Secondhand Smoke May Boost Risk of Learning Problems, ADHD

Researchers Urge Smoke-Free Home Policies to Reduce Effects

Medically Reviewed by Laura J. Martin, MD on July 11, 2011
From the WebMD Archives

July 11, 2011 -- Children exposed to secondhand smoke in the home are more likely than children in smoke-free homes to develop behavior and learning problems, according to new research. These include learning disabilities, attention deficit hyperactivity disorder, and behavior and conduct disorders.

Worse, the problems often come in twos or more.

"We found that children who are exposed to secondhand smoke in the home have a 50% increased odds of having two or three of these common neurobehavioral disorders," says researcher Hillel Alpert, ScM, at the Harvard School of Public Health.

The study is published in the journal Pediatrics.

In the same issue, another study looked at how children's reaction to secondhand smoke may predict whether they will smoke.

Secondhand Smoke and Learning and Behavior Problems

For years, doctors have known that secondhand smoke can take a health toll on children. It increases the risk of respiratory problems, ear ailments, and other problems, Alpert says.

His team wanted to look at learning and behavior problems. They evaluated data from the 2007 National Survey of Children's Health. The telephone survey included more than 91,000 children. For this study, the researchers focused in on the 55,358 children younger than 12.

Of these 55,358 children, 6% were exposed to secondhand smoke in the home in 2007.

Parents reported if their child had been diagnosed or treated for ADHD, behavioral and conduct disorders, or learning disabilities.

''We analyzed the relationship between parents who reported smoking in the home as opposed to those not smoking in the home and these disorders," Alpert says.

He calls the 50% increased risk substantial. The findings do not prove cause and effect, he says, only a link.

Exactly how the smoke exposure is linked with the disorders is not known, Alpert says.

The study was supported by the Flight Attendants Medical Research Institute. Researchers included Zubair Kabir, MD, PhD, of the Tobacco Free Research Institute in Dublin.

Secondhand Smoke and Susceptibility Study

In a second study, Christina Lessov-Schlaggar, PHD, a research assistant professor at the Washington University School of Medicine, polled 165 children, aged 8 to 13, about their reaction to secondhand smoke in the home.

None of the children had smoked. All lived with at least one adult smoker.

Over 12 months, Lessov-Schlaggar asked for their reactions at four different times.

She tested their ''smoking susceptibility." To be classified as not susceptible, children had to respond ''definitely not" to questions such as whether they would try a cigarette soon.

''We found that kids who reported that secondhand smoke exposure is 'unpleasant' or 'gross' were less likely to be susceptible to smoking,'' she says.

Secondhand Smoke and Children's Health: Perspective

Neither study result is surprising, says John Banzhaf, executive director of Action on Smoking and Health, an advocacy group for nonsmokers' rights. He reviewed the findings for WebMD.

The link between secondhand smoke and neurobehavioral effects has been found in other research, he says.

Banzhaf says the researchers, who conclude that smoke-free homes should be encouraged, should have gone further.

He says the researchers should have urged pediatricians and emergency room doctors to report parents who smoke to authorities if children develop smoking-related health problems.

"If doctors would begin to report situations where children are adversely affected by exposure to tobacco smoke, just as they would do when children are exposed to asbestos, benzene, lead or other toxins, you would have -- particularly from the publicity that would result -- a very dramatic decrease in smoking in the home," he says.

Show Sources


Kabir, Z. Pediatrics, online August 2011.

Lessov-Schlaggar, C. Pediatrics, online August 2011.

Christina N. Lessov-Schlaggar, PhD, assistant research professor, Washington University School of Medicine, St. Louis.

Hillel Alpert, ScM, research scientist, Harvard School of Public Health, Boston.

John Banzhaf, founder and executive director, Action on Smoking and Health, professor of public interest law, George Washington University Law School, Washington, D.C.

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