Prenatal and Childhood Smoke Exposure Associations with Cognition, Language, and Attention-Deficit/Hyperactivity Disorder

Objective To assess the relationships of prenatal and childhood smoke exposure with specific neurodevelopmental and behavioral problems during early childhood. Study design A subsample (n = 386) of mother-child dyads from the Newborn Epigenetic Study (NEST) prebirth cohort participated in the study. Cotinine concentrations were used to objectively measure prenatal and childhood smoke exposure when youth were aged 3-13 years. Multivariable regression models were used to estimate associations of prenatal and childhood cotinine concentrations with performance on the National Institutes of Health (NIH) Toolbox and attention-deficit/hyperactivity disorder and behavioral symptoms, measured using the Behavior Assessment System for Children, 2nd edition (BASC-2). Results After adjusting for confounders, childhood cotinine concentrations were associated with poorer cognitive performance on tasks measuring cognitive flexibility (B = -1.29; P = .03), episodic memory (B = -0.97; P = .02), receptive language development (B = -0.58; P = .01), and inhibitory control and attention (B = -1.59; P = .006). Although childhood cotinine concentration was associated with higher levels of attention problems (B = 0.83; P = .004) on the BASC-2, after adjustment for confounders, the association is nonsignificant. Although associations for maternal cotinine concentrations were null, an interaction was detected between prenatal and childhood cotinine concentrations on the NIH Toolbox Picture Vocabulary Task (P = .02). Conclusions Our findings suggest that childhood tobacco smoke exposure may lead to poorer attention regulation and language acquisition, complexvisual processing ability, and attention problems.

Automated summary

This study examines the relationship between prenatal and childhood smoke exposure and neurodevelopmental and behavioral problems in early childhood. The results show that childhood smoke exposure is associated with poorer cognitive performance, language development, and attention regulation. However, the association between childhood smoke exposure and attention problems becomes nonsignificant after adjusting for confounders. There was no significant association found for maternal smoke exposure, but an interaction was detected between prenatal and childhood smoke exposure on language development.