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Exposure to secondhand smoke in the home and mental health in children: a population-based study
  1. Alicia Padrón1,
  2. Iñaki Galán2,3,
  3. Esther García-Esquinas3,4,
  4. Esteve Fernández5,6,7,
  5. Montse Ballbè5,6,
  6. Fernando Rodríguez-Artalejo3,4
  1. 1Department of Public Health Sciences, University of Miami Miller School of Medicine, Clinical Research Building, Miami, Florida, USA
  2. 2National Centre for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
  3. 3Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ, Madrid, Spain
  4. 4CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
  5. 5Tobacco Control Unit, Cancer Prevention and Control Program, Institut Català d'Oncologia-ICO, L'Hospitalet de Llobregat, Barcelona, Spain
  6. 6Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
  7. 7Department of Clinical Sciences, Universitat de Barcelona, Campus de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
  1. Correspondence to Dr Iñaki Galán, National Centre for Epidemiology, Instituto de Salud Carlos III, C/Monforte de Lemos 5, Madrid 28029, Spain; igalan{at}


Objectives To examine the association between exposure to secondhand smoke (SHS) in the home and mental health among children.

Methods Cross-sectional study of 2357 children representative of the Spanish population aged 4–12 years in 2011–2012. Duration of SHS exposure in children was reported by parents. Probable mental disorder was defined as a score >90th centile in the parental version of the Strengths and Difficulties Questionnaire (SDQ). Statistical analysis was performed with logistic regression and adjusted for sociodemographic variables, lifestyle, neighbourhood environment and family characteristics, including parental mental health.

Results Among study participants, 6.9% (95% CI 5.7% to 8.0%) were exposed to SHS in the home for <1 h/day and 4.5% (95% CI 3.5% to 5.5%) for ≥1 h/day. Compared to children not habitually exposed to SHS, the multivariate ORs for probable mental disorder were 1.49 (95% CI 0.85 to 2.62) for SHS exposure <1 h/day and 2.73 (95% CI 1.38 to 5.41) for SHS exposure ≥1 h/day (p for linear trend=0.002). The corresponding ORs for attention-deficit and hyperactivity disorder (ADHD) were 2.18 (95% CI 1.30 to 3.64) for <1 h/day exposure and 3.14 (95% CI 1.63 to 6.04) for ≥1 h/day exposure (p for linear trend <0.001). No association was found between SHS and the rest of the components of the SDQ.

Conclusions Among children, SHS exposure in the home during ≥1 h/day is associated with a higher frequency of mental disorder. This association was mostly due to the impact of SHS on ADHD.

  • Secondhand smoke
  • Smoking Caused Disease
  • Priority/special populations
  • Prevention

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