Tobacco Smoke Exposure, School Engagement, School Success, and Afterschool Activity Participation Among US Children.
Ashley L Merianos, Wura Jacobs, Afolakemi C Olaniyan and 2 others
PMID 35989183WHAT IT FOUND
In US school-age children, home tobacco exposure was linked to lower school engagement, more school-to-home contacts about problems, and less afterschool activity participation.
Grade repetition differences disappeared after adjustment. This is association, not proof smoke caused outcomes.
Key findings
01After adjustment, children with household tobacco use but no smoking inside had lower odds of school engagement (AOR = 0.69, 95%CI = 0.57, 0.83), and children with smoking inside had lower odds (AOR = 0.63, 95%CI = 0.41, 0.97).
02After adjustment, school-to-home contacts about school problems were more likely for household tobacco use without smoking inside (AOR = 1.83, 95%CI = 1.50, 2.23) and for smoking inside (AOR = 1.58, 95%CI = 1.05, 2.37), while grade repetition was not significant after adjustment.
03After adjustment, children with household tobacco use without smoking inside had an activity count ratio of 0.90 (95%CI = 0.83, 0.96) and children with smoking inside had 0.74 (95%CI = 0.61, 0.89), with lower odds of any afterschool activity participation (AOR = 0.68 and 0.55).
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The study is cross-sectional, so it cannot show that home tobacco exposure caused poorer school engagement, school success, or activity participation. Exposure and outcomes were parent-reported at one time, and recall or social desirability bias may have affected responses. The survey only asked about household combustible tobacco use and smoking inside, not smoking in cars, cigars, or e-cigarettes. The group with smoking inside was small, 297 children, so estimates for that group are less stable. The survey did not collect biological samples to objectively measure tobacco exposure. It measured only organized afterschool activities, not unstructured play or other leisure activities.
The easy way to misread this
Do not conclude that household tobacco smoke causes poorer school engagement or that cessation will improve school outcomes. The study is cross-sectional, used parent-reported proxy exposure, and the grade repetition association was not significant after adjustment.