Correlation between Secondhand Smoking and Mental Health in Children

Abstract

health are major public health problems among children and adolescents. SHS may be affecting the mental health of children as many mental disorders have an onset in youth, a time when SHS exposure is high. The aim of the current study was to investigate the potential association between secondhand smoking (SHS) exposure and emotional, behavioral, and or psychiatric problems in children and adolescents. Also, the combination of SDQ & PCL screening tools seemed worthy of investigation comparing them concerning their specificity and sensitivity in diagnosing behavioral and or psychiatric disorders. The current study was conducted on 45 apparently healthy children, 32 boys and 13 girls. Their age ranged from 4 to 12 years with a mean value 7.9 ± 2.4 years. All of them had one smoking parent and were exposed to environmental tobacco smoke (SHS children). Thirty age and sex matched healthy children with no history of parental smoking were included as controls. For all studied patients and controls, complete history laying stress on their parents smoking habits and smoking index (number of cigarettes smoked per day × total duration in years/20), and clinical examination with special emphasis on their weight, height, and BMI were carried out. Psychiatric assessment using two screening tests Pediatric Checklist (PCL) and Strength and DifficultiesQuestionnaire(SDQ) together with IQ assessment in some cases was done in addition to laboratory assessment of secondhand smoke through measuring their urinary cotinine levels. All the studied SHS children (group I) were exposed to their fathers cigarette smoke during both pre and postnatal periods. Twenty eight percent of their parents smoked 11-20 cigarettes per day. Sixty two percent of SHS children lived nearby smoking areas and 40% of them had history of recurrent chest infection Studied SHS children had significantly lower birth weight compared to controls (p<0.05 for both). Other anthropometric percentile distribution frequencies were not suitable for statistical comparison because of the small number of children within different percentile subgroups. SHS children had significantly higher mean value of PCL score compared to controls indicating a significant degree of psychosocial dysfunction of those children (p<0.001). Also, mean value of total SDQ scores was significantly higher in SHD children compared to controls (p<0.05) representing a significant psychological stress indicative of worse mental health. Mean values of ADHD, internalization behavior, and externalization behavior sub-scores of PCL were significantly higher in SHS children compared to controls; p<0.05, p<0.05, and p<0.001 respectively.Psychosocial dysfunction as judged by the total PCL score was significantly more prevalent among SHS children (93.3%) compared to controls (53.3%); p<0.001. On the other hand, clinically significant combined disorders were frequently more encountered among SHS children (57.8%) compared to controls (20%); p<0.001. Also, clinically significant ADHD and internalization subs-cores were more encountered among