Prenatal and Childhood Exposure to Secondhand Smoke is Associated With Attention Problems

Many children are exposed to second hand chemicals from smoked tobacco and vaped nicotine, but the impact of this exposure has not been extensively studied. Nicotine binds to acetyl choline receptors in the central nervous system and causes the release of neurotransmitters, impacting many parts of the brain. This study followed a cohort of mother-child dyads (N=386) from pregnancy through childhood to assess the association between cotinine levels in children—an objective measure of prenatal and childhood smoke exposure—and behavioral symptoms (assessed via the Behavior Assessment System for Children, 2nd edition [BASC-2]).

• Increased cotinine concentrations in children were associated with poorer performance on cognitive (B=-1.29), memory (B=-0.97), and attention tasks (B=-1.59).
• Prenatal cotinine concentration was not associated with behavioral problems in childhood.

Comments:  Nicotine use during pregnancy has long been associated with fetal growth retardation. This study found that tobacco exposure in childhood is associated poorer performance on cognition, learning, and attention tasks. Together, these findings suggest that tobacco exposure has adverse effects on children with outcomes that vary across developmental windows.

Sharon Levy, MD, MPH

Reference: Fuemmeler BF, Glasgow TE, Schechter JC, et al. Prenatal and childhood smoke exposure associations with cognition, language, and attention-deficit/hyperactivity disorder. J Pediatr. 2023;256:77–84.e1.