Secondhand smoke exposure and risk of wheeze in early childhood: a prospective pregnancy birth cohort study
Keiko Tanaka 1, 2  
,   Yoshihiro Miyake 1, 2,   Shinya Furukawa 1, 2,   Masashi Arakawa 3
More details
Hide details
Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Ehime, Japan
Epidemiology and Medical Statistics Unit, Translational Research Center, Ehime University Hospital, Ehime, Japan
Health Tourism Research Fields, Graduate School of Tourism Sciences, University of the Ryukyus, Okinawa, Japan
Keiko Tanaka   

Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295, Japan
Submission date: 2017-02-16
Acceptance date: 2017-07-12
Publication date: 2017-07-18
Tob. Induc. Dis. 2017;15(July):30
Evidence regarding the independent and additive effects of both pre- and postnatal smoking exposure on the risk of wheeze in children is limited. The purpose of this prospective pregnancy birth cohort study was to examine the association between prenatal and postnatal tobacco smoke exposure during the first year of life and the risk of wheeze in Japanese children aged 23 to 29 months.

Study subjects were 1354 Japanese mother-child pairs. Information on the variables under study was obtained using repeated questionnaires that were completed by mothers, first prior to delivery, then shortly after birth and subsequently around 4, 12, and 24 months after delivery. Wheeze was defined according to the criteria of the International Study of Asthma and Allergies in Childhood.

Compared with no maternal smoking during pregnancy, maternal smoking throughout pregnancy was significantly associated with an increased risk of wheeze in children, yet there were no associations between maternal smoking in the first trimester only or in the second and/or third trimesters and the risk of wheeze. No association was observed between postnatally living with at least one household smoker and the risk of wheeze. An analysis to assess the additive effect of prenatal and postnatal smoking exposure revealed that, compared with children not exposed to maternal smoking during pregnancy and not postnatally living with at least one household smoker, those who were both exposed to maternal smoking during pregnancy and postnatally living with at least one household smoker had twofold odds of developing wheeze.

Our findings suggest that maternal smoking throughout pregnancy might be associated with an increased risk of wheeze in children. There is also the possibility of a positive additive effect of pre- and postnatal smoking exposure on the risk of childhood wheeze.

