 21205, USA; rdsemba{at}


Objective: To determine whether paternal smoking is associated with an increased risk of child malnutrition among families in rural Indonesia.

Methods: The relation between paternal smoking and child malnutrition was examined in a population-based sample of 438 336 households in the Indonesia Nutrition and Health Surveillance System, 2000–2003. Main outcome measures were child underweight (weight-for-age Z score <−2) and stunting (height-for-age Z score <−2) and severe underweight and severe stunting, defined by respective Z scores <−3, for children aged 0–59 months of age.

Results: The prevalence of paternal smoking was 73.7%. The prevalence of underweight and stunting was 29.4% and 31.4%, and of severe underweight and severe stunting was 5.2%, and 9.1%, respectively. After adjusting for child gender, child age, maternal age, maternal education, weekly per capita household expenditure and province, paternal smoking was associated with an increased risk of underweight (odds ratio (OR) 1.03, 95% confidence interval (CI) 1.01 to 1.05, p = 0.001) and stunting (OR 1.11, 95% CI 1.09 to 1.13, p<0.001) and severe underweight (OR 1.06, 95% CI 1.01 to 1.10) p = 0.020) and severe stunting (OR 1.12, 95% CI 1.08 to 1.16, p<0.001).

Conclusions: Paternal smoking is associated with an increased risk of child malnutrition in families living in rural Indonesia.

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  • Funding: This work was supported in part by a Lew R Wasserman Award from Research to Prevent Blindness to RDS.

  • Competing interests: None.