Influence of passive smoking on learning in elementary school

Jorge, Juliana Gomes; Botelho, Clóvis; Silva, Ageo Mário Cândido; Moi, Gisele Pedroso

doi:10.1016/j.jped.2015.08.010

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Original articles • J. Pediatr. (Rio J.) 92 (3) • May-Jun 2016 • https://doi.org/10.1016/j.jped.2015.08.010 copy

Influence of passive smoking on learning in elementary school^☆ ☆ Please cite this article as: Jorge JG, Botelho C, Silva AM, Moi GP. Influence of passive smoking on learning in elementary school. J Pediatr (Rio J). 2016;92:260-7.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

To analyze the association between household smoking and the development of learning in elementary schoolchildren.

Methods

Cross-sectional study with 785 students from the 2nd to the 5th year of elementary school. Students were evaluated by the School Literacy Screening Protocol to identify the presence of learning disabilities. Mothers/guardians were interviewed at home through a validated questionnaire. Descriptive and bivariate analysis, as well as multivariate Poisson regression, were performed.

Results

In the final model, the variables associated with learning difficulties were current smoking at the household in the presence of the child (PR = 6.10, 95% CI: 4.56 to 8.16), maternal passive smoking during pregnancy (PR = 1.46, 95% CI: 1.07 to 2.01), students attending the 2nd and 3rd years of Elementary School (PR = 1.44, 95% CI: 1.10 to 1.90), and being children of mothers with only elementary level education (PR = 1.36, 95% CI: 1.04 to 1.79).

Conclusion

The study demonstrated an association between passive exposure to tobacco smoke and learning difficulties at school.

Keywords
Smoking; Tobacco smoke pollution; Learning disorders; Children

Variables			N	%
Students’ sociodemographic variables
	Learning difficulties
		Normal	635	80.9
		Altered	150	19.1
	Gender
		Male	443	56.4
		Female	342	43.6
	Age
		7 Years	120	15.2
		8 Years	177	22.5
		9 Years	229	29.3
		10 Years	188	23.8
		11 Years	71	9.2
	Educational level
		2nd Year	227	28.9
		3rd Year	207	26.4
		4th Year	174	22.2
		5th Year	177	22.5
	Ethnicity/skin color
		White	363	46.2
		Black	69	8.8
		Brown	349	44.5
		Yellow	4	0.5
	Learning difficulties
		Normal	635	80.9
		Altered	150	19.1

			Prevalence of learning difficulties
			n/N	%	Gross PR^c c Prevalence ratio. (95% CI)	p-Value^b b Chi-square test for trend <0.013.
Sociodemographic variables of the schoolchildren
	Gender
		Female	55/342	16.1	1.00
		Male	95/443	21.4	1.33 (0.99-1.80)	0.058
	Age group
		11 years	12/71	16.9	1.00
		7 and 8 years	73/297	24.6	1.45 (0.83-2.53)	0.168
		9 and 10 years	65/417	15.6	0.92 (0.52-1.62)	0.779
	Educational level
		4th and 5th grades	52/351	14.8	1.00
		2nd and 3rd grades	98/434	22.6	1.52 (1.12-2.07)	<0.001
	Ethnicity/skin color
		White	55/363	15.2	1.00
		Non-white	95/422	22.5	1.48 (1.10-2.01)	0.009

Maternal sociodemographic variables
	Age group (years)
		≥30	106/634	16.7	1.00
		<30	44/151	29.1	1.74 (1.29-2.36)	<0.001
	Educational level ^a a Chi-squared test for trend <0.023.
		College/University	7/78	9.0	1.00
		Illiterate	11/20	55.0	6.12 (2.72-13.78)	<0.001
		Elementary school	78/315	24.8	2.76 (1.32-5.74)	0.002
		High School	54/372	14.5	1.62 (0.76-3.42)	0.194
	Ethnicity
		White	57/373	15.3	1.00
		Non-white	93/412	22.6	1.48 (1.09-1.99)	0.009
	Marital status
		With partner	116/667	17.4	1.00
		No partner	34/118	28.8	1.65 (1.19-2.30)	0.003
	Religion
		Catholic	87/490	17.8	1.00
		Non-Catholic	63/295	21.4	1.20 (0.90-1.60)	0.214
	Economic class ^b b Chi-square test for trend <0.013.
		B	1/23	4.3	1.00
		C	21/154	13.6	3.13 (0.44-22.21)	0.181
		D	67/355	18.9	4.34 (0.62-29.87)	0.057
		E	61/253	24.1	5.54 (0.80-38.18)	0.018