Oberg M, Jaakkola MS, Woodward A, Peruga A, Prüss-Ustün A. Worldwide burden of disease from exposure to second-hand smoke: a retrospective analysis of data from 192 countries. Lancet. 2011;377:139–46.
Cheraghi M, Salvi S. Environmental tobacco smoke (ETS) and respiratory health in children. Eur J Pediatr. 2009;168:897–905.
McEvoy CT, Spindel ER. Pulmonary effects of maternal smoking on the fetus and child: effects on lung development, respiratory morbidities, and life long lung health. Paediatr Respir Rev. 2017;21:27–33.
Rehan VK, Asotra K, Torday JS. The effects of smoking on the developing lung: insights from a biologic model for lung development, homeostasis, and repair. Lung. 2009;187:281–9.
Jayes L, Haslam PL, Gratziou CG, Powell P, Britton J, Vardavas C, et al. SmokeHaz: systematic reviews and meta-analyses of the effects of smoking on respiratory health. Chest. 2016;150:164–79.
Brand PL, Baraldi E, Bisgaard H, Boner AL, Castro-Rodriguez JA, Custovic A, et al. Definition, assessment and treatment of wheezing disorders in preschool children: an evidence-based approach. Eur Respir J. 2008;32:1096–10.
Hess J, De Jongste JC. Epidemiological aspects of paediatric asthma. Clin Exp Allergy. 2004;34:680–5.
Henderson J, Granell R, Heron J, Sherriff A, Simpson A, Woodcock A, et al. Associations of wheezing phenotypes in the first 6 years of life with atopy, lung function and airway responsiveness in mid-childhood. Thorax. 2008;63:974–80.
Hovland V, Riiser A, Mowinckel P, Carlsen KH, Lødrup Carlsen KC. The significance of early recurrent wheeze for asthma outcomes in late childhood. Eur Respir J. 2013;41:838–45.
Burke H, Leonardi-Bee J, Hashim A, Pine-Abata H, Chen Y, Cook DG, et al. Prenatal and passive smoke exposure and incidence of asthma and wheeze: systematic review and meta-analysis. Pediatrics. 2012;129:735–44.
Vardavas CI, Hohmann C, Patelarou E, Martinez D, Henderson AJ, Granell R, et al. The independent role of prenatal and postnatal exposure to active and passive smoking on the development of early wheeze in children. Eur Respir J. 2016;48:115–24.
Miyake Y, Tanaka K, Okubo H, Sasaki S, Arakawa M. Maternal consumption of dairy products, calcium, and vitamin D during pregnancy and infantile allergic disorders. Ann Allergy Asthma Immunol. 2014;113:82–7.
den Dekker HT, AM S-v d V, de Jongste JC, Reiss IK, Hofman A, Jaddoe VW, Duijts L. Tobacco smoke exposure, airway resistance, and asthma in school-age children: the generation R study. Chest. 2015;148:607–17.
Duijts L, Jaddoe VW, van der Valk RJ, Henderson JA, Hofman A, Raat H, et al. Fetal exposure to maternal and paternal smoking and the risks of wheezing in preschool children: the generation R study. Chest. 2012;141:876–85.
Fuentes-Leonarte V, Estarlich M, Ballester F, Murcia M, Esplugues A, Aurrekoetxea JJ, et al. Pre- and postnatal exposure to tobacco smoke and respiratory outcomes during the first year. Indoor Air. 2015;25:4–12.
Xepapadaki P, Manios Y, Liarigkovinos T, Grammatikaki E, Douladiris N, Kortsalioudaki C, et al. Association of passive exposure of pregnant women to environmental tobacco smoke with asthma symptoms in children. Pediatr Allergy Immunol. 2009;20:423–9.
Raherison C, Pénard-Morand C, Moreau D, Caillaud D, Charpin D, Kopfersmitt C, et al. In utero and childhood exposure to parental tobacco smoke, and allergies in schoolchildren. Respir Med. 2007;101:107–17.
Ciaccio CE, DiDonna A, Kennedy K, Barnes CS, Portnoy JM, Rosenwasser LJ. Secondhand tobacco smoke exposure in low-income children and its association with asthma. Allergy Asthma Proc. 2014;35:462–6.
Lee SL, Lam TH, Leung TH, Wong WH, Schooling M, Leung GM, et al. Foetal exposure to maternal passive smoking is associated with childhood asthma, allergic rhinitis, and eczema. ScientificWorldJournal. 2012;2012:542983.
Lux AL, Henderson AJ, Pocock SJ. Wheeze associated with prenatal tobacco smoke exposure: a prospective, longitudinal study. ALSPAC study team. Arch Dis Child. 2000;83:307–12.
Magnusson LL, Olesen AB, Wennborg H, Olsen J. Wheezing, asthma, hayfever, and atopic eczema in childhood following exposure to tobacco smoke in fetal life. Clin Exp Allergy. 2005;35:1550–6.
Tanaka K, Miyake Y. Association between prenatal and postnatal tobacco smoke exposure and allergies in young children. J Asthma. 2011;48:458–63.
Neuman A, Hohmann C, Orsini N, Pershagen G, Eller E, Kjaer HF, et al. Maternal smoking in pregnancy and asthma in preschool children: a pooled analysis of eight birth cohorts. Am J Respir Crit Care Med. 2012;186:1037–43.
Vieira SE. The health burden of pollution: the impact of prenatal exposure to air pollutants. Int J Chron Obstruct Pulmon Dis. 2015;10:1111–21.
Maritz GS. Perinatal exposure to nicotine and implications for subsequent obstructive lung disease. Paediatr Respir Rev. 2013;14:3–8.
Wang L, Pinkerton KE. Detrimental effects of tobacco smoke exposure during development on postnatal lung function and asthma. Birth Defects Res C Embryo Today. 2008;84:54–60.
Statistic Bureau, Ministry of Public Management, Home Affairs, Posts and Telecommunications. 2000 Population Census of Japan, Vol. 3-2-40, Labour Force Status of Population, Industry (Major Groups) of Employed Persons, and Education: Fukuoka-ken. Tokyo: Statistic Bureau, Ministry of Public Management, Home Affairs, Posts and Telecommunications; 2002 (in Japanese).
Treatment of Allergic Rhinitis as a Strategy for Preventing Asthma
Jaymin B. Morjaria, Massimo Caruso, Rosalia Emma, Cristina Russo, Riccardo Polosa
Current Allergy and Asthma Reports
Association between secondhand smoke exposure and early eruption of deciduous teeth: a cross-sectional study
Takashi Hanioka, Miki Ojima, Keiko Tanaka, Nao Taniguchi, Kaoru Shimada, Takeshi Watanabe
Tobacco Induced Diseases
Imbalance in Level of Tobacco Smoke Exposure Between Groups Likely Explains the “Effect” of Palivizumab on Subsequent Wheezing
Harold J. Farber
American Journal of Respiratory and Critical Care Medicine
Awareness, Attitudes and Behaviors of Parents for Child Exposure to Tobacco Smoke
Seda Topçu, Elenur Akın, Betül Ulukol, Orhon Şimşek, Sevgi Başkan
Turkish Journal of Family Medicine and Primary Care
Developmental Timing Determines the Protective Effect of Maternal Electroacupuncture on Perinatal Nicotine Exposure-Induced Offspring Lung Phenotype
Jian Dai, Bo Ji, Guozhen Zhao, Yawen Lu, Yitian Liu, Qiujie Mou, Reiko Sakurai, Yana Xie, Qin Zhang, Shuang Xu, Virender Rehan
BioMed Research International
Caffeine, alcohol, khat, and tobacco use during pregnancy in Butajira, South Central Ethiopia
Alehegn Alamneh, Bilal Endris, Seifu Gebreyesus, Yael Abreu-Villaça
Magnitude and associated factors of substance use among pregnant women attending antenatal care in public hospitals of eastern Ethiopia
Metsihet Fetene, Kedir Teji, Nega Assefa, Wubet Bayih, Genet Tsehaye, Habtamu Hailemeskel
BMC Psychiatry