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CORK Bibliography: Children of Substance Abusers



75 citations. January 2010 to present

Prepared: March 2012



Adeniji AA; Purcell A; Pearson L; Antcliffe JM; Tutty S; Sinha C et al. Multidisciplinary antenatal care for opiate-using women: Child-care issues. Drug and Alcohol Review 29(2): 189-192, 2010. (1 refs.)

Introduction and Aims. The fact that particular parents suffer afflictions limiting their ability to care does not mean that they should automatically be deemed unsuitable parents. Prompted by neonatal team concerns about child-care issues, a local multidisciplinary group was set up to care for substance-abusing pregnant women in our region. Design and Methods. This project was conducted in order to review the records of all the women who had been discussed at our management planning meetings over the past 5 years. Our assessment tool records were reviewed and analysed using spss. Results. A total of 233 women were assessed. The majority of patients booked before 20 weeks (62%) and 96 women (41%) attended over 80% of their antenatal appointments. There was little change in substance use during the course of pregnancy. Overall, at delivery, 196 of the 233 women (84%) used methadone and 89(38%) used heroin. There was no correlation between usage and foster care of the baby (methadone: chi 2 = 0.5, P = 0.8 NS) (heroin: chi 2 = 3.1, P = 0.08 NS). There was an absolute correlation between social services involvement and foster care (chi 2 = 2.33, P < 0.0001). Adherence with planned antenatal appointments significantly increased the likelihood of a child being discharged with his mother (chi 2 = 6.7, P = 0.009). Discussion and Conclusions. The majority of newborns were discharged home with their mothers directly with the most significant factor in placing a child in foster care being prior involvement of social services. However, many of these families will continue to need support during the children's early years.

Copyright 2010, Wiley-Blackwell


Alwan N; Siddiqi K; Thomson H; Cameron I. Children's exposure to second-hand smoke in the home: A household survey in the North of England. Health & Social Care in the Community 18(3): 257-263, 2010. (25 refs.)

Exposure of children to second-hand smoke (SHS) leads to increased risk of health and social problems and uptake of smoking in the future. We aimed to assess the prevalence of children's exposure to SHS in their homes, in a deprived area in the North of England and identify what people thought would help them achieve a smoke-free home (SFH). We performed a cross-sectional survey of 318 households with at least one child aged under 16 years in Beeston Hill, a deprived locality in Leeds, England in June 2008. One hundred and seventy-three households [54%, 95% confidence interval (C.I.) 49-60] had at least one smoker in the house. In 42% (95% C.I. 35-50) of these households (n = 73), smoking took place in the presence of children. The odds of allowing smoking in front of children were 2.2 (95% C.I. 1.1-4.5) times greater in households whose head had less than A-level (national exams at 18 years) or equivalent qualification than in homes with a more qualified head of household. 92% of respondents were aware that SHS has negative effects on children's health. However, 71% felt more information about health risks to children would help reduce exposure to SHS in the home. Smoking in the presence of children takes place in a relatively high proportion of households with smoker(s), despite media awareness campaigns regarding the dangers of passive smoking launched alongside the recently enforced smoke-free public and workplaces legislation. Specific promotion of SFHs is needed to protect the health of children.

Copyright 2010, Wiley-Blackwell


Ashrafioun L; Dambra CM; Blondell RD. Parental prescription opioid abuse and the impact on children. American Journal of Drug and Alcohol Abuse 37(6): 532-536, 2011. (22 refs.)

Objective: The purpose of this study was to identify which characteristics of opioid-abusing parents were associated with greater global impairment of their children. Methods: Data regarding participant demographics, drug use, and child demographics were collected from 14 patients in a chemical dependency unit who had at least one child between the ages of 4 and 17, inclusive. Child global impairment was measured by the parents' report using the Brief Impairment Scale (BIS). Regression analyses were conducted to assess which parental characteristics were associated with child BIS scores. Results: The mean age of the 14 participants was approximately 40 years, 9 (64.3%) were women, and 12 (85.7%) were white. At the time of hospitalization, 12 (85.7%) had had prior substance abuse treatment, 9 (64.3%) had received prescription opioids through non-medical sources, and 9 (64.3%) had a criminal history. The mean BIS score of 24 children was 15.5, which is associated with moderate global impairment of function. Greater child BIS scores were associated with a number of parental characteristics, such as obtaining any prescription opioids through non-medical sources, having a greater number of arrests, previously using drugs intravenously, and having a greater number of prior substance abuse treatment episodes. Conclusions: By assessing these parental characteristics, clinicians may be able to assess children who are at risk for impairment and, in turn, may be in need of mental health services. Due to limitations of this study, further evaluation is needed.

Copyright 2011, Informa Healthcare


Baska T; Warren CW; Hudeckova H; Ochaba R; Stastny P; Lea V et al. The role of family background on cigarette smoking among adolescent school children in Slovakia: Findings from the 2007 Slovakia Global Youth Tobacco Survey. International Journal of Public Health 55(6): 591-597, 2010. (26 refs.)

To analyse Global Youth Tobacco Survey (GYTS) data to determine the role of family background on cigarette smoking among adolescents in Slovakia. The GYTS is a school-based survey of students aged 13-15 years developed by the World Health Organization and the Centers for Disease Control and Prevention. The GYTS was conducted in Slovakia in 2007. Students from families where one or more parents were smokers were significantly more likely to report lifetime smoking, current cigarette smoking and signs of nicotine dependence (only girls). Socioeconomic status of parents as measured by parent educational level and employment status was not statistically associated with students' smoking status. Girls from families with lower socioeconomic status showed more frequently positive attitudes regarding smoking of their peers. Considering family background, parental smoking plays the most important role in smoking of their children regardless of employment status and educational level. The findings suggest that the tobacco control program effort in Slovakia needs to focus on implementation and enforcement for those policies already in place as well as expansion into additional measures.

Copyright 2010, Birkhauser Verlag AG


Borelli JL; Luthar SS; Suchman NE. Discrepancies in perceptions of maternal aggression: Implications for children of methadone-maintained mothers. American Journal of Orthopsychiatry 80(3): 412-421, 2010. (79 refs.)

Despite a long history of documenting discrepancies in parent and child reports of parental care and child psychopathology, it has only been in recent years that researchers have begun to consider these discrepancies as meaningful indicators of parent-child relationship quality and as predictors of long-term child adjustment. Discrepancies in perceptions of parenting may be particularly important for the children of mothers with a history of substance abuse who may be less aware of the impact of their behavior on their child and of their child's internalizing symptoms. This study examined associations between (a) mother-child discrepancies in reports of maternal aggression, and (b) mother and child reports of child internalizing and externalizing symptoms. Data collected from 99 mother-child dyads (with children 4-16 years of age) during the baseline phase of a randomized clinical trial testing a parenting intervention were used in this study. Measures included parent and child versions of the Parental Acceptance-Rejection Questionnaire and the Behavioral Assessment Scale for Children. Findings indicated that as children viewed their mothers as increasingly more aggressive than mothers viewed themselves, children reported more internalizing and externalizing symptoms but mothers only reported more child externalizing symptoms. Mother-child discrepancies in reports of parenting behavior have potentially meaningful implications for child emotional and behavioral problems.

Copyright 2010, American Psychological Association


Brook DW; Brook JS; Rubenstone E; Zhang CS; Finch SJ. A longitudinal study of sexual risk behavior among the adolescent children of HIV-positive and HIV-negative drug-abusing fathers. Journal of Adolescent Health 46(3): 224-231, 2010. (40 refs.)

Purpose: This is a longitudinal study of the precursors of sexual risk behavior among a cohort of adolescent children of HIV-positive and HIV-negative drug-abusing or drug-dependent fathers. Methods: Individual structured interviews were administered to 296 drug-abusing or drug-dependent fathers, 43% of whom were HIV positive, and an adolescent child of each father (mean age = 16.3 years; SD = 2.8). Adolescents were reinterviewed approximately 1 year later, at Time 2. Results: Structural equation modeling showed multiple direct and indirect pathways from psychosocial factors to adolescent sexual risk behavior (sexually active, number of sexual partners, and frequency of condom use). Greater paternal drug addiction and infection with HIV/AIDS, and the youth's perception of environmental hostility (discrimination and victimization), were both related to increased adolescent maladjustment and substance use. Greater paternal drug addiction and infection with HIV/AIDS also were associated with a weaker father-child mutual attachment, which was linked with increased adolescent maladjustment and substance use. Greater perceived environmental hostility (discrimination and victimization), a weak father-child relationship, and greater adolescent maladjustment and substance use had direct pathways to adolescent sexual risk behavior. Conclusions: Findings suggest complex interrelationships among paternal, environmental, social, personal, and substance use factors as longitudinal predictors of sexual risk behavior in children whose fathers abuse or are dependent upon drugs. The importance of perceived environmental hostility, the father-child relationship, and adolescent maladjustment and substance use may have implications for public policy as well as prevention and treatment programs.

Copyright 2010, Elsevier Science


Brook JS; Saar NS; Brook DW. Developmental pathways from parental substance use to childhood academic achievement. American Journal on Addictions 19(3): 270-276, 2010. (58 refs.)

This cross-sectional study examined the pathways to childhood academic achievement in 209 African American and Puerto Rican children and their mothers. There were three pathways to childhood academic achievement: (a) the mother-child relationship and the child's personality mediated between low parental substance use and childhood academic achievement; (b) the child's personality mediated between high parental education and childhood academic achievement; and (c) there was a direct relationship between the child's gender and childhood academic achievement. Policy and clinical implications suggest the importance of increasing educational opportunities for all parents by providing substance use treatment and self-esteem workshops.

Copyright 2010, Wiley-Blackwell


Brown JA; Hohman M. The impact of methamphetamine use on parenting. Journal of Social Work Practice in the Addictions 6(1): 63-88, 2006

Children whose parents abuse substances are often exposed to chaotic and neglectful lifestyles. Because of the increase in methamphetamine abuse, especially by females of child-bearing age, it is important to understand how the use of this drug impacts parenting. In this qualitative study, ten parents being treated for methamphetamine abuse were interviewed. Results indicated that while using, parents utilized a polarized style of parenting and specific drug management strategies, allowed exposure to violence, created upheaval in their children's daily living structure, and felt ambivalence when discussing these effects on children. Implications for social work practice include early intervention focusing on strengthening parenting skills.

Copyright 2006, Routledge


Carter VB. Factors predicting placement of urban American Indian/Alaskan Natives into out-of-home care. Children and Youth Services Review 32(5): 657-663, 2010. (52 refs.)

American Indian/Alaskan Native children have disproportionately been placed into out-of-home care compared to White children in the child welfare system What were the factors that child protective set vices (CPS) workers considered when deciding to remove a child from the home? Utilizing data from the National Survey of Child and Adolescent Well-Being, this study examined out-of-home care factors for 2215 urban American Indian/Alaskan Native (AI/AN) and White children. In the urban sample, children from White families were younger and were more likely to be investigated for lack of supervision, while AI/AN families were investigated for physical neglect. In the placement regression models, urban AI/AN children came from homes where caregivers had greater alcohol, drug and mental health problems. Decisions by CPS workers to place AI/AN children may have been influenced by racial bias. A CPS system that acknowledges culture and race may reduce overrepresentation in placement. Efforts to work with AI/AN families prior to a child's removal may prove to be beneficial and less expensive.

