title: Early second-hand smoke exposure and child and adolescent mental health: evidence from Hong Kong's 'Children of 1997' birth cohort.
abstract: OBJECTIVE
  Second-hand smoke (SHS) exposure is associated negatively with childhood behavioural problems in western settings. In a developed non-western setting, we estimated the associations of early SHS exposure during the prenatal and postnatal periods with several aspects of adolescent mental health.
  
  
  METHODS
  Multivariable linear regression was used to estimate the adjusted associations of pre- and postnatal SHS exposure with adolescent mental health.
  
  
  METHODS
  Hong Kong.
  
  
  METHODS
  Population-representative "Children of 1997" birth cohort. Behavioural problems at ~11 years were available for 5598, self-esteem at ~11 years for 6937 and depressive symptoms at ~13 years for 5797.
  
  
  METHODS
  SHS was categorized as no SHS exposure, occasional prenatal SHS exposure from non-parental sources, daily prenatal SHS exposure from non-parental sources, postnatal SHS exposure from non-parental sources, prenatal and postnatal SHS exposure from non-parental sources, occasional paternal smoking, daily paternal smoking and any maternal smoking. Behavioural problems were assessed from parent-reported Rutter score, self-esteem from self-reported Culture-Free Self-Esteem Inventory score and depressive symptoms from self-reported Patient Health Questionnaire-9 score.
  
  
  RESULTS
  Prenatal SHS exposure from non-parental sources was associated with behavioural problems at ~11 years (1.24, 95% confidence interval 0.20-2.28) adjusted for sex, age of assessment, survey mode (for depressive symptoms only), socio-economic position (SEP), mother's birthplace, gestational age and parity; paternal smoking and maternal smoking were associated with more mental health problems but also with lower SEP.
  
  
  CONCLUSIONS
  In Hong Kong, prenatal second-hand tobacco smoke exposure appears to be a risk factor for behavioural problems at age 11 years independent of socio-economic position.
authors.affiliation: School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
authors.forename: Cherry Y
authors.initials: CY
authors.lastname: Leung
authors.affiliation: School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
authors.forename: Gabriel M
authors.initials: GM
authors.lastname: Leung
authors.affiliation: School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.|CUNY School of Public Health and Hunter College, New York, USA.
authors.forename: C Mary
authors.initials: CM
authors.lastname: Schooling
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology*; D002648:Child; D015331:Cohort Studies; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D016014:Linear Models; D008297:Male; D008603:Mental Health; D015999:Multivariate Analysis; D010290:Parents; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology*; D000066553:Problem Behavior; D012649:Self Concept; D012907:Smoking; D012923:Social Class; D014028:Tobacco Smoke Pollution / Q000706:statistics & numerical data*
chemical_list: D014028:Tobacco Smoke Pollution
keywords: Adolescent; PHQ-9; behaviour; child; cohort study; mental health; rutter score; second-hand smoke; self-esteem