BACKGROUND: Tobacco use is a significant public health problem worldwide, especially in low- and middle-income countries. Tobacco exposure during pregnancy and childhood can have detrimental effects on maternal and child health and development. However, the extent and impact of tobacco use and its consequences on childhood outcomes in sub-Saharan Africa (SSA) are poorly documented and understood.
METHODS: We conducted a pooled analysis of the latest available demographic and health surveys from SSA countries within the past 10 years (2014-2024). We used descriptive statistics to summarise the prevalence of tobacco use and exposure among women and children and multivariable logistic regression models to examine the relationship between manufactured tobacco use by mothers as well as someone smoking inside the house and malnutrition in children, adjusting for individual, household, and country-level factors.
RESULTS: Maternal smoking and in-house tobacco smoking were both statistically associated with increased odds of stunted growth in children in SSA, with adjusted odds ratios (AOR) of 1.24 (95% CI: 1.08–1.43) and 1.11 (95% CI: 1.07–1.15), respectively. Mother’s age, employment status, marital status, education level, as well as father’s employment and education, number of siblings in the household, location, and socioeconomic status were significant predictors of a child's exposure to in-house tobacco smoke and maternal smoking.
CONCLUSIONS: Most interventions that are conducted in SSA and LMICs rarely consider smoking as a risk factor for childhood stunting. This study confirms the presence of a significant relationship between the two and highlights a need to include tobacco smoke exposure reduction in the management and control of childhood chronic malnutrition in sub-Saharan Africa.