Racial differences in the effects of postnatal environmental tobacco smoke on neurodevelopment.
OBJECTIVE
We used the 2001-2004 National Health and Nutrition Examination Survey to examine the association between postnatal environmental tobacco smoke exposure, measured as serum cotinine levels, and attention-deficit/hyperactivity disorder (ADHD) among children 4 to 15 years of age. We further investigated the interactions of race and serum cotinine levels with ADHD.


METHODS
Logistic regression models were used to evaluate associations.


RESULTS
This study found that the prevalence of ADHD increased as blood cotinine levels increased. The effects of blood cotinine levels on ADHD differed according to race. Compared with children of the same racial group with the lowest blood cotinine levels, the odds ratios were 2.72 (95% confidence interval: 1.25-5.93) for Mexican American children and 5.32 (95% confidence interval: 1.55-18.3) for children in other racial groups with the highest blood cotinine levels, with controlling for the effect of maternal smoking during pregnancy. However, no significant associations between blood cotinine levels and ADHD were observed among non-Hispanic white or non-Hispanic black children.


CONCLUSIONS
The findings of this study underscore the possibility of racial disparities in the effects of environmental tobacco smoke on behavioral problems in children. These findings warrant further investigation.
Xu
Xiaohui
X
University of Florida, College of Public Health and Health Professions, Department of Epidemiology and Biostatistics, 101 S. Newell Dr, Room 3116, Gainesville, FL 32610-0182, USA. xhxu@phhp.ufl.edu
Cook
Robert L
RL
Ilacqua
Vito A
VA
Kan
Haidong
H
Talbott
Evelyn O
EO
D000293:Adolescent; D001741:Black or African American / Q000706:statistics & numerical data*; D001289:Attention Deficit Disorder with Hyperactivity / Q000208:ethnology* / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D003367:Cotinine / Q000097:blood; D006801:Humans; D017058:Mexican Americans / Q000706:statistics & numerical data; D015995:Prevalence; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data
D014028:Tobacco Smoke Pollution; D003367:Cotinine