Exposure to environmental tobacco smoke and cognitive abilities among u.S. Children and adolescents
Open accessAbstract
We used the Third National Health and Nutrition Examination Survey (NHANES III), conducted from 1988 to 1994, to investigate the relationship between environmental tobacco smoke (ETS) exposure and cognitive abilities among U.S. children and adolescents 6-16 years of age. Serum cotinine was used as a biomarker of ETS exposure. Children were included in the sample if their serum cotinine levels were less than or equal to 15 ng/mL, a level consistent with ETS exposure, and if they denied using any tobacco products in the previous 5 days. Cognitive and academic abilities were assessed using the reading and math subtests of the Wide Range Achievement Test-Revised and the block design and digit span subtests of the Wechsler Intelligence Scale for Children-III. Analyses were conducted using SUDAAN software. Of the 5,365 6- to 16-year-olds included in NHANES III, 4,399 (82%) were included in this analysis. The geometric mean serum cotinine level was 0.23 ng/mL (range, 0.035-15 ng/mL); 80% of subjects had levels < 1 ng/mL. After adjustment for sex, race, region, poverty, parent education and marital status, ferritin, and blood lead concentration, there was a significant inverse relationship between serum cotinine and scores on reading (beta = -2.69, p = 0.001), math (beta = -1.93, p = 0.01), and block design (beta = -0.55, p < 0.001) but not digit span (beta = -0.08, p = 0.52). The estimated ETS-associated decrement in cognitive test scores was greater at lower cotinine levels. A log-linear analysis was selected as the best fit to characterize the increased slope in cognitive deficits at lower levels of exposure. These data, which indicate an inverse association between ETS exposure and cognitive deficits among children even at extremely low levels of exposure, support policy to further restrict children's exposure.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Cognitive deficits have been associated with childhood and adolescent exposure to secondhand cigarette smoke.
“cognitive deficits have also been associated with childhood and adolescent exposure to secondhand cigarette smoke.”
From Developmental toxicity of nicotine: A transdisciplinary synthesis and implications for emerging tobacco products (2017) · cites this paper as [275]
Even low nicotine exposure from secondhand smoke harms fetal brain development and cognition.
“and that even the low levels of nicotine exposure associated with secondhand smoke are injurious to fetal brain development and cognitive function.(79, 321, 322)”
From Developmental toxicity of nicotine: A transdisciplinary synthesis and implications for emerging tobacco products (2017) · cites this paper as [322]
Components of tobacco smoke besides nicotine worsen nicotine's harmful effects.
“several recent studies indicate that other tobacco smoke components amplify the adverse effects of nicotine,”
From Developmental toxicity of nicotine: A transdisciplinary synthesis and implications for emerging tobacco products (2017) · cites this paper as [322]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Intellectual Impairment in Children with Blood Lead Concentrations below 10 μg per Deciliter
Canfield, R. L., Henderson, C. R., Cory-Slechta, D. A., Cox, C., Jusko, T. A., & Lanphear, B. P. (2003) · New England Journal of Medicine · doi:10.1056/nejmoa022848 · Cited by 2,081 · see citing works
Self-citationCigarette smoking among adults — United States, 1988
Bachman, J. G., Johnston, L. D., & O’Malley, P. M. (1992) · Patient Education and Counseling · doi:10.1016/0738-3991(92)90149-d · Cited by 1,710 · see citing works
SUDAAN User's Manual, Release 7.5,
Bieler, G. S., Barnwell, B., & Shah, B. V. (1997) · Cited by 1,285 · see citing works
Cotinine as a Biomarker of Environmental Tobacco Smoke Exposure
Benowitz, N. L. (1996) · Epidemiologic Reviews · doi:10.1093/oxfordjournals.epirev.a017925 · Cited by 1,029 · see citing works
Lanphear, B. P. (2000) · Public Health Reports · doi:10.1093/phr/115.6.521 · Cited by 877 · see citing works
Self-citationService, P. H. (1994) · PubMed · Cited by 740 · see citing works
Pirkle, J. L. (1996) · JAMA · doi:10.1001/jama.275.16.1233 · Cited by 707 · see citing works
Cook, D. G., & Strachan, D. P. (1999) · Thorax · doi:10.1136/thx.54.4.357 · Cited by 615 · see citing works
Association between Exposure to Environmental Tobacco Smoke and Exacerbations of Asthma in Children
Chilmonczyk, B. A., Salmun, L. M., Megathlin, K. N., Neveux, L. M., Palomaki, G. E., Knight, G. J., Pulkkinen, A. J., & Haddow, J. E. (1993) · New England Journal of Medicine · doi:10.1056/nejm199306103282303 · Cited by 524 · see citing works
Fried, P. A., Watkinson, B., & Gray, R. (2003) · Neurotoxicology and Teratology · doi:10.1016/s0892-0362(03)00029-1 · Cited by 458 · see citing works
Health effects of passive smoking
Chinn, S., Rona, R. J., Cook, D. G., Strachan, D. P., & Carey, I. M. (1999) · Thorax · doi:10.1136/thx.54.5.468a · Cited by 445 · see citing works
Increased Incidence of Asthma in Children of Smoking Mothers
Martínez, F. D., Cline, M. G., & Burrows, B. (1992) · PEDIATRICS · doi:10.1542/peds.89.1.21 · Cited by 382 · see citing works
Gergen, P. J., Fowler, J. A., Maurer, K. R., Davis, W. W., & Overpeck, M. D. (1998) · PEDIATRICS · doi:10.1542/peds.101.2.e8 · Cited by 342 · see citing works
Bernert, J. T., Turner, W. E., Pirkle, J. L., Sosnoff, C. S., Akins, J. R., Waldrep, M. K., Ann, Q., Covey, T. R., Whitfield, W. E., Gunter, E. W., et al. (1997) · Clinical Chemistry · doi:10.1093/clinchem/43.12.2281 · Cited by 335 · see citing works
Sample design: Third National Health and Nutrition Examination Survey.
