title: Passive Smoke Exposure and Its Effects on Cognition, Sleep, and Health Outcomes in Overweight and Obese Children.
abstract: BACKGROUND
  Passive smoke exposure (PSE) may be a risk factor for childhood overweight and obesity and is associated with worse neurocognitive development, cognition, and sleep in children. The purpose of the study is to examine the effects of PSE on adiposity, cognition, and sleep in overweight and obese children using an objective measure of PSE.
  
  
  METHODS
  Overweight or obese children (n = 222) aged 7-11 (9.4 ± 1.1 years; 58% black; 58% female; 85% obese) were recruited from schools near Augusta, Georgia, over the course of the school year from 2003-2006 for a clinical trial, with data analyzed in 2009-2010. Passive smoke exposure was measured with plasma cotinine. Health, cognitive, and sleep measures and parent report of smoke exposure were obtained.
  
  
  RESULTS
  Overweight and obese children with PSE had greater overall and central adiposity than nonexposed overweight and obese children (p < 0.03). However, PSE was unrelated to prediabetes, insulin resistance, or visceral fat. PSE was linked to poorer cognitive scores (p < 0.04) independent of adiposity, but was not related to sleep-disordered breathing.
  
  
  CONCLUSIONS
  PSE is associated with fatness and poorer cognition in children. Tailored interventions that target multiple health risk factors including nutrition, physical activity, and tobacco use in children and families are needed to prevent adverse health outcomes related to tobacco use and obesity.
authors.affiliation: 1 Georgia Prevention Institute, Department of Pediatrics, Augusta University , Augusta, GA.
authors.forename: Catherine L
authors.initials: CL
authors.lastname: Davis
authors.affiliation: 1 Georgia Prevention Institute, Department of Pediatrics, Augusta University , Augusta, GA.
authors.forename: Martha S
authors.initials: MS
authors.lastname: Tingen
authors.affiliation: 1 Georgia Prevention Institute, Department of Pediatrics, Augusta University , Augusta, GA.
authors.forename: Jenny
authors.initials: J
authors.lastname: Jia
authors.affiliation: 1 Georgia Prevention Institute, Department of Pediatrics, Augusta University , Augusta, GA.
authors.forename: Forrest
authors.initials: F
authors.lastname: Sherman
authors.affiliation: 1 Georgia Prevention Institute, Department of Pediatrics, Augusta University , Augusta, GA.
authors.forename: Celestine F
authors.initials: CF
authors.lastname: Williams
authors.affiliation: 1 Georgia Prevention Institute, Department of Pediatrics, Augusta University , Augusta, GA.
authors.forename: Kruti
authors.initials: K
authors.lastname: Bhavsar
authors.affiliation: 1 Georgia Prevention Institute, Department of Pediatrics, Augusta University , Augusta, GA.|2 Pediatric Associates of Mobile , Mobile, AL.
authors.forename: Nancy
authors.initials: N
authors.lastname: Wood
authors.affiliation: 1 Georgia Prevention Institute, Department of Pediatrics, Augusta University , Augusta, GA.|3 University Pediatrics, Memorial University Medical Center , Savannah, GA.
authors.forename: Jessica
authors.initials: J
authors.lastname: Kobleur
authors.affiliation: 4 Department of Biostatistics and Epidemiology, Medical College of Georgia, Augusta University , Augusta, GA.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Waller
mesh_terms: D050154:Adiposity; D000293:Adolescent; D002648:Child; D003071:Cognition / Q000187:drug effects*; D003367:Cotinine / Q000378:metabolism*; D004781:Environmental Exposure / Q000009:adverse effects* / Q000517:prevention & control; D005260:Female; D005845:Georgia / Q000453:epidemiology; D006266:Health Education / Q000379:methods*; D006801:Humans; D008297:Male; D010290:Parents / Q000193:education / Q000523:psychology*; D063766:Pediatric Obesity / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D012307:Risk Factors; D012891:Sleep Apnea Syndromes / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D012907:Smoking / Q000009:adverse effects*; D012959:Socioeconomic Factors; D014028:Tobacco Smoke Pollution / Q000009:adverse effects* / Q000517:prevention & control
chemical_list: D014028:Tobacco Smoke Pollution; D003367:Cotinine
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