Variables			Prevalence of learning difficulties
			n/N	%	Gross PR (95%CI)	p-Value
	Prenatal care
		Yes	148/779	19.0	1.00
		No	2/6	33.3	1.75 (0.56-5.49)	0.322
	Number of consultations
		≥6	133/748	17.8	1.00
		<6	17/37	45.9	2.58 (1.76-3.78)	<0.001
	Type of delivery
		Vaginal	91/475	19.2	1.00
		Cesarean section	59/309	19.1	0.99 (0.74-1.34)	0.982
	Low birth weight
		No	144/769	18.7	1.00
		Yes	6/16	37.5	2.00 (1.04-3.83)	0.059
Variables			Prevalence of learning difficulties
			n/N	%	Gross PR (95%CI)	p-Value
	Preterm birth
		No	138/716	19.3	1.00
		Yes	12/69	17.4	0.90 (0.52-1.54)	0.704
	Alcohol consumption
		No	129/735	17.6	1.00
		Yes	21/50	42.0	2.39 (1.67-3.43)	<0.001
	Drug use
		No	148/779	19.0	1.00
		Yes	2/5	40.0	2.10 (0.71-6.22)	0.234
	Medication use
		No	140/749	18.7	1.00
		Yes	10/36	27.8	1.48 (0.85-2.57)	0.176
	Gestational diseases
		No	138/754	18.3	1.00
		Yes	12/31	38.7	2.11 (1.32-3.38)	0.004

Variables			Prevalence of learning difficulties
			n/N	%	Gross PR^a a Prevalence ratio. (95% CI)	p-Value^b b Chi-squared test for trend <0.001.
Current household smoking in the child's presence
		Nonsmoker	54/615	8.8	1.00
		Smoker	36/53	67.9	7.73 (5.64-10.60)	<0.001
		Passive smoker	53/83	63.9	7.27 (5.38-9.83)	<0.001
		Ex-smoker	7/34	20.6	2.34 (1.15-4.75)	0.022

Smoking during pregnancy
	Smoker
		No	137/753	18.2	1.00
		Yes	13/32	40.6	2.23 (1.43-3.48)	0.001
	Passive smoker
		No	118/698	16.9	1.00
		Yes	32/87	36.8	2.15 (1.57-3.00)	<0.001

Smoking during breastfeeding
	Smoker
		No	138/754	18.3	1.00
		Yes	12/31	38.7	2.11 (1.32-3.37)	0.004
	Passive smoker
		No	120/707	16.9	1.00
		Yes	30/76	39.5	2.32 (1.68-3.21)	<0.001

Variables		Adjusted PR^a a Prevalence ratio adjusted for alcohol consumption and student's educational level. (95%)
Current household smoking in the child's presence
	No	1.00
	Yes	6.10 (4.56-8.16)
Gestational passive smoking
	No	1.00
	Yes	1.46 (1.07-2.01)
Student's educational level
	4th and 5th grades	1.00
	2nd and 3rd grades	1.44 (1.10-1.90)
Maternal education
	High school and higher	1.00
	Elementary	1.36 (1.04-1.79)

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E-mail: jped@jped.com.br

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[1] Conflicts of interest

The authors declare no conflicts of interest.

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Influence of passive smoking on learning in elementary school☆ ☆ Please cite this article as: Jorge JG, Botelho C, Silva AM, Moi GP. Influence of passive smoking on learning in elementary school. J Pediatr (Rio J). 2016;92:260-7.

Abstract

Objective

Methods

Results

Conclusion

Influence of passive smoking on learning in elementary school^☆ ☆ Please cite this article as: Jorge JG, Botelho C, Silva AM, Moi GP. Influence of passive smoking on learning in elementary school. J Pediatr (Rio J). 2016;92:260-7.