Ezzati, T. M., Massey, J. T., Waksberg, J., Chu, A., & Maurer, K. R. (1992) · PubMed · Cited by 326 · see citing works
Maternal smoking during pregnancy and the risk of conduct disorder in boys
Wakschlag, L. S. (1997) · Archives of General Psychiatry · doi:10.1001/archpsyc.1997.01830190098010 · Cited by 326 · see citing works
Relationship of Sudden Infant Death Syndrome to Maternal Smoking During and After Pregnancy
Schoendorf, K. C., & Kiely, J. (1992) · PEDIATRICS · doi:10.1542/peds.90.6.905 · Cited by 303 · see citing works
Smoking and the Sudden Infant Death Syndrome
Mitchell, E. A., Ford, R. P. K., Stewart, A., Taylor, B. J., Becroft, D. M. O., Thompson, J., Scragg, R. K. R., Hassall, I. B., Barry, D. M., Allen, E. M., et al. (1993) · PEDIATRICS · doi:10.1542/peds.91.5.893 · Cited by 284 · see citing works
Parental Smoking Enhances Bronchial Responsiveness in Nine-Year-Old Children
Martinez, F. D., Antognoni, G., Macrì, F., Bonci, E., Midulla, F., Castro, G. D., & Ronchetti, R. (1988) · American Review of Respiratory Disease · doi:10.1164/ajrccm/138.3.518 · Cited by 265 · see citing works
Fried, P. A., Watkinson, B., & Gray, R. (1992) · Neurotoxicology and Teratology · doi:10.1016/0892-0362(92)90036-a · Cited by 255 · see citing works
Fried, P. A., Watkinson, B., & Gray, R. (1998) · Neurotoxicology and Teratology · doi:10.1016/s0892-0362(97)00091-3 · Cited by 235 · see citing works
Eskenazi, B., & Castorina, R. (1999) · Environmental Health Perspectives · doi:10.1289/ehp.99107991 · Cited by 220 · see citing works
Cigarette smoking among adults--United States, 2000.
(2002) · PubMed · Cited by 215 · see citing works
Nicotinic receptors in aging and dementia
Picciotto, M. R., & Zoli, M. (2002) · Journal of Neurobiology · doi:10.1002/neu.10102 · Cited by 207 · see citing works
Maternal cigarette smoking and child psychiatric morbidity: a longitudinal study
Williams, G. M., O'Callaghan, M., Najman, J. M., Bor, W., Andersen, F. M. J., Richards, A. D., & BSc, C. U. (1998) · PEDIATRICS · doi:10.1542/peds.102.1.e11 · Cited by 203 · see citing works
Health Effects Related to Environmental Tobacco Smoke Exposure in Children in the United States
Mannino, D. M., Moorman, J. E., Kingsley, B. S., Rose, D., & Repace, J. (2001) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/archpedi.155.1.36 · Cited by 200 · see citing works
Intellectual Impairment in Children of Women Who Smoke Cigarettes During Pregnancy
Olds, D. L., Henderson, C., & Tatelbaum, R. C. (1994) · PEDIATRICS · doi:10.1542/peds.93.6.973 · Cited by 192 · see citing works
Risk Factors for Childhood Asthma and Wheezing. Importance of Maternal and Household Smoking
Ehrlich, R. I., du Toit, D., Jordaan, E., Zwarenstein, M., Potter, P., Volmink, J. A., & Weinberg, E. G. (1996) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.154.3.8810605 · Cited by 187 · see citing works
Predictors of Early Grade Retention Among Children in the United States
Byrd, R. S., & Weitzman, M. L. (1994) · PEDIATRICS · doi:10.1542/peds.93.3.481 · Cited by 170 · see citing works
Reading and language in 9- to 12-year olds prenatally exposed to cigarettes and marijuana
Fried, P. A., Watkinson, B., & Siegel, L. S. (1997) · Neurotoxicology and Teratology · doi:10.1016/s0892-0362(97)00015-9 · Cited by 170 · see citing works
Intellectual Impairment in Children of Women Who Smoke Cigarettes During Pregnancy
