The economic impact of early life environmental tobacco smoke exposure: early intervention for developmental delay.
OBJECTIVE
Early-life exposure to environmental tobacco smoke (ETS) can result in developmental delay as well as childhood asthma and increased risk of cancer. The high cost of childhood asthma related to ETS exposure has been widely recognized; however, the economic impact of ETS-related developmental delay has been less well understood.


RESULTS
The Columbia Center for Children's Environmental Health (CCCEH) has reported adverse effects of prenatal ETS exposure on child development in a cohort of minority women and children in New York City (odds ratio of developmental delay = 2.36; 95% confidence interval 1.22-4.58). Using the environmentally attributable fraction (EAF) approach, we estimated the annual cost of one aspect of ETS-related developmental delay: Early Intervention Services. The estimated cost of these services per year due to ETS exposure is > Dollars 50 million per year for New York City Medicaid births and Dollars 99 million per year for all New York City births.


CONCLUSIONS
The high annual cost of just one aspect of developmental delay due to prenatal exposure to ETS provides further impetus for increased prevention efforts such as educational programs to promote smoke-free homes, additional cigarette taxes, and subsidizing of smoking cessation programs.
Miller
Thaddeus
T
Columbia Center for Children's Environmental Health, Mailman School of Public Health, Columbia University, New York, New York 10032, USA.
Rauh
Virginia A
VA
Glied
Sherry A M
SA
Hattis
Dale
D
Rundle
Andrew
A
Andrews
Howard
H
Perera
Frederica
F
D016902:Air Pollution, Indoor; D002648:Child; D015331:Cohort Studies; D002658:Developmental Disabilities / Q000209:etiology*; D005260:Female; D006801:Humans; D008913:Minority Groups; D009519:New York City; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D012906:Smoke; D016540:Smoking Cessation; D014026:Nicotiana
D012906:Smoke