title: School absenteeism among children living with smokers.
abstract: OBJECTIVE
  Involuntary tobacco smoke exposure causes substantial morbidity in children. We hypothesized that children exposed to tobacco smoke in the home would have increased school absenteeism with associated costs due to lost caregiver wages/time.
  
  
  METHODS
  We analyzed data on health and absenteeism among schoolchildren aged 6 to 11 years identified in the 2005 National Health Interview Survey (NHIS). We used multivariate models to assess the relationships between adult-reported household smoking and child health and school absenteeism. Analyses were adjusted for children's and parents' demographic and socioeconomic characteristics. The value of lost caregiver time was estimated by using self-reported employment and earnings data in the NHIS and publicly available time-use data.
  
  
  RESULTS
  Children living with 1 or ≥ 2 adults who smoked in the home had 1.06 (95% confidence interval [CI]: 0.54-1.55) and 1.54 (95% CI: 0.95-2.12) more days absent from school per year, respectively, than children living with 0 smokers in the home. Living with ≥ 2 adults who smoked in the home was associated with increased reports of having ≥ 3 ear infections in the previous 12 months (adjusted odds ratio [aOR]: 2.65 [95% CI: 1.36-5.16]) and having a chest cold in the 2 weeks before interview (aOR: 1.77 [95% CI: 1.03-3.03]) but not with having vomiting/diarrhea in the previous 2 weeks (aOR: 0.93 [95% CI: 0.45-1.89]). Caregivers' time tending children absent from school was valued at $227 million per year.
  
  
  CONCLUSIONS
  Tobacco smoke exposure has significant consequences for children and families above and beyond child morbidity, including academic disadvantage and financial burden.
authors: Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, Massachusetts 02114, USA. dlevy3@partners.org
authors: Douglas E
authors: DE
authors: Levy
authors: Jonathan P
authors: JP
authors: Winickoff
authors: Nancy A
authors: NA
authors: Rigotti
mesh_terms: D000041:Absenteeism; D000328:Adult; D017028:Caregivers; D002648:Child; D017281:Cost of Illness; D003967:Diarrhea / Q000191:economics / Q000453:epidemiology; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007182:Income; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D012140:Respiratory Tract Diseases / Q000191:economics / Q000453:epidemiology / Q000209:etiology*; D012574:Schools; D014028:Tobacco Smoke Pollution / Q000009:adverse effects* / Q000191:economics / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology; D014839:Vomiting / Q000191:economics / Q000453:epidemiology
chemical_list: D014028:Tobacco Smoke Pollution