Olds, D. L., Henderson, C. R., & Tatelbaum, R. C. (1994) · PEDIATRICS · doi:10.1542/peds.93.2.221 · Cited by 154 · see citing works
Cigarette Smoking Among Adults—United States, 1999
(2001) · JAMA · doi:10.1001/jama.286.22.2802-jwr1212-2-1 · Cited by 152 · see citing works
A comparison of active and passive smoking during pregnancy: Long-term effects
Makin, J., Fried, P. A., & Watkinson, B. (1991) · Neurotoxicology and Teratology · doi:10.1016/0892-0362(91)90021-n · Cited by 149 · see citing works
Measures of Maternal Tobacco Exposure and Infant Birth Weight at Term
England, L. J. (2001) · American Journal of Epidemiology · doi:10.1093/aje/153.10.954 · Cited by 139 · see citing works
Fried, P. A., & Watkinson, B. (2000) · Neurotoxicology and Teratology · doi:10.1016/s0892-0362(99)00046-x · Cited by 131 · see citing works
Smoking during pregnancy in the 1990s.
Tj, M. (2001) · PubMed · Cited by 129 · see citing works
A prospective study of smoking during pregnancy and SIDS
Wisborg, K. (2000) · Archives of Disease in Childhood · doi:10.1136/adc.83.3.203 · Cited by 123 · see citing works
Child Behavior Problems Increased by Maternal Smoking During Pregnancy
Orlebeke, J. F., Knol, D. L., & Verhulst, F. C. (1999) · Archives of Environmental Health An International Journal · doi:10.1080/00039899909602231 · Cited by 100 · see citing works
Eskenazi, B., & Bergmann, J. (1995) · American Journal of Epidemiology · doi:10.1093/aje/142.supplement_9.s10 · Cited by 86 · see citing works
The Relationship Between Idiopathic Mental Retardation and Maternal Smoking During Pregnancy
Drews‐Botsch, C., Murphy, C. C., Yeargin‐Allsopp, M., & Decouflé, P. (1996) · PEDIATRICS · doi:10.1542/peds.97.4.547 · Cited by 85 · see citing works
Matt, G. E., Hovell, M. F., Zakarian, J. M., Bernert, J. T., Pirkle, J. L., & Hammond, S. K. (2000) · Health Psychology · doi:10.1037//0278-6133.19.3.232 · Cited by 83 · see citing works
Smoking during pregnancy in the 1990s
Matthews, T. J. (2001) · PsycEXTRA Dataset · doi:10.1037/e558942006-001 · Cited by 81 · see citing works
Contribution of maternal smoking during pregnancy and lead exposure to early child behavior problems
Wasserman, G. A., Liu, X., Pine, D. S., & Graziano, J. H. (2001) · Neurotoxicology and Teratology · doi:10.1016/s0892-0362(00)00116-1 · Cited by 72 · see citing works
PARENTAL SMOKING, URINARY COTININE, AND WHEEZING BRONCHITIS IN CHILDREN
Rylander, E., Pershagen, G., Eriksson, M., & Bermann, G. (1995) · Epidemiology · doi:10.1097/00001648-199505000-00017 · Cited by 70 · see citing works
Matt, G. E., Hovell, M. F., Zakarian, J. M., et al. (2000) · Health Psychology · doi:10.1037/0278-6133.19.3.232 · Cited by 67 · see citing works
Plasma Cotinine: Stability in Smokers and Validation of Self-Reported Smoke Exposure in Nonsmokers
Kemmeren, J. M., vanPoppel, G., Verhoef, P., & Jarvis, M. J. (1994) · Environmental Research · doi:10.1006/enrs.1994.1059 · Cited by 65 · see citing works
Infantile colic: maternal smoking as potential risk factor
Reijneveld, S. A. (2000) · Archives of Disease in Childhood · doi:10.1136/adc.83.4.302 · Cited by 64 · see citing works
Parental cigarette smoking and cognitive performance of children.
Bauman, K. E., Flewelling, R. L., & LaPrelle, J. (1991) · Health Psychology · doi:10.1037//0278-6133.10.4.282 · Cited by 59 · see citing works
Parental cigarette smoking and cognitive performance of children.