Copyright 2010, Elsevier Science


Chen X; Stanton B; Hopper J; Khankari N. Sources, locations, and predictors of environmental tobacco smoke exposure among young children from inner-city families. Journal of Pediatric Health Care 25(6): 365-372, 2011

The purpose of this study was to determine the levels, sources, and locations of and influential factors for exposure to environmental tobacco smoke (ETS) among pediatric patients from inner-city families. Descriptive and associative analysis of ETS exposure in children 6 to 10 years of age was performed with survey data collected at Children's Hospital of Michigan through mothers' report and children's urine cotinine. The sample included 397 participants, 82.4% of whom were African American. Urine cotinine levels were correlated with reported ETS exposure and 71% of children with urine cotinine levels > 10 ng/mL. The mean duration of ETS exposure was 14.3 minutes (SD = 11.0) in the past week and 58.9 minutes (SD = 50.8) in the past month. Smoking parents (30%), grandparents (30%), and non-family members (28%) were the major ETS sources, and relatives' homes (40%), the children's own homes (24%), automobiles (15%), and friends' homes (11%) were the main ETS locations. Child ETS exposure was inversely correlated with having a non-single mother, maternal education, income, use of prenatal preventive care, and satisfactory parenting. ETS exposure in inner-city children was prevalent. Findings of this study may aid pediatric practitioners and public health workers in providing targeted interventions.

Copyright 2011, National Association of Pediatric Nurse Associates & Practitioners


Chen XG; Abdulhamid I; Woodcroft K. Maternal smoking during pregnancy, polymorphic CYP1A1 and GSTM1, and lung-function measures in urban family children. Environmental Research 111(8): 1215-1221, 2011. (65 refs.)

Purpose: Understanding the interplay between genes and in-utero tobacco exposure in affecting child lung development is of great significance. In this study, we tested the hypothesis that tobacco-related lung-function reduction in children differs by maternal polymorphic genes Cytochrome P450 1A1 (CYP1A1) and Glutathione S-transferase Mu 1 (GSTM1). Materials and methods: Data were collected among 370 children (6-10 years old, 81.6% African-Americans) and their biological mothers visiting a large children's hospital. Study hypotheses were tested using multiple regression method. Results: Among the study sample, 143 mothers smoked throughout pregnancy and 72 smoked on a daily basis. Spirometric measures (mean +/- SD) included were: forced vital capacity(FVC)=1635 +/- 431 mL, forced expiratory volume in the first 1 s (FEV(1))=1440 +/- 360 mL, percent FEV(1)/FVC ratio=89 +/- 12, and forced expiratory flow between the 25% and 75% of PVC (FEF(25-75))=1745 +/- 603 mL In addition to a tobacco effect on FVC (-131 mL, 95% Cl: -245, -17) and FEV(1)/FVC ratio (42, 95% Cl: 1,83), regression analysis controlling for covariates indicated that for the subsample of children whose mothers were CYP1A1*2A homozygous, maternal daily smoking was associated with -734 mL (95% Cl: -1206, -262) reductions in FEV(1) and -825 mL (95% Cl: -909, -795) reductions in PVC; reduced smoking was still associated with -590 mL (95% CI: -629, -551) reductions in PVC. For children of mothers with GSTM1 deletion, persistent daily smoking was associated with -176 mL (95% CI: -305, -47) reductions in FVC. Discussion and conclusions: Maternal smoking during pregnancy was significantly associated with lung-function reduction in children, particularly for those whose mothers possessed the polymorphic CYP1A1*2A and GSTM1 deletion.

Copyright 2011, Elseveir Science


Chowdhury F; Chisti MJ; Hossain MI; Malek MA; Salam MA; Faruque AG. Association between paternal smoking and nutritional status of under-five children attending Diarrhoeal Hospital, Dhaka, Bangladesh. Acta Paediatrica 100(3): 390-395, 2011. (20 refs.)

Aim: The study aimed at determining whether there is an association between paternal smoking and nutritional status of children aged 0-59 months. Furthermore, the study looked at the presence of any nutritional differentials within different socio-economic groups. Methods: Secondary analysis of data on children aged 0-59 months enrolled in the Hospital Surveillance System of International Centre for Diarrhoeal Disease Research, Dhaka Hospital, Bangladesh, during 1996-2006. Results: Among 13,555 under-five children, fathers of 49% were smokers. In multivariate logistic regression models adjusting for potential confounders, fathers' smoking was significantly associated with increased risk of moderate underweight (OR 1.16, 95% CI 1.08-1.25), severe underweight (OR 1.15, 95% CI 1.06-1.26), moderate stunting (OR 1.15, 95% CI 1.06-1.23) and severe stunting (OR 1.13, 95% CI 1.03-1.25). In middle and lower socio-economic strata, risk of moderate and severe child malnutrition was found to be significantly increased in the group where the father was a smoker. Conclusion: Results indicate that there is an association between fathers' smoking and malnutrition of under-five children particularly in lower socio-economic group. A possible mechanism - if this association is causal - may be through a negative effect on family economy.

Copyright 2011, Wiley-Blackwell


Cinar ND; Dede C. Effects of environmental tobacco smoke on the respiratory health of children. (review). Pakistan Journal of Medical Sciences 26(1): 223-228, 2010. (42 refs.)

Infections of the respiratory tract are the most common acute illness of childhood. Apart from the morbidity (and occasional mortality) attributable to respiratory infections, they also represent risk factors for asthma and possibly other chronic respiratory effects in later life. Children's exposure to harmful substances of tobacco smoke begins at prenatal period, if pregnant woman smokes after the delivery, it continues postnatally to be paced. Children are especially sensitive to the respiratory effects of environmental tobacco smoke (ETS) exposure. ETS exposure is an significant & avoidable risk factor for respiratory diseases among children. ETS is a wide-spread environmental pollutant that has been long linked with respiratory problems. In children of all ages ETS exposure has been found to be associated with increased respiratory symptoms such as wheeze and cough. The role ETS plays in the development of atopy is of great interest, as atopy is closely related to the development of childhood asthma. Exposure to environmental tobacco smoke is preventable. This review discusses primarily on impact of ETS on during the fetal period and infancy and childhood. This paper reviews of several articles between year 1992-2009 obtained from the internet; Pubmed and Medline.

Copyright 2010, Professional Medical Publications


Cuthbertson L; Britton J. Passive smoking and children's health. Clnical Medicine 10(2): 113-114, 2010. (6 refs.)

This is an update to a report issued in 1992, on the effects of passive smoking on children. At that time, the findings were still tentative. Passive smoking is cited as a significant health hazard as a result of exposure in the home, which in 2003 caused nearly 11,000 deaths among adults in the UK. The impact of second-hand smoke on the health of the approximately two million children who are currently exposed to passive smoke in the home, however, has not been established. Each year in the UK there are 20,000 cases of lower respiratory tract infections, 120,000 cases of middle ear disease, at least 22,000 cases of wheeze and asthma, 200 cases of bacterial meningitis and 40 sudden infant deaths in UK children. This burden of disease results in over 300,000 UK GP consultations, around 9,500 hospital dmissions each year, and represents a significant cost to the NHS - an estimated �9.7 million to primary care, �13.6 million on hospital admissions and �4 million on asthma drugs. It also estimates that around 23,000 children become regular smokers by the age of 15 as a result of exposure to smoking by their parents. The impact of this influence on the future health of these individuals is potentially catastrophic. It is noted that children have a right to grow up in a safe environment, and parents and governments have a moral duty to provide one.

Copyright 2010, Royal College of Physicians


Diaz-Olavarrieta C; Garcia-Pina CA; Loredo-Abdala A; Paz F; Garcia SG; Schilmann A. Abusive head trauma at a tertiary care children's hospital in Mexico City. A preliminary study. Child Abuse & Neglect 35(11): 915-923, 2011. (50 refs.)

Objectives: Determine the prevalence, clinical signs and symptoms, and demographic and family characteristics of children attending a tertiary care hospital in Mexico City, Mexico, to illustrate the characteristics of abusive head trauma among this population. Methods: This is a cross-sectional descriptive study of infants and children under 5, who suffered head trauma and were admitted to the National Pediatrics Institute in Mexico City, a tertiary care referral center. We reviewed medical records and extracted data on clinical and neurological signs and symptoms, fundus, radiological (long bones, thorax. CAT scan), and laboratory tests. We administered a standardized questionnaire assessing child abuse and neglect to the parents of the children included in the study. Results: One hundred and twenty children, under 5 presenting with head trauma, were recruited, 13 (11%) were considered abusive head trauma (AbHT) and 107 (89%) were diagnosed as accidental head injury (AcHl). The AbHT group comprised younger infants (mean age 8 months) and the AcHl group included toddlers about an average of 25 months. To account for this significant age difference, we performed a comparison of age matched cases. The children in the AbHT were more likely to be female, the result of the first unintended pregnancy and the children of younger mothers (17-19). Mothers in this group had attended fewer than 5 prenatal care visits and fathers had a history of alcohol abuse. Five (38%) of the 13 AbHT children did not survive their injuries and overall showed greater neurological and respiratory compromise, increased prothrombin time (PT), and lower hematocrit values. The most common intracranial injuries suffered by children in the AbHT group were subdural/epidural hematoma and parenchymal/subarachnoid hemorrhage. Retinal hemorrhage was the most frequent ocular injury. Conclusions: In a tertiary care children's hospital, 11% of the children presenting with head trauma, were considered of abusive origin. Unintended pregnancy among teen mothers and substance abuse in the father were associated with abusive head trauma in this descriptive study.

Copyright 2011, Elsevier Science


Ding D; Wahlgren DR; Liles S; Jones JA; Hughes SC; Hovell MF. Secondhand smoke avoidance by preteens living with smokers: To leave or stay? Addictive Behaviors 35(11): 989-994, 2010. (53 refs.)

Introduction: Secondhand smoke (SHS) is hazardous to children's health. Designing interventions to reduce exposure requires understanding children's behavior in the presence of smokers, yet little is known about this behavior. Purpose: To determine whether children's avoidance of SHS is associated with lower exposure and to explore predictors of avoidance based on a behavioral ecological model. Method: Preteens aged 8-13 (N = 358) living with a smoker identified their primary source of SHS exposure, and reported whether they left (avoided exposure) or stayed the last time they were exposed to that person's smoke. The SHS avoidance measure was validated by examining associations with SHS exposure. Multiple Logistic Regression was used to determine predictors of SHS avoidance. Results: Based on urine cotinine and reported exposure, preteens who left the presence of SHS had lower exposure than those who stayed. Preteens were more likely to leave SHS if they were less physically mature, had not tried smoking, had a firm commitment not to smoke, did not assist family smoking, had family/friends who discouraged breathing SHS, or had friends who disliked smoking. Discussion: Most SHS exposure reduction interventions have targeted changes in smokers' behavior. Reductions can also be achieved by changing exposed nonsmokers' behavior, such as avoiding the exposure. Future studies should measure young people's SHS avoidance and test interventions to increase their avoidance practices.

