Secondhand smoke exposure is associated with autism spectrum disorder in US males but not in females: Results from the National Survey on Children's Health
Naila Khalil1, Bhupinder Kaur2, Alexandra Lawson3, James Ebert4, Ramzi Nahhas5
1 Department of Population and Public Health Sciences, Boonshoft School of Medicine, Wright State University, Dayton, OH, USA
2 Child and Adolescent Psychiatry Fellow, Kobacker Center, University of Toledo Medical Center, Toledo, OH, USA
3 Medical Student, Boonshoft School of Medicine, Wright State University, Dayton, OH, USA
4 Director, The Pediatric Lipid Clinic, Dayton Children's Hospital, Dayton, OH, USA
5 Department of Population and Public Health Sciences; Department of Psychiatry, Boonshoft School of Medicine, Wright State University, Dayton, OH, USA
Dr. Naila Khalil
3123 Research Blvd, Suite #200, Department of Population and Public Health Sciences, Boonshoft School of Medicine, Wright State University, Dayton, OH
Source of Support: None, Conflict of Interest: None
Background: Secondhand smoke (SHS) exposure is linked with neurobehavioral disorders in children. This study evaluated the SHS exposure and autism spectrum disorders (ASD) in children in the United States.
Materials and Methods: Parent-reported postnatal SHS exposure and ASD diagnosis were examined in children age 2 to 12 years using the 2011–2012 National Survey on Children's Health. The physician diagnosis of current ASD as reported by the parents was used as the outcome. Logistic regression analysis was used to evaluate the association of ASD with SHS after adjusting for risk factors.
Results: Of the 56,710 children, 24% had SHS exposure, 2% had ASD, and the mean age was 7 years. SHS exposure was associated with 47% greater odds of ASD in male children (adjusted odds ratio [OR] = 1.47; 95% confidence interval [CI] =1.05, 2.07; P = 0.025). In contrast, SHS was not significantly associated with ASD in female children (adjusted OR = 0.72; 95% CI = 0.40, 1.29; P = 0.266). Other significant factors associated with ASD diagnosis in male children were age, income, mother's education, and mental health status.
Conclusions: SHS is significantly associated with ASD in male children. Sociodemographic factors, natal and prenatal characteristics are important etiologic influences for ASD. Targeted efforts to change the smoking behavior of parents and caregivers of children could reduce ASD.