Bauman, K. E., Flewelling, R. L., & LaPrelle, J. (1991) · Health Psychology · doi:10.1037/0278-6133.10.4.282 · Cited by 53 · see citing works
Lung tissue concentrations of nicotine in sudden infant death syndrome (SIDS)
McMartin, K., Platt, M. S., Hackman, R., et al. (2002) · The Journal of Pediatrics · doi:10.1067/mpd.2002.121937 · Cited by 50 · see citing works
Exposure to Passive Cigarette Smoking and Child Development
Rush, D., & CALLAHAN, K. R. (1989) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.1989.tb21008.x · Cited by 49 · see citing works
Total Cotinine in Plasma: A Stable Biomarker for Exposure to Tobacco Smoke
de León, J., DÍAZ, F. J., Rogers, T. J., Browne, D., Dinsmore, L., Ghosheh, O. A., Dwoskin, L. P., & Crooks, P. A. (2002) · Journal of Clinical Psychopharmacology · doi:10.1097/00004714-200210000-00009 · Cited by 45 · see citing works
Schneider, J. S., Huang, F., & Vemuri, M. C. (2003) · Neurotoxicology and Teratology · doi:10.1016/s0892-0362(03)00018-7 · Cited by 32 · see citing works
Environmental Tobacco Smoke Exposure in Children: Household and Community Determinants
Jordaan, E., Ehrlich, R. I., & Potter, P. (1999) · Archives of Environmental Health An International Journal · doi:10.1080/00039899909602494 · Cited by 30 · see citing works
Audesirk, T., & Cabell, L. (1999) · PubMed · Cited by 25 · see citing works
ADULT SMOKING IN THE HOME ENVIRONMENT AND CHILDREN'S IQ
Johnson, D. L., Swank, P. R., Baldwin, C. D., & McCormick, D. (1999) · Psychological Reports · doi:10.2466/pr0.1999.84.1.149 · Cited by 24 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Nicotine and the Developing Human
England, L. J., Bunnell, R. E., Pechacek, T. F., Tong, V. T., & McAfee, T. A. (2015) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2015.01.015 · Cited by 320 · see citing works
England, L. J., Aagaard, K., Bloch, M., Conway, K., Cosgrove, K., Grana, R., Gould, T. J., Hatsukami, D., Jensen, F., Kandel, D., et al. (2017) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2016.11.013 · Cited by 181 · see citing works
Self-citationChen, R., Clifford, A., Lang, L., & Anstey, K. J. (2013) · Annals of Epidemiology · doi:10.1016/j.annepidem.2013.07.001 · Cited by 142 · see citing works
Smoking during pregnancy affects speech-processing ability in newborn infants
Key, A. P. F., Ferguson, M., Molfese, D. L., Peach, K., Lehman, C., & Molfese, V. J. (2007) · Environmental Health Perspectives · doi:10.1289/ehp.9521 · Cited by 78 · see citing works
Rindermann, H., & Ceci, S. J. (2018) · Journal for the Education of the Gifted · doi:10.1177/0162353218799481 · Cited by 68 · see citing works
Hall, B. J., Cauley, M., Burke, D. A., Kiany, A., Slotkin, T. A., & Levin, E. D. (2016) · Toxicological Sciences · doi:10.1093/toxsci/kfw042 · Cited by 57 · see citing works
- Authors
- Yolton, K., Dietrich, K., Auinger, P., Lanphear, B. P., & Hornung, R.
- Affiliations
- Cincinnati Children's Hospital Medical Center (US)
- American Academy of Pediatrics (US)
- Venue
- Environmental Health Perspectives
- Publisher
- American Chemical Society (ACS)
- Published
- 2004-10-07
- Volume
- 113
- Issue
- 1
- Pages
- 98-103
- ISSN
- 0091-6765 (ISSN-L)
- 1552-9924
- PMC
- PMC1253717
- OpenAlex
- W2006872336
- Cited by
- 331
- References
- 56
- Citations by year
- 2026: 5 · 2025: 13 · 2024: 9 · 2023: 6 · 2022: 12 · 2021: 12 · 2020: 15 · 2019: 12 · 2018: 10 · 2017: 13 · 2016: 18 · 2015: 15 · 2014: 23 · 2013: 21 · 2012: 18
- FWCI
- 9.94
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- public-domain
- creativecommons.org/licenses/by/4.0/ (vor, 4831 d)
- Locations
- Environmental Health Perspectives (publishedVersion, public-domain)
- Europe PMC (PubMed Central) (publishedVersion, public-domain)
- PubMed Central (publishedVersion, public-domain)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Air Quality and Health Impacts
- Keywords
- environmental tobacco smoke, passive smoking, cognitive ability, children, adolescents, serum cotinine, reading achievement, mathematics achievement, intelligence, low-dose exposure, blood lead levels, NHANES III
- MeSH terms
- Adolescent, Child, Cognition Disorders, Environmental Exposure, Female, Health Surveys, Humans, Intelligence, Intelligence Tests, Male, Tobacco Smoke Pollution, Epidemiologic Studies
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