Copyright 2010, Elsevier Science


Dubowitz H; Kim J; Black MM; Weisbart C; Semiatin J; Magder LS. Identifying children at high risk for a child maltreatment report. Child Abuse & Neglect 35(2): 96-104, 2011. (46 refs.)

Objective: To help professionals identify factors that place families at risk for future child maltreatment, to facilitate necessary services and to potentially help prevent abuse and neglect. Method: The data are from a prospective, longitudinal study of 332 low-income families recruited from urban pediatric primary care clinics, followed for over 10 years, until the children were approximately 12 years old. Children with prior child protective services involvement (CPS) were excluded. The initial assessment included sociodemographic, child, parent and family level variables. Child maltreatment was assessed via CPS reports. Risk ratios (RRs) and their 95% confidence intervals (CIs) were estimated using Cox regression models. Results: Of the 224 children without a prior CPS report and with complete data who were followed for an average of 10 years, 97 (43%) later had a CPS report. In a multivariate survival analysis, 5 risk factors predicted CPS reports: child's low performance on a standardized developmental assessment (RR = 1.23, 95% CI = 1.01-1.49, p = .04), maternal education <= high school (RR = 1.55, CI = 1.01-2.38, p = .04), maternal drug use (RR = 1.71, Cl = 1.01-2.90, p < .05), maternal depressive symptoms (RR per one standard deviation higher score = 1.28, CI = 1.09-1.51, p < .01), and more children in the family (RR per additional child = 1.26, Cl = 1.07-1.47, p < .01). Conclusions: Five risk factors were associated with an increased risk for later maltreatment. Child health care and other professionals can identify these risk factors and facilitate necessary services to strengthen families, support parents and potentially help prevent child maltreatment.

Copyright 2011, Elsevier Science


Eiden RD; Granger DA; Schuetze P; Veira Y. Child behavior problems among cocaine-exposed toddlers: Indirect and interactive effects. Development and Psychopathology 23(2): 539- 550, 2011. (71 refs.)

This study examined the role of maternal psychopathology and maternal warmth as mediators of the association between prenatal cocaine and other substance exposure and toddler behavior problems. It was also hypothesized that infant cortisol reactivity and environmental risk may moderate these associations. Participants were 220 caregiver-infant dyads (119 cocaine exposed, 101 not cocaine exposed; 49% boys). Mother-infant dyads were recruited at delivery with assessments at 4-8 weeks and 7, 13, and 18 months of child ages. Results yielded no direct associations between prenatal cocaine/other substance exposure and toddler behavior problems, but significant indirect associations between prenatal cigarette/alcohol exposure and toddler behavior problems at 18 months. With regard to moderation, results indicated an indirect association between prenatal cocaine exposure and toddler behavior problems via lower maternal warmth for children with higher, but not lower, cortisol reactivity at 7 months. Results suggest potential pathways to toddler behavior problems among children at high biological risk.

Copyright 2011, Cambridge University Press


Elgan TH; Leifman H. Children of substance abusing parents: A national survey on policy and practice in Swedish schools. Health Policy 101(1): 29-36, 2011. (34 refs.)

Objectives: This study aims at examining policy and practice within the Swedish school setting pertaining to children of substance abusing parents/caregivers. Methods:A cross-sectional survey, involving a representative sample of randomized schools (n = 443) throughout Sweden was conducted using a self-completed questionnaire. Descriptive analysis was performed including bivariate analysis combined with logistic regression modeling to examine possible correlates between variables. Results: The response rate was 66%, and participants reported that 37% had been trained in issues related to children of substance abusing parents, 33% of the schools had a policy document, and 73% of the schools had identified students with this complex of problems. Whether or not schools identify these students depends upon the occurrence of schools being "compulsory" or "upper secondary", "public" or "independent", the "school size", and respondents' participation in further training, which in turn is associated with the presence of a policy document. Conclusions: It appears as if a policy document does not directly predict whether schools identify students having substance abusing parents. However, it does influence whether respondents have participated in further training, which subsequently predicts the identification of students having substance abusing parents. Implications for policy and practice within the school setting are discussed.

Copyright 2011, Elsevier Science


Fasting MH; Nilsen TIL; Holmen TL; Vik T. Changes in parental weight and smoking habits and offspring adiposity: Data from the HUNT-study. International Journal of Pediatric Obesity 6(2-2): E399-E407, 2011. (38 refs.)

Objective. Adverse parental life-style habits are associated with offspring adiposity, but it is unclear how changes in these habits affect offspring adiposity. Thus, the aim of this study was to assess how parental change in body weight, smoking habits and levels of physical activity were associated with adiposity in their children. Methods. The study population consisted of 3 681 adolescents and their parents from the Nord-Trondelag-Health-Study (HUNT). The parents participated in the two first waves of HUNT (HUNT-1: 1984-86, HUNT-2: 1995-97), where information on anthropometry, smoking habits and physical activity were obtained. The adolescents participated in the Youth-Part of HUNT-2. We used logistic regression to calculate odds-ratios (ORs) for adolescent offspring overweight according to parental change in body-weight, smoking habits and physical activity, adjusting for these factors in both parents, as well as for socioeconomic status and adolescent age and sex. Results. Children of parents who changed weight from normal weight to overweight from HUNT-1 to HUNT-2 had higher OR for overweight in adolescence than children of parents who remained normal weight (mothers: 1.9 [95% CI: 1.4,2.5], fathers: 2.2 [95% CI: 1.5,3.0]). Children of mothers who reduced their weight from overweight to normal weight had no higher OR for overweight in adolescence than mothers who remained normal weight (OR: 1.0; 95% CI: 0.2, 4.7). Children of mothers who quit smoking (OR: 0.5; 95% CI: 0.3, 0.8) had lower OR for overweight in adolescence than children of mothers who persisted in smoking. Conclusions. Healthy changes in parental life-style during childhood are associated with lower occurrence of offspring overweight in adolescence.

Copyright 2011, Informa Healthcare


Ferris JS; Flom JD; Tehranifar P; Mayne ST; Terry MB. Prenatal and childhood environmental tobacco smoke exposure and age at menarche. Paediatric and Perinatal Epidemiology 24(6): 515-523, 2010. (42 refs.)

Previous studies have reported mixed results regarding the association between age at menarche and environmental tobacco smoke exposure, both prenatally and during early childhood; however, few studies have had data available during both time periods. The present study examined whether exposure to prenatal tobacco smoke (PTS) via maternal smoking during pregnancy or childhood environmental tobacco smoke (ETS) was associated with age at menarche in a multi-ethnic birth cohort. With the uniquely available prospectively collected data on body size and growth at birth and in early life, we further examined whether the association between PTS and ETS exposure and age at menarche was mediated by these variables. From 2001 to 2006, we recruited 262 women born between 1959 and 1963 who were enrolled previously in a New York City site of the National Collaborative Perinatal Project. Mothers who smoked during pregnancy vs. those who did not were more likely to be White, younger, have more education and have lower birthweight babies. Daughters with heavy PTS exposure (>= 20 cigarettes per day) had a later age at menarche (> 12 years vs. < 12 years), odds ratio (OR) = 2.1 [95% confidence interval (CI) 0.9, 5.0] compared with daughters with no PTS. Daughters exposed to only childhood ETS had a later age at menarche, OR = 2.1 [95% CI 1.0, 4.3], and those exposed to PTS and ETS combined had a statistically significant later age at menarche, OR = 2.2 [95% CI 1.1, 4.6] compared with daughters with no PTS and no ETS. These results did not change after further adjustment for birthweight and postnatal growth suggesting that exposure to PTS and ETS is associated with later age at menarche even after considering possible relationships with growth.

Copyright 2010, Wiley-Blackwell


Flaherty EG; Thompson R; Litrownik AJ; Zolotor AJ; Dubowitz H; Runyan DK et al. Adverse childhood exposures and reported child health at age 12. Academic Pediatrics 9(3): 150-156, 2009. (33 refs.)

Objective.-The relationship between adverse childhood exposures and poor health, illness, and somatic complaints at age 12 was examined. Methods.-LONGSCAN (Consortium for Longitudinal Studies of Child Abuse and Neglect) tracks a group of children with variable risk for maltreatment. Of the participating child-caregiver dyads, 805 completed an interview when the child was age 4 or age 6, as well as interviews at age 8 and 12. The relationships between 8 categories of childhood adversity (psychological maltreatment, physical abuse, sexual abuse, child neglect, caregiver's substance/alcohol use, caregiver's depressive symptoms, caregiver's being treated violently, and criminal behavior in the household) and child health at age 12 were analyzed. The impact of adversity in the first 6 years of life and adversity in the second 6 years of life on child health were compared. Results.-Only 10% of the children had experienced no adversity, while more than 20% had experienced 5 or more types of childhood adversity. At age 12, 37% of the children sampled had some health complaint. Exposure to 5 or more adversities, particularly exposure in the second 6 years of life, was significantly associated with increased risks of any health complaint (odds ratio [OR] 2.24, 95% confidence interval [95% CI] 1.02-4.96), an illness requiring a doctor (OR 3.69, 95% Cl 1.02-15.1), and caregivers' reports of child's somatic complaints (OR 3.37, 95% Cl 1.14-1.0). There was no association between adverse exposures and self-rated poor health or self-rated somatic complaints. Conclusions.-A comprehensive assessment of children's health should include a careful history of their past exposure to adverse conditions and maltreatment. Interventions aimed at reducing these exposures may result in better child health.

Copyright 2009, Elsevier Science


Francis SA. Using a framework to explore associations between parental substance use and the health outcomes of their adolescent children. Journal of Child & Adolescent Substance Abuse 20(1): 1-14, 2011. (44 refs.)

Risk-taking behavior plays a significant role in the lives of adolescents. Adolescents engaging in risk behaviors such as substance use and risky sexual activity are at increased risk for contracting STDs, unplanned pregnancy, and other health problems. Consequently, children of substance abusers are at even greater risk for engaging in maladaptive behaviors given their social environment and the potential exposure to parental substance use/abuse. Although the empirical literature on adolescent risk-taking behavior is vast, less empirical research has examined how parental substance use is associated with the health outcomes of adolescent children of substance abusers, especially children of parents who use illicit substances. This study proposes a framework to synthesize the research on the health outcomes of adolescent children of substance abusers and provides recommendations for future study.

Copyright 2011, Haworth Press


Fukuda M; Fukuda K; Shimizu T; Nobunaga M; Andersen EW; Byskov AG et al. Paternal smoking habits affect the reproductive life span of daughters. Fertility and Sterility 95(8): 2542-2544, 2011. (18 refs.)

The present study assessed whether the smoking habits of fathers around the time of conception affected the period in which daughters experienced menstrual cycles (i.e., the reproductive life span). The study revealed that the smoking habits of the farther shortened the daughters' reproductive life span compared with daughters whose fathers did not smoke.

Copyright 2011, American Society for Reproductive Medicine


Haber JR; Bucholz KK; Jacob T; Grant JD; Scherrer JF; Sartor CE et al. Effect of paternal alcohol and drug dependence on offspring conduct disorder: Gene-environment interplay. Journal of Studies on Alcohol and Drugs 71(5): 652-663, 2010. (40 refs.)

