title: Contribution of tobacco smoke exposure to learning disabilities.
abstract: OBJECTIVE
  To investigate the contribution of exposure to prenatal tobacco smoke (PTS) and environmental tobacco smoke (ETS) to parent-reported learning disabilities.
  
  
  METHODS
  A nationally representative, cross-sectional survey conducted in the United States, the National Health and Nutrition Examination Survey (NHANES) 1999 to 2002, was used to explore the association between reported learning disability and exposure to PTS and ETS.
  
  
  METHODS
  Data were analyzed from 5,420 children ages 4 to 15 years old.
  
  
  METHODS
  Secondary data analysis was conducted using logistic regression controlling for a number of potential confounders and covariates.
  
  
  RESULTS
  Overall, 10.6% of children had a parent-reported learning disability (LD), exceeding previous estimates. Exposure to PTS (odds ratio [OR] = 1.6) and ETS (OR = 1.6) were significantly associated with increased odds for LD in children, with a greater odds noted (OR = 2.6) when exposed to PTS and ETS.
  
  
  CONCLUSIONS
  Exposure to tobacco smoke significantly increases the odds for children to have a learning disability. Overall, results indicate that if tobacco exposure is causally associated to LD, eliminating exposures could prevent an estimated 750,000 of parent-reported learning disabilities in the United States. Results underscore the need for diligence in the promotion of smoking prevention and cessation efforts.
authors.affiliation: Robert and Kathleen Scanlon Endowed Chair for Values Based Health Care in the School of Nursing and Health Studies, Georgetown University, Washington, DC.. Electronic address: la266@georgetown.edu.
authors.forename: Laura
authors.initials: L
authors.lastname: Anderko
authors.affiliation: Department of Epidemiology at the University of North Carolina, Chapel Hill, NC.
authors.forename: Joe
authors.initials: J
authors.lastname: Braun
authors.affiliation: Department of Neurology, University of Rochester School of Medicine and the American Academy of Pediatrics Center for Child Health Research, Rochester, NY.
authors.forename: Peggy
authors.initials: P
authors.lastname: Auinger
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D015986:Confounding Factors, Epidemiologic; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007859:Learning Disabilities / Q000453:epidemiology / Q000209:etiology*; D016015:Logistic Models; D008297:Male; D009749:Nutrition Surveys; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology / Q000209:etiology*; D012307:Risk Factors; D017678:Sex Distribution; D012959:Socioeconomic Factors; D018709:Statistics, Nonparametric; D014028:Tobacco Smoke Pollution / Q000009:adverse effects* / Q000706:statistics & numerical data; D014481:United States
chemical_list: D014028:Tobacco Smoke Pollution