Objective: Not only are substance-use disorders and externalizing disorders frequently comorbid, they often co-occur in families across generations. The current study examined the role of genetic and environmental influences in the relationship between paternal histories of drug dependence or alcohol dependence and offspring conduct disorder using an offspring-of-twins design. Method: Participants were male twins (n = 1,774) from the Vietnam Era Twin Registry, their offspring (n = 1,917), and mothers of the offspring (n = 1,202). Twins had a history of drug dependence, alcohol dependence, or neither. Based on the father's and his co-twin's drug-dependence or alcohol-dependence history and zygosity, risk groups were constructed to reflect different levels of genetic and environmental risk that were then used to predict offspring conduct disorder. Results: After controlling for potentially confounding variables, the offspring of men with a history of drug dependence or alcohol dependence had significantly higher rates of conduct disorder, compared with offspring of men without this history. Offspring at higher genetic risk had higher rates of conduct disorder. High-risk offspring at lower environmental risk had lower rates of conduct disorder but only in the case of paternal drug-dependence risk. Lower environmental risk did not influence rates of offspring conduct disorder when the father had an alcohol-dependence history. Conclusions: Genetic risk associated with both paternal drug-dependence and paternal alcohol-dependence histories predicted offspring conduct-disorder risk, but only risk associated with paternal drug-dependence history was mitigated by having a low-risk environment. These results demonstrated a significant gene environment interaction effect.

Copyright 2010, Alcohol Reearch Documentation


Halterman JS; Borrelli B; Conn KM; Tremblay P; Blaakman S. Motivation to quit smoking among parents of urban children with asthma. Patient Education and Counseling 79(2): 152-155, 2010. (43 refs.)

Objective: To identify factors associated with motivation to quit smoking among parents of urban Children with asthma. Methods: We analyzed data from parents who smoke and had a child enrolled in the School-Based Asthma Therapy (SBAT) trial. We assessed asthma symptoms, children's cotinine, and parent smoking behaviors. Motivation to quit smoking was assessed by a 10-point continuous measure (1, not at all motivated; 10, very motivated). Results: 209 parents smoked (39% of sample), and children's mean cotinine was 2.48 ng/ml. Motivation to quit was on average 6.9, and 47% of parents scored >= 8 on the scale. Parents who believed their child's asthma was not under good control, and parents who strongly agreed their child's asthma symptoms would decrease if they stop smoking had higher motivation to quit compared to their counterparts (p < .05). In a multivariate analysis, parents who believed their child's asthma was not under control had more than twice the odds of reporting high motivation to quit. Conclusion: Parents' perception of the risks of smoking to their child with asthma is associated with motivation to quit. Practice implications: Raising awareness about the effect of smoking and quitting on children's asthma might increase motivation to quit among parents.

Copyright 2010, Elsevier Science


Hanioka T; Ojima M; Tanaka K; Yamamoto M. Does secondhand smoke affect the development of dental caries in children? A systematic review. (review). International Journal of Environmental Research and Public Health 8(5): 1503- 1519, 2011. (49 refs.)

This review evaluated evidence of the relationship between secondhand smoke (SHS) and dental caries in children in epidemiological studies. Relevant literature was searched and screened, and the methodological quality was assessed. The search yielded 42 citations. High-quality studies including one cohort format and 14 case-control format studies were selected. Early childhood caries was examined in 11 studies. The independent association of SHS was significant in 10 studies, and the strength was mostly weak to moderate. One study did not select SHS as a significant variable. Three studies reported decreases in the risk of previous exposure, and the association was not significant. Dose-response relationships were evident in five studies. Permanent teeth were examined in seven studies. Five studies reported significant associations, which were mostly weak. The risk of previous exposure remained similar to that of current exposure, and a dose-response relationship was not evident in one study. The overall evidence for the causal association in early childhood caries is possible regarding epidemiological studies, and the evidence of permanent teeth and the effect of maternal smoking during pregnancy were insufficient. The results warrant further studies of deciduous teeth using a cohort format and basic studies regarding the underlying mechanism.

Copyright 2011, MDPI AG


Harakeh Z; Scholte RHJ; Vermulst AA; de Vries H; Engels RCME. The relations between parents' smoking, general parenting, parental smoking communication, and adolescents' smoking. Journal of Research on Adolescence 20(1): 140-165, 2010. (58 refs.)

The present study examined whether the associations between general parenting practices (i.e., support, behavioral control, and psychological control) and parental smoking on the one hand and older and younger siblings' smoking on the other were mediated by parental smoking communication (i.e., frequency and quality of parent-adolescent communication concerning smoking-related issues). The focus of this paper was on examining whether these associations of parental actions and adolescents' smoking were different in older and younger siblings within the family. Participants were 428 Dutch families (mother, father, and their 2 adolescent siblings aged 13-17). The results of parent and adolescent reports indicated that general parenting practices and parental smoking were associated with parental smoking communication, which, in turn, was related with adolescent smoking. The magnitude of the associations between parenting and adolescent smoking did not differ between older and younger siblings. Supportive parents were generally more likely to engage in a high quality communication about smoking with their adolescent children; this was related to a lower likelihood to smoke. Parents who exerted psychological control were more likely to talk more frequently with their adolescents on smoking matters, which in turn, relates to a higher likelihood to smoke. Also, smoking parents were less likely to have high-quality parent-adolescent communication that relates to higher likelihoods to smoke. In general, the findings were similar across reporters. Implications for prevention are addressed.

Copyright 2010, Wiley-Blackwell


Hedden SL; Whitaker DE; von Thomsen S; Severtson SG; Latimer WW. Latent patterns of risk behavior in urban African-American middle school students in Baltimore City. Journal of Child & Adolescent Substance Abuse 20(1): 34-47, 2011. (47 refs.)

Students who engage in high-risk behaviors, including early initiation of sexual intercourse, alcohol use, marijuana use, tobacco use, and externalizing behavior are vulnerable to a broad range of adverse outcomes as adults. Latent class analysis was used to determine whether varying patterns of risk behavior existed for 212 urban African-American students from Baltimore public schools who were recruited as part of a study for the prevention of drug use. A two-class model was estimated. The proportion of the sample bearing a high probability of each of the five risk behaviors was 10.7%; in comparison, the proportion of students with a low probability of the risk behaviors was 89.3%. Controlling for other variables, older age and parental drug or alcohol use was associated with being in the high-risk class, whereas neighborhood was not predictive of latent class. Results from this study may be used to target early adolescents with co-occurring risk behaviors for prevention and treatment.

Copyright 2011, Haworth Press


Hirata K; Yamano Y; Suzuki H; Miyagawa S; Nakadate T. Passive smoking is associated with lower serum HDL-C levels in school children. Pediatrics International 52(2): 252-256, 2010. (16 refs.)

Background: In recent years, a number of studies have reported that exposure to environmental tobacco smoke (ETS) reduces high-density lipoprotein cholesterol (HDL-C) levels in children, as well as in adults. Further, a number of countries have indicated that passive smoking increases the risk of early arteriosclerosis onset. Here, to evaluate the effects of ETS exposure, we conducted a cross-sectional epidemiological study on primary school children in Japan using answers from a questionnaire survey, as well as urine cotinine and lipid metabolism-related variable measurements. Methods: A total of 121 sixth-grade primary school children participated in this study by completing a questionnaire about their food intake, lifestyle and family smoking habits. Early in the morning, we also measured height, weight, blood pressure, serum levels of total cholesterol, triglyceride, HDL-C, and blood sugar, as well as urine levels of cotinine and creatinine under unfed conditions. Results: From the questionnaire, 40 and 81 children reported being exposed and not exposed to ETS, respectively. Serum HDL-C levels, which were adjusted for the degree of corpulence and exercise habits, were significantly lower in the passive smoker group than the non-passive-smoker group (65.3 and 72.1 mg/dL, respectively; P = 0.012). In addition, proportional differences in serum HDL-C levels were also observed based on the amount of cigarettes smoked at home by family members of the child. Conclusions: Results: suggest that ETS exposure at home is associated in a dose-related manner with lower serum HDL-C levels in primary school children. In addition, our results suggest that smoking in the presence of children who are not usually exposed to ETS increases the risk of arteriosclerosis. Given these findings, we strongly recommend the establishment of anti-passive-smoking measures.

Copyright 2010, Wiley-Blackwell


Hjerkinn B; Lindbaek M; Skogmo I; Rosvold EO. Neuropsychological screening of children of substance-abusing women attending a Special Child Welfare Clinic in Norway. Substance Abuse Treatment, Prevention and Policy 5: e-journal 17, 2010. (45 refs.)

Background: Exposure to alcohol and illicit substances during pregnancy can have an impact on the child for the rest of his/her life. A Special Child Welfare Clinic (SCWC) in Norway provides care for pregnant women with substance abuse problems. Treatment and support are provided without replacement therapy. Methods: We performed a neuropsychological screening of 40 children aged four to 11 years whose mothers had attended the SCWC during pregnancy, and of a comparison group of 80 children of women without substance abuse problems. The children were presented with tests chosen from Wechsler Intelligence Scale for Children, third version (WISC-III), Nepsy, Halstead-Reitan and Raven's Progressive Matrices, Coloured Version. The tests were grouped into five main domains; (1) learning and memory, (2) visual scanning, planning and attention, (3) executive function, (4) visuo-motor speed and dexterity and (5) general intellectual ability. Results: No children in the study had test results in the clinical range in any domain. Bivariate analyses revealed that children of short-term substance-abusing mothers (who stopped substance abuse within the first trimester) had significantly lower test scores than the comparison group in three out of five domains (domain 2,3,4). Children of long-term substance abusers (who maintained moderate substance abuse throughout pregnancy) had significantly lower test results than the comparison group in one domain of the test results (domain 1). All but one child in the long-term group were or had been in foster homes. Most children in the short-term group stayed with their mothers. Multivariate regression analyses revealed that foster care minimum 50% of life time was associated with better scores on domains (1) learning and memory, (2) visual scanning, planning and attention, and (3) executive functions, while no significant associations with test scores was found for substance abuse and birth before 38 weeks of gestation. Conclusion: Children raised by former substance abusing mothers scored worse on the neuropsychological screening than children who had substance abusing mothers and mostly were raised in foster homes. This indicates that it is important to focus on the environment in cases where help and support are provided to presently or formerly addicted women raising children.

Copyright 2010, BioMed Central Ltd.


Hockenberry JM; Timmons EJ; Weg MV. Smoking, parent smoking, depressed mood, and suicidal ideation in teens. Nicotine & Tobacco Research 12(3): 235-242, 2010. (45 refs.)

We address whether smoking is related to suicidal ideation in teens and whether there is evidence of a causal pathway. We use data from the 2002 National Annenberg Survey of Youth and employ multivariate logistic regression to model each teen's risk of suicidal ideation as a function of self-report of depressive symptoms, own smoking, parent smoking, and demographic and household income variables. Individuals reporting depressive symptoms have an increased risk of suicidal ideation (odds ratio [OR] = 13.13; 95% CI = 5.98-28.81). Relative to teens who do not smoke and whose parents do not smoke, teens who smoke and do not have a parent who smokes have increased risk of suicidal ideation (OR = 8.10; 95% CI = 2.88-22.80), whereas those with a parent who smokes do not have a statistically significant increased risk of suicidal ideation regardless of teen smoking behavior. Relative to teens who do not smoke and do not have parents who smoke, suicidal ideation risk is increased in teens who smoke only if they do not have a parent who smokes. We find evidence that the smoking and suicidal ideation of the teens is likely due to common psychosocial causes rather than a causal pathway from smoking to suicidal ideation.

Copyright 2010, Oxford University Press


Hovell MF; Wahlgren DR; Liles S; Jones JA; Hughes SC; Matt GE et al. Providing coaching and cotinine results to preteens to reduce their secondhand smoke exposure: A randomized trial. Chest 140(3): 681-689, 2011. (42 refs.)

Background: Secondhand smoke exposure (SHSe) poses health risks to children living with smokers. Most interventions to protect children from SHSe have coached adult smokers. This trial determined whether coaching and cotinine feedback provided to preteens can reduce their SHSe. Methods: Two hundred one predominantly low-income families with a resident smoker and a child aged 8 to 13 years who was exposed to two or more cigarettes per day or had a urine cotinine concentration >= 2.0 ng/mL were randomized to control or SHSe reduction coaching groups. During eight in-home sessions over 5 months, coaches presented to the child graphic charts of cotinine assay results as performance feedback and provided differential praise and incentives for cotinine reductions. Generalized estimating equations were used to determine the differential change in SHSe over time by group. Results: For the baseline to posttest period, the coaching group had a greater decrease in both urine cotinine concentration (P = .039) and reported child SHSe in the number of cigarettes exposed per day (child report, P = .003; parent report, P = .078). For posttest to month 12 follow-up, no group or group by time differences were obtained, and both groups returned toward baseline. Conclusions: Coaching preteens can reduce their SHSe, although reductions may not be sustained without ongoing counseling, feedback, and incentives. Unlike interventions that coach adults to reduce child SHSe, programs that increase child avoidance of SHSe have the potential to reduce SHSe in all settings in which the child is exposed, without requiring a change in adult smoking behavior.

Copyright 2011, American College of Chest Physicians


Hujova Z; Alberty R; Paulikova E; Ahlers I; Ahlersova E; Gabor D et al. The prevalence of cigarette smoking and its relation to certain risk predictors of cardiovascular diseases in central-Slovakian Roma children and adolescents. Central European Journal of Public Health 19(2): 67-72, 2011. (26 refs.)

The objective of the study was to determine some cardiovascular disease (CVD) risk factors in relation to cigarette smoking in 174 Roma children and adolescents (88 males and 86 females) and 131 non-Roma probands (males and females) aged 7-18 in central Slovakia. In this biethnic study, 26.4% of the Roma children and adolescents (more than twice contrary to the control group) were smokers. Among the studied ethnicities, the majority of smokers was Roma (79.3%, 46 subjects). Smoking Roma have higher means of TG, Lp(a) and WHR compared with non-smoking non-Roma. The most frequent CVD risk predictors of smoking Roma probands was low serum levels HDL-C, apo A (the Fisher test confirmed a significant relationship between cigarette smoking and HDL-C, apo A; p<0.01). The results of the research should help to develop an effective preventative health education programs focused on Roma education (who live in a higher-risk environment compared to the majority population) in order to stem the spread of CVD as well as morbidity and mortality in this ethnic group living in Slovakia.

Copyright 2011, National Institute of Public Health (Czech Republic)


Johnson-Kozlow M; Wahlgren DR; Hovell MF; Flores DM; Liles S; Hofstetter CR et al. Adolescents validly report their exposure to secondhand smoke. Journal of Clinical Epidemiology 63(8): 914-919, 2010. (21 refs.)

Objective: This study examined the validity of child-reported exposure to secondhand smoke (SHS) and investigated factors, such as child's age, which might affect accuracy of recall. Study Design and Setting: Participants were drawn from a nonprobability sample of 380 families who completed baseline assessment as part of a randomized trial of an SHS reduction intervention conducted in an urban setting in Southern California. Parents and children (aged 8-13 years) retrospectively reported child's exposure to SHS. using timeline followback methodology; reports were compared with child's urine cotinine. Results: Validity coefficients for parents and children were comparable (r = 0.58 vs. r = 0.53), but parents recalled three times more exposure than children (2.2 vs. 0.8 cigarettes per day; P < 0.001). Regression models predicting cotinine indicated that including child in addition to parent reports resulted in better prediction than either alone. Conclusion: When there is a choice, parent reports are preferable over child reports because of decreased underreporting. However, child-reported SHS exposure had adequate validity (r > 0.50) and might be appropriate in some situations. Researchers might consider collecting both parent and child reports because each made a unique contribution to the prediction of cotinine.

Copyright 2010, Elsevier Science


Kelley SJ; Whitley DM; Campos PE. Behavior problems in children raised by grandmothers: The role of caregiver distress, family resources, and the home environment. Children and Youth Services Review 33(11): 2138-2145, 2011. (50 refs.)

Over the past few decades there has been a dramatic increase in children being raised by grandparents due to a variety of factors including child maltreatment, parental abandonment, substance abuse, and incarceration. The purpose of this study is to examine the extent of behavior problems in children being raised by grandmothers and to determine factors in their current environment that are related to child behavior problems. The study draws on McCubbin's resiliency model of family stress, adjustment and adaptation. The sample comprised of 230 children ages 2 to 16 years who were being raised by grandmothers in parent-absent homes. The families were predominantly low income and African American. The grandmothers ranged in age from 37 to 80 years. Grandmothers responded to several self-report measures pertaining to child behavior problems, family resources, social support, and caregiver psychological distress. Trained research assistants completed a standardized observational measure of the home environment. Results indicated that 31.3% of child participants scored in the clinically elevated range for total behavior problems, with 21.3% and 32.6% scoring in the elevated range for internalizing and externalizing behaviors, respectively. Hierarchical regression analyses revealed that of the variables examined, increased psychological distress in grandmothers was most predictive of child behavior problems, followed by less supportive home environments and fewer family resources. Results of the present study underscore the need for interventions that focus on reducing child behavior problems, as well as enhancing the parenting skills of grandmothers raising grandchildren. Findings also support the need for strategies to reduce stress in grandmother caregivers and to improve access to resources needed to provide supportive home environments for their grandchildren.

Copyright 2011, Elsevier Science


Kintz P; Evans J; Villain M; Cirimele V. Interpretation of hair findings in children after methadone poisoning. Forensic Science International 196(1-3): 51-54, 2010. (12 refs.)

Methadone is not licensed for use in children though it can be employed for the management of neonatal opiate withdrawal syndrome. During the last 2 years, our laboratory has been asked to test for methadone and EDDP, its major metabolite, in hair from children that were admitted to hospital unconscious and where methadone had already been identified in a body fluid (4 cases) or where the children were deceased and evidence of methadone overdosage having already been established (2 cases). In all of these cases, segmental analysis revealed approximately the same amount of drug along the hair lock. As a consequence, contamination was considered as an issue and interpretation of the results was a challenge that deserves particular attention. After decontamination with dichloromethane and segmentation the hair was cut into small pieces, incubated overnight at 40 degrees C, liquid-liquid extracted and analysed with LC-MS/MS, using 2 transitions per compound. The LOQ for both methadone and EDDP was 10 pg/mg. In the first series involving children admitted to hospital, the following results were obtained: case 1: 4 x 1 cm section, methadone at 0.05-0.08 ng/mg, no EDDP detected, case 2: 4 x 1 cm section, methadone at 0.13-0.15 ng/mg, EDDP at 0.02 ng/mg, case 3: 3 x 1.5 cm section, methadone at 0.07-0.09 ng/mg, EDDP at 0.01-0.03 ng/mg, case 4: 6 x 2 cm section, methadone at 0.06-0.13 ng/mg, EDDP at 0.02-0.03 ng/mg. The following concentrations were obtained from the children who had died following a methadone overdose: case 5: 2 x 2 cm section, methadone at 0.53-0.58 ng/mg, no EDDP detected, case 6: 4 x 1 cm section, methadone at 0.44-0.77 ng/mg, EDDP at 0.04-0.06 ng/mg. The first observation is that all these concentrations are low by comparison with those observed in adults on methadone maintenance therapy. However, the more surprising observation is the relative homogenous concentrations along the hair locks in each specific case. This raises concerns around the possibility that contamination could have occurred prior to sampling and makes it hard to reach a conclusion regarding the possibility of repeated methadone exposure in the months prior the incidents. In these cases it was impossible to conclude that the children were deliberately administered methadone. The results of the analysis of hair could indicate that they were in an environment where methadone was being used and where the drug was not being handled and stored with appropriate care. The homogenous concentrations found on segmental analyses could be indicative of external contamination that may have arisen not only from direct contamination with the drug but also via contamination with body fluids at the post mortem or from sweat produced close to the time of the incident. In view of these results we concluded that a single determination should not be used firmly to discriminate long-term exposure to a drug.

Copyright 2010, Elsevier Science


Kwok MK; Schooling CM; Lam TH; Leung GM. Paternal smoking and childhood overweight: Evidence from the Hong Kong "Children of 1997". Pediatrics 126(1): E46-E56, 2010. (50 refs.)

OBJECTIVE: This study examined, in a non-Western sociohistorical context, whether prenatal or postnatal secondhand smoke (SHS) exposure for children of nonsmoking mothers was associated with higher childhood BMI, and it clarified whether the observed associations were biologically mediated or socioeconomically confounded. METHODS: A total of 6710 and 6519 children of nonsmoking mothers (N = 7924) with BMI data at similar to 7 and similar to 11 years, respectively, from a population-representative (N = 8327), Hong Kong Chinese birth cohort ("Children of 1997"), born in April or May 1997, were included in the analysis. RESULTS: Compared with no SHS exposure, daily paternal smoking increased mean BMI z scores, but not height, at 7 years (difference: 0.10 [95% confidence interval: 0.02-0.19]) and at 11 years (difference: 0.16 [95% confidence interval: 0.07-0.26]), with adjustment for gender, birth order, socioeconomic position, mother's place of birth, breast-feeding, serious morbidity, and pubertal status. CONCLUSIONS: Our findings, although preliminary, suggest that the association of paternal smoking with child overweight might be biologically mediated. Given the known harms of smoking, reducing SHS exposure from conception as a precautionary action for childhood overweight might be warranted.

Copyright 2010, American Academy of Pediatrics


Levy DE; Rigotti NA; Winickoff JP. Medicaid expenditures for children living with smokers. BMC Health Services Research 11(e-article 125), 2011. (30 refs.)

Background: Children's exposure to secondhand smoke is associated with increased morbidity. We estimated Medicaid expenditures for children living with smokers compared to those living with no smokers in the United States. Methods: Data were overall and service-specific (i.e., inpatient, ambulatory, emergency department, prescription drug, and dental) annual Medicaid expenditures for children 0-11 years old from the 2000-2007 Medical Expenditures Panel Surveys. Smokers' presence in households was determined by adult respondents' self reports. There were 25,835 person-years of observation. We used multivariate analyses to adjust for child, parent, and geographic characteristics. Results: Children with Medicaid expenditures were nearly twice as likely to live with a smoker as other children in the U.S. population. Adjusted analyses revealed no detectable differences in children's overall Medicaid expenditures by presence of smokers in the household. Medicaid children who lived with smokers on average had $10 (95% CI $3, $18) higher emergency department expenditures per year than those living with no smokers. Conclusions: Living with at least one smoker (a proxy for secondhand smoke exposure) is unrelated to children's overall short-term Medicaid expenditures, but has a modest impact on emergency department expenditures. Additional research is necessary to understand the relationship between secondhand smoke exposure and long-term health and economic outcomes.

Copyright 2011, BioMed Central


Liebrechts-Akkerman G; Lao O; Liu F; van Sleuwen BE; Engelberts AC; L'Hoir MP et al. Postnatal parental smoking: An important risk factor for SIDS. European Journal of Pediatrics 170(10): 1281-1291, 2011. (21 refs.)

Sudden infant death syndrome (SIDS) is the unexpected death of an infant that remains unexplained after a thorough investigation of the circumstances, family history, paediatric investigation and complete autopsy. In Western society, it is the leading cause of post-neonatal death below 1 year of age. In the Netherlands, the SIDS incidence is very low, which offers opportunities to assess the importance of old and new environmental risk factors. For this purpose, cases were collected through pathology departments and the working group on SIDS of the Dutch Paediatrician Foundation. A total of 142 cases were included; these occurred after the parental education on sleeping position (1987), restricted to the international age criteria and had no histological explanation. Age-matched healthy controls (N = 2,841) came from a survey of the Netherlands Paediatric Surveillance Unit, completed between November 2002 and April 2003. A multivariate analysis was performed to determine the risk factors for SIDS, including sleeping position, antenatal maternal smoking, postnatal parental smoking, premature birth, gender, lack of breastfeeding and socio-economic status. Postnatal smoking was identified as an important environmental risk factor for SIDS (OR one parent = 2.5 [1.2, 5.0]; both parents = 5.77 [2.2, 15.5]; maternal = 2.7 [1.0, 6.4]; paternal = 2.4 [1.3, 4.5] ) as was prone sleeping (OR put prone to sleep = 21.5 [10.6, 43.5]; turned prone during sleep = 100 [46, 219]). Premature birth was also significantly associated with SIDS (OR = 2.4 [1.2, 4.8]). Postnatal parental smoking is currently a major environmental risk factor for SIDS in the Netherlands together with the long-established risk of prone sleeping.

Copyright 2011, Springer


Lietz CA. Empathic action and family resilience: A narrative examination of the benefits of helping others. Journal of Social Service Research 37(3): 254- 265, 2011. (41 refs.)

Empathy is identified as a protective factor that has been helpful for children considered at high risk for poor mental health and social functioning due to experiencing stressful circumstances such as family violence, substance abuse of a parent, or poverty. Yet, little is known about its relevance to a family's ability to overcome adversity. This study examined the narratives of 20 resilient families who maintained family functioning despite experiencing a multitude of risk factors including poverty, death of a child, significant health problems, or substance abuse problems. Narrative analysis was used to identify the ways families situated empathic actions within their stories of resilience. Findings suggest families developed increased compassion for others as a result of their own experiences with loss, trauma, or stress and discussed how helping others increased their ability to cope with the challenges they faced. Future research and practice implications are outlined and support the usefulness of strengths-based concepts and interventions.

Copyright 2011, Haworth Press


Loke AY; Wong YPI. Smoking among young children in Hong Kong: Influence of parental smoking. Journal of Advanced Nursing 66(12): 2659-2670, 2010. (33 refs.)

Aims. This paper is a report of a study comparing children with smoking parents and those with non-smoking parents, in terms of knowledge and attitude towards smoking and the influence of parents and peers on smoking initiation. Background. Adolescence is a developmental stage when smoking habits are likely to start. Adolescents are most influenced by the smoking habits of their parents and friends. Method. A cross-section study was conducted with students aged 13-15 years in two schools in 2008, using a questionnaire that collected information on the smoking habits of their parents and peers, knowledge and attitude towards smoking, initiation and inclination towards smoking. Chi-square tests and binary logistic regression were used to analyse the data. Results. A total of 257 of 575 (44 center dot 7%) students had smoking parent(s), and 25 center dot 4% reported having peers who smoked. Children with non-smoking parents were more likely than those with smoking parents to consider 'smoking as disgusting' (67 center dot 3% vs. 45 center dot 9%), and to know that 'smoking is addictive' (80 center dot 5% vs. 70 center dot 4%) and 'harmful to health' (81 center dot 8% vs. 67 center dot 7%). More of those with smoking parents had tried smoking than those with non-smoking parents (13 center dot 2% vs. 3 center dot 8%). Conclusion. Preventive programmes should involve smoking parents to increase their awareness of the impact their smoking has on their children. Interventions should include problem-solving skills for children to deal with daily stresses and thus eradicate the potential risk of smoking initiation.

Copyright 2010, Wiley-Blackwell


Loureiro ML; Sanz-de-Galdeano A; Vuri D. Smoking habits: Like father, like son, like mother, like daughter? Oxford Bulletin of Economics and Statistics 72(6): 717-743, 2010. (52 refs.)

We use instrumental variable methods to investigate whether the impact of parental smoking habits on their children's smoking decisions is a causal one. We find suggestive evidence of same-sex role models in two-parent households: mothers play a more crucial role in determining their daughters' smoking decisions, whereas fathers' smoking habits are primarily imitated by their sons. This same-sex parent-child link is no longer at play for teenagers living in single-mother households, for whom the influence of their only cohabiting parent turns out to be predominant independently of gender.

Copyright 2010, Wiley-Blackwell Publishing


Mangrio E; Lindstrom M; Rosvall M. Early life factors and being overweight at 4 years of age among children in Malmo, Sweden. BMC Public Health 10: e-article 764, 2010. (43 refs.)

Background: Rising rates of obesity and overweight is an increasing public health problem all over the world. Recent research has shown the importance of early life factors in the development of child overweight. However, to the best of our knowledge there are no studies investigating the potential synergistic effect of early life factors and presence of parental overweight on the development of child overweight. Methods: The study was population-based and cross-sectional. The study population consisted of children who visited the Child Health Care (CHC) centers in Malmo for their 4-year health check during 2003-2008 and whose parents answered a self-administered questionnaire (n = 9009 children). Results: The results showed that having overweight/obese parents was strongly associated with the child being overweight or obese. Furthermore, there was an association between unfavorable early life factors (i.e., mother smoking during pregnancy, presence of secondhand tobacco smoke early in life, high birth weight) and the development of child overweight/obesity at four years of age, while breastfeeding seemed to have a protective role. For example, maternal smoking during pregnancy was associated with an odds ratio (OR) of 1.47 (95% CI: 1.22, 1.76) for overweight and 2.31 (95% CI: 1.68, 3.17) for obesity. The results further showed synergistic effects between parental overweight and exposure to unfavourable early life factors in the development of child overweight. Conclusions: The present study shows the importance of early life factors in the development of child overweight and obesity, and thus puts focus on the importance of early targeted interventions.

Copyright 2010, BioMed Central


Martin LA; Dilley KJ; Ariza AJ; Sullivan C; Seshadri R; Binns HJ. Tobacco-related documentation in pediatric practice. Academic Pediatrics 9(5): 353-359, 2009. (32 refs.)

Objective. The goal of this study was to evaluate tobacco-related documentation in children's medical records. Method. A cross-sectional, consecutive sample of 42 I 6 parents at 13 primary care practices was surveyed on demographics, health habits, and smoking status of household members. The medical records of 2085 children from a subsample of 1149 families (all households with smokers and a sample of nonsmoking households) were reviewed for tobacco-related documentation at the first visit to the practice and visits in the 14 months preceding recruitment. Relationships of documentations with visit type, household smoking status, and use of charting prompts were examined. Results. Most children (93%) had >= 1 visit during the reviewed period (77% had a health supervision visit), 23% were aged >= 11 years, 52% were Medicaid/uninsured, and 70% lived with smokers; 30.6% of children had family tobacco use status documented at a first visit to the practice and 15.4% had prenatal tobacco use status documented. Among children with a visit in the reviewed period, 39.3% with a health supervision visit and 9.6% without had a tobacco-related notation at a visit (P < .001). Overall, 15.2% of children living with a smoker had a visit notation indicating that someone in the household smoked. In households with smokers, documentation of household tobacco use status often disagreed with parent survey. Charting prompts significantly increased rates of identification of family tobacco use history and prenatal tobacco use history. Conclusions. Correct identification of household smoking status was absent for most children living with smokers. Improved documentation systems may facilitate tobacco-related surveillance and counseling.

Copyright 2009, Elsevier Science


McCaffree DR. Second hand smoke and children. (editorial). Journal of the Oklahoma State Medical Association 104(7-8): 308-309, 2011


Melchior M; Choquet M; Le Strat Y; Hassler C; Gorwood P. Parental alcohol dependence, socioeconomic disadvantage and alcohol and cannabis dependence among young adults in the community. European Psychiatry 26(1): 13-17, 2011. (48 refs.)

We tested the hypothesis that socioeconomic disadvantage exacerbates the intergenerational transmission of substance dependence. Among 3056 community-based young adults (18-22 years, 2007), the prevalence of alcohol dependence (WHO AUDIT, 5.8%) and cannabis dependence (DSM IV criteria, 7.3%) was doubled in the presence of combined parental alcohol dependence and socioeconomic disadvantage.

Copyright 2011, Elsevier Science


Mellor JM. Do cigarette taxes affect children's body mass index? The effect of household environment on health. Health Economics 20(4): 417-431, 2011. (38 refs.)

Several recent studies demonstrate a positive effect of cigarette prices and taxes on obesity among adults, especially those who smoke. If higher cigarette costs affect smokers' weights by increasing calories consumed or increasing food expenditures, then cigarette taxes and prices may also affect obesity in children of smokers. This study examines the link between child body mass index (BMI) and obesity status and cigarette costs using data from the National Longitudinal Survey of Youth-79 (NLSY79). Controlling for various child, mother, and household characteristics as well as child-fixed effects, I find that cigarette taxes and prices increase BMI in the children of smoking mothers. Interestingly, and unlike previous research findings for adults, higher cigarette taxes do not increase the likelihood of obesity in children. These findings are consistent with a causal mechanism in which higher cigarette costs reduce smoking and increase food expenditures and consumption in the household.

Copyright 2011, Wiley-Blackwell


Mills AL; White MM; Pierce JP; Messer K. Home smoking bans among US households with children and smokers opportunities for intervention. American Journal of Preventive Medicine 41(6): 559-565, 2011. (36 refs.)

Background: Public health campaigns have reduced the exposure of U. S. children to secondhand smoke at home; however, these may not have been equally effective across subgroups. Purpose: To examine prevalence of home smoking bans among U. S. households with both children and smokers, over time and by demographic subgroups. Methods: The Tobacco Use Supplement to the Current Population Survey (TUS-CPS) is a nationally representative household survey of tobacco use. The 1992/1993 and 2006/2007 TUS-CPS interviewed 22,746 households from a major racial/ethnic group with both children and adult smokers. Predictors of complete home smoking bans among demographic subgroups were identified using multivariate logistic regression. Analyses were conducted in 2010 - 2011. Results: Complete home smoking bans among U. S. households with children and smokers (smoking families) more than tripled, from 14.1% in 1992/1993 to 50.0% in 2006/2007. However, non-Hispanic white and African-American smoking families lagged behind Asian/Pacific Islanders and Hispanics. In 2006/2007, 67.2% of African-American smoking families allowed smoking in the home, as did 59.2% of smoking families with all children aged >= 14 years. Bans were more likely among more-educated households and in states with lower adult smoking prevalence; however, these differences were attenuated in some racial/ethnic groups. Conclusions: As of 2006/2007, only half of U. S. households with both children and smokers had complete home smoking bans. Home bans were less common among smoking families with older children, in African-American households, and in Hispanic or non-Hispanic white households in states with high smoking prevalence. Interventions are needed to promote smokefree homes among these groups.

Copyright 2011, Elsevier Science


Mitrani VB; Weiss-Laxer NS; Feaster DJ. Factors related to loss of child custody in HIV plus women in drug abuse recovery. American Journal of Drug and Alcohol Abuse 35(5): 320-324, 2009. (25 refs.)

Background: Mothers who are dually-diagnosed with HIV/AIDS and drug abuse are particularly burdened and vulnerable to loss of child custody. Objectives: This study explores factors associated with child custody loss among HIV+ women in drug abuse recovery, and compares mothers who have custody of their children to mothers who do not have custody of all of their children. Methods: Descriptive analyses were conducted on 68 HIV+ mothers in drug recovery, 46% who had custody of all of their children, and 54% who did not. Results: The lost-custody group was less likely to be employed and had more history of violent impulses and arrest, particularly on drug charges. The groups reported similar recent and lifetime drug use patterns, but the custody group had received more drug treatment. Post-hoc analyses found the lost-custody group had lower rates of participation in the interventions offered in the parent clinical trial and higher avoidant coping. Conclusions: The sample in the current study supports that HIV+ women in drug recovery are at high risk of loss of child custody. Non-adherence to available treatment seems to be associated with loss of child custody. Scientific significance: Results suggest the need for further research and active treatment outreach for this population.

Copyright 2009, Taylor & Francis


Mitrou F; Gaudie J; Lawrence D; Silburn SR; Stanley FJ; Zubrick SR. Antecedents of hospital admission for deliberate self-harm from a 14-year follow-up study using data-linkage. BMC Psychiatry 10: e-article 82, 2010. (53 refs.)

Background: A prior episode of deliberate self-harm (DSH) is one of the strongest predictors of future completed suicide. Identifying antecedents of DSH may inform strategies designed to reduce suicide rates. This study aimed to determine whether individual and socio-ecological factors collected in childhood and adolescence were associated with later hospitalisation for DSH. Methods: Longitudinal follow-up of a Western Australian population-wide random sample of 2,736 children aged 4-16 years, and their carers, from 1993 until 2007 using administrative record linkage. Children were aged between 18 and 31 years at end of follow-up. Proportional hazards regression was used to examine the relationship between child, parent, family, school and community factors measured in 1993, and subsequent hospitalisation for DSH. Results: There were six factors measured in 1993 that increased a child's risk of future hospitalisation with DSH: female sex; primary carer being a smoker; being in a step/blended family; having more emotional or behavioural problems than other children; living in a family with inconsistent parenting style; and having a teenage mother. Factors found to be not significant included birth weight, combined carer income, carer's lifetime treatment for a mental health problem, and carer education. Conclusions: The persistence of carer smoking as an independent risk factor for later DSH, after adjusting for child, carer, family, school and community level socio-ecological factors, adds to the known risk domains for DSH, and invites further investigation into the underlying mechanisms of this relationship. This study has also confirmed the association of five previously known risk factors for DSH.

Copyright 2010, BioMed Central


Moore T; McArthur M; Noble-Carr D. Different but the same? Exploring the experiences of young people caring for a parent with an alcohol or other drug issue. Journal of Youth Studies 14(2): 161-177, 2011. (50 refs.)

Although children of parents with an alcohol or other drug (AOD) issue appear to assume a range of caring responsibilities within their families they have, until recently, been excluded from the growing body of young-carer research, policy and practice. This is problematic, as this group may experience greater levels of social exclusion whilst experiencing similar negative impacts of care as their caring peers. This paper discusses the findings of an exploratory qualitative research project conducted in Canberra, Australia which attempted to further understand these young people's experiences and to consider how they might best be supported. The paper challenges the way that young caring has been conceptualised and suggests that unless a number of conceptual, structural and organisational changes are made, young people caring for a parent with an AOD issue may remain relatively unsupported.

Copyright 2011, Taylor & Francis


Moss DR; Lucht LA; Kip KE; Reis SE. Acute physiologic effects of secondhand smoke exposure in children. Nicotine & Tobacco Research 12(7): 708-714, 2010. (27 refs.)

We investigated the hypothesis that exhaled carbon monoxide (eCO), heart rate (HR), and blood pressure (BP) would increase acutely in exposed but not in unexposed children. In a nonrandomized controlled design, parent-child dyads were assigned to groups based on exposure: child subjects, 7-18 years of age, exposed to smoking daily in the home (exposed) or with no household exposure (unexposed control). HR, BP, and eCO were measured before and after exposure to a parent smoking 1 cigarette (exposed) or a time-lapse equivalent (control). The primary analysis compared mean acute changes in physiological measures following intervention or control procedure. Forty-one dyads were enrolled. At baseline, no differences in child gender, race, ethnicity, HR, BP, lipids, or fasting glucose were noted between exposure groups. Following experimental or control procedures, the median change in eCO was similar between groups (-0.1 ppm exposed vs. 0.0 ppm unexposed, p = .27). Acute hemodynamic changes were also similar between exposed and unexposed children, respectively: (HR change 4.2 vs. 2.6 beats per minute, p = .62; systolic blood pressure change 0.08 vs. 0.41 mm Hg, p = .91; diastolic blood pressure 0.08 vs. 2.27 mm Hg, p = .37). This is the first study to report on acute physiologic changes of secondhand smoke exposure in children in a naturalistic setting. A single acute dose of passive smoke exposure in children did not alter the physiologic variables of HR or BP. Further in-home study using continuous monitoring is needed. Demonstration of acute effects may serve as clinical feedback to motivate parents to quit smoking.

Copyright 2010, Oxford University Press


O'Callaghan FV; Al Mamun A; O'Callaghan M; Alati R; Williams GM; Najman JM. Is smoking in pregnancy an independent predictor of academic difficulties at 14 years of age? A birth cohort study. Early Human Development 86(2): 71-76, 2010. (35 refs.)

Background. Studies of the effects of maternal smoking during pregnancy have reported inconsistent findings in relation to measures of offspring cognitive functioning Few studies, however, have examined learning outcomes in adolescents, as opposed to IQ Aim To examine the association between maternal smoking during pregnancy and academic performance among adolescent offspring Study design: Population-based birth cohort study. Subjects: 7223 mothers and children were enrolled in the Mater-University of Queensland Study of Pregnancy in Brisbane (Australia) from 1981 to 1984. Analyses were restricted to the 4294 mothers and children for whom all information was reported at 14-year follow-up Outcome measures Reports of academic performance of 14-year-old offspring in English. Science and Mathematics with different patterns of maternal smoking (never smoked, smoked before and/or after pregnancy but not during pregnancy, or smoked during pregnancy) Results. Low academic achievement was more common only in those whose mothers had smoked during pregnancy. Effect sizes were, however, small. The adjusted mean difference in total learning score for smoking before and/or after pregnancy but not during pregnancy, and for smoking during pregnancy were -0.18 (-0 58, 0 22) and -0 40 (-0 69, -0 12). Similarly, the adjusted odds ratios were 0.9 (0.65, 1.24) and 1.35(1 07, 1 70) Conclusion: Maternal smoking during pregnancy is a preventable prenatal risk factor associated with small decrements in offspring academic performance that continue into adolescence.

Copyright 2010, Elsevier Science


Office of Applied Studies, Substance Abuse and Mental Health Services Administration. The NSDUH Report: Adolescent Smoking and Maternal Risk Factors. (May 7, 2010). Rockville MD: Substance Abuse and Mental Health Administration, 2010. (6 refs.)

The National Survey on Drug Use and Health (NSDUH) allows an examination of some potential risk factors for adolescent cigarette use and the extent to which exposure to these risk factors is associated with an increased likelihood of adolescents becoming smokers. This report examines mothers' smoking and mothers' depression as possible risk factors for their adolescent children's cigarette use. The key findings in this report are based on combined 2005 to 2007 NSDUH data from the subsample of mothers aged 18 or older and their children aged 12 to 17 who lived in the same households.4 NSDUH asks persons aged 12 or older to report whether they smoked cigarettes. It also asks persons aged 18 or older questions to determine whether they experienced a major depressive episode (MDE) in the past year. Among adolescents living with their mothers, 9.7 percent lived with mothers who had major depressive episode (MDE) in the past year, and 25.6% lived with mothers who used cigarettes in the past month. Adolescents living with mothers who had past year MDE had a higher rate of past month smoking than those living with mothers who did not have MDE (14.3 vs. 7.9%), and adolescents were more likely to smoke if their mothers smoked than if their mothers did not smoke (16.9 vs. 5.8%). The rate of smoking among adolescents living with their mothers was 5.6 percent for adolescents whose mothers neither smoked in the past month nor had a past year MDE, 8.1% for those whose mothers had MDE only, 15.5 percent for those whose mothers smoked only, and 25.3 percent for adolescents exposed to both maternal MDE and maternal smoking.

Public Domain


Pawson R; Owen L; Wong G. Legislating for health: Locating the evidence. Journal of Public Health Policy 31(2): 164-177, 2010. (35 refs.)

This article examines the timorous courtship between public health law and evidence-based policy. Legislation, in the form of direct prescriptions or proscriptions on behaviour, is perhaps the most powerful tool available to the public health policymaker. Increasingly, the same policymakers have striven to ensure that interventions are based soundly on a secure evidence base. The modern mantra is that the policies to follow are the ones that have been demonstrated to work. Legislative interventions, involving trade-offs between public benefit and private interests, present formidable challenges for the evaluator. Systematic reviews of their overall efficacy, the main tool of evidence-based policy, are in their infancy. The article presents a design for such reviews using the example of a forthcoming synthesis on the effectiveness of banning smoking in cars carrying children.

Copyright 2010, Palgrave MacMillan


Pawson R; Wong G; Owen L. Known knowns, known unknowns, unknown unknowns: The predicament of evidence-based policy. American Journal of Evaluation 32(4): 518-546, 2011. (66 refs.)

The authors present a case study examining the potential for policies to be "evidence-based." To what extent is it possible to say that a decision to implement a complex social intervention is warranted on the basis of available empirical data? The case chosen is whether there is sufficient evidence to justify banning smoking in cars carrying children. The numerous assumptions underpinning such legislation are elicited, the weight and validity of evidence for each is appraised, and a mixed picture emerges. Certain propositions seem well supported; others are not yet proven and possibly unknowable. The authors argue that this is the standard predicament of evidence-based policy. Evidence does not come in finite chunks offering certainty and security to policy decisions. Rather, evidence-based policy is an accumulative process in which the data pursue but never quite capture unfolding policy problems. The whole point is the steady conversion of "unknowns" to "knowns."

Copyright 2011, Sage Publications


Pawson R; Wong G; Owen L. Myths, facts and conditional truths: What is the evidence on the risks associated with smoking in cars carrying children? Canadian Medical Association Journal 183(10): E680-E684, 2011. (16 refs.)

This article is a response to a spat of articles on the dangers to children exposed to second-hand smoke in cars. One of the letters challenged the use of a widely cited but unsubstantiated statistic that second-hand smoke was 23 times more toxic in a vehicle than in the home. This article provides a review of the evidence on the effects of second-hand smoke in cars. The health impact is a function of multiple factors, including the nature of the pollutant, the prevalence, the exposure, and the sensitivity. The question of the effect of ventilation also needs to be considered, as does the question of how comparable are the risks to those of other environments. A major point made is that there is an understandable tendency for researchers, policy- and decision-makers, clinicians and others to simplify scientific findings into convenient sound bites, which can lead to unintended consequences, such as misuse of the evidence on the risks associated with smoking in cars. While simple messages may be necessary, when the underlying evidence is complex, cautious presentation is needed. However, the need for policy is recognized. The author concludes "Incomplete knowledge is no reason for postponing policy decisions or short-circuiting them via the installation of absolutist regulatory edicts. There is an abundance of evidence to help legislators decide on this matter, but that evidence always consists of conditional truths. Policy based on science and evidence has to exist amid uncertainty, and this is managed by acknowledging the contingencies. Thus, i) because of the confirmed cabin space, and ii) under the worst ventilation conditions, and iii) in terms of peak contamination, the evidence permits us to say that smoking in cars generates fine particulate concentration that are, iv) very rarely experienced in the realm of air-quality studies, and that will thus constitute a significant health risk because, v) exposure to smoking in cars is still commonplace, and vi) children are particularly susceptible and vii) are open to furthther contamination if their parents are smokers.

Copyright 2011, Canadian Medical Association


Ronel N; Levy-Cahana M. Growing-up with a substance-dependent parent: Development of subjective risk and protective factors. Substance Use & Misuse 46(5): 608-619, 2011. (68 refs.)

A qualitative phenomenological study of high-risk adolescents, who are children of substance-dependent parents, explored the presence of subjective risk and protective factors. Nineteen adolescents were interviewed, all of whom had a father or both parents either actively dependent on psychoactive substances or recovering from substance dependence. The participants were assigned to one of two groups, based on the degree to which they maintained normative lives or had misused substances themselves. It was found that certain perceptions of the participants, concerning themselves and their parents, served as either subjective risk or protective factors, respectively. Implications for the treatment of this population are outlined.

Copyright 2011, Informa Healthcare


Rudolph AE; Jones KC; Latkin C; Crawford ND; Fuller CM. The association between parental risk behaviors during childhood and having high risk networks in adulthood. Drug and Alcohol Dependence 118(2-3): 437-443, 2011. (29 refs.)

Background: Prior research suggests that both social networks and parent drug use influence individual drug use among adolescents and that peers continue to influence drug use among adults. This analysis aims to determine whether parent drug use during childhood is associated with having drug-using networks in adulthood after adjusting for individual adult drug use. Methods: 650 young adult drug users were recruited through targeted street outreach and respondent-driven sampling in New York City (2006-2009). Baseline surveys ascertained demographics, network characteristics, drug use behaviors, and parental drug use during childhood. Negative binomial regression was used to evaluate this association. Results: The median age was 33 years, 22% injected, 49% were Black, and during childhood 26% of mothers, 32% of fathers, and 13% of primary caregivers used drugs. After adjustment, having >1 parent who used drugs was associated with having a greater proportion of drug using (Adjusted Prevalence Ratio [APR] = 1.18; 95%CI: 1.01-1.38) and specifically crack-smoking networks (APR = 1.71; 95%CI: 1.21-2.43) in adulthood. Females' networks consisted of more drug users (APR = 1.18; 95%CI: 1.01-1.38), injectors (APR = 1.44; 95%CI: 1.09-1.90), crack smokers (APR = 1.48; 95%CI: 1.18-1.87) and heroin users (APR = 1.43; 95%CI: 1.13-1.81); blacks had a greater proportion of crack smoking (APR = 1.41; 95%CI: 1.09-1.82), but a smaller proportion of injecting (APR = 0.64; 95%CI: 0.43-0.94) and heroin smoking (APR = 0.60; 95%CI: 0.47-0.77) networks as adults. Conclusions: These data suggest that parental drug use is independently associated with having drug-using networks in adulthood. Interventions that target parents and caregivers and that promote drug cessation could impede risky network formation in both adolescents and adults.

Copyright 2011, Elsevier Science


Salvo EPD; Liu YH; Brenner S; Weitzman M. Adult household smoking is associated with increased child emotional and behavioral problems. Journal of Developmental and Behavioral Pediatrics 31(2): 107-115, 2010. (67 refs.)

Context: Although maternal smoking has been associated with child emotional and behavioral problems, to our knowledge, no study has evaluated the association between overall household smoking and such problems. Objectives: To investigate whether children who live with smokers are more likely than children who do not live with smokers to have emotional or behavioral problems and to explore this association in households with nonsmoking mothers. Design, Setting, and Participants: Nationally representative data from the 2000 to 2004 medical expenditure panel surveys, involving 30,668 children aged 5 to 17 years, were used. Associations between child emotional or behavioral problems and household smoking, and child, maternal, and family characteristics were examined. SUDAAN software was used to adjust for complex sampling design. Main Outcome Measures: Overall score on the Columbia Impairment Scale, a 13-item parent-report measure of child emotional or behavioral functioning (range, 0-52, >= 16 indicates a child with such problems). Results: Children in smoking versus nonsmoking households were significantly more likely to have behavioral problems (17.39% vs 9.29%, p < .001). After adjusting for all covariates, male sex, older age of child, younger age of mother, unmarried mother, maternal depression, and below average maternal physical and mental health, each were independently associated with increased likelihood of emotional and behavioral problems, as was the presence of one or more adult smokers in the household (adjusted odds ratio 1.42; 95% confidence interval: 1.26-1.60). The odds of Columbia Impairment Scale score >= 16 increased with increasing number of smokers in the household, even among children whose mothers did not smoke. Conclusion: Children living with smokers are at increased risk for emotional or behavioral problems, and rates of such problems increase with increasing numbers of smokers in the household, even in the absence of maternal smoking.

Copyright 2010, Lippincott, Williams & Wilkins


Sarkola T; Gissler M; Kahila H; Autti-Ramo I; Halmesmaki E. Early healthcare utilization and welfare interventions among children of mothers with alcohol and substance abuse: A retrospective cohort study. Acta Paediatrica 100(10): 1379-1385, 2011. (23 refs.)

Aim: Early childhood healthcare utilization, mortality and welfare interventions were studied among children of mothers with identified gestational alcohol and/or substance abuse. Methods: Register-based retrospective cohort study. The exposed cohort consisted of 638 children born to 524 women followed up antenatally 1992-2001 at special outpatient clinics in the capital area of Finland. Nonexposed children (n = 1914) born to control women were matched for maternal age, parity, number of foetuses, month of birth and delivery hospital of the index child. Postnatal data of both cohorts were collected from national registers until 2007. Results: The exposed cohort displayed twice the amount of in- and outpatient hospital care episodes compared with nonexposed children. Differences attributable to exposure were found in categories of conditions originating in the perinatal period, mental and behavioural disorders, and nonspecific factors influencing health status and contact with health services. This was reflected in amounts of reimbursements for drugs of the central nervous system, as well as special care allowances and rehabilitation for mental and behavioural disorders. The highest degree of healthcare utilization was observed among exposed children placed in out-of-home care. One-third of these children received outpatient care and one-tenth required inpatient care for a mental and behavioural disorder. No significant differences were found in early mortality. Conclusion: The exposed children displayed significant neonatal and early mental and behavioural healthcare utilization, and need for significant psychosocial support during their first decade of life.

Copyright 2011, Wiley-Blackwell


Schuck K; Otten R; Kleinjan M; Bricker JE; Engels RC. Effectiveness of proactive telephone counselling for smoking cessation in parents: Study protocol of a randomized controlled trial. BMC Public Health 11: e-732, 2011. (21 refs.)

Smoking is the world's fourth most common risk factor for disease, the leading preventable cause of death, and it is associated with tremendous social costs. In the Netherlands, the smoking prevalence rate is high. A total of 27.7% of the population over age 15 years smokes. In addition to the direct advantages of smoking cessation for the smoker, parents who quit smoking may also decrease their children's risk of smoking initiation. A randomized controlled trial will be conducted to evaluate the effectiveness of proactive telephone counselling to increase smoking cessation rates among smoking parents. A total of 512 smoking parents will be proactively recruited through their children's primary schools and randomly assigned to either proactive telephone counselling or a control condition. Proactive telephone counselling will consist of up to seven counsellor-initiated telephone calls (based on cognitive-behavioural skill building and Motivational Interviewing), distributed over a period of three months. Three supplementary brochures will also be provided. In the control condition, parents will receive a standard brochure to aid smoking cessation. Assessments will take place at baseline, three months after start of the intervention (post-measurement), and twelve months after start of the intervention (follow-up measurement). Primary outcome measures will include sustained abstinence between post-measurement and follow-up measurement and 7-day point prevalence abstinence and 24-hours point prevalence abstinence at both post- and follow-up measurement. Several secondary outcome measures will also be included (e.g., smoking intensity, smoking policies at home). In addition, we will evaluate smoking-related cognitions (e.g., attitudes towards smoking, social norms, self-efficacy, intention to smoke) in 9-12 year old children of smoking parents. This study protocol describes the design of a randomized controlled trial to evaluate the effectiveness of proactive telephone counselling in smoking cessation. It is expected that, in the telephone counseling condition, parental smoking cessation rates will be higher and children's cognitions will be less favorable about smoking compared to the control condition.

Copyright 2011, BioMed Central


Singh GK; Siahpush M; Kogan MD. Disparities in children's exposure to environmental tobacco smoke in the United States, 2007. Pediatrics 126(1): 4-13, 2010. (22 refs.)

OBJECTIVES: This study examined racial/ethnic, socioeconomic, and geographic disparities in children's exposure to environmental tobacco smoke (ETS) or secondhand smoke in the home. METHODS: The 2007 National Survey of Children's Health (N = 90 853) was used to calculate the prevalence of children's exposure to ETS. State-level data on home smoking ban from the 2006-2007 Current Population Survey-Tobacco Use Supplement were used to supplement analyses. Logistic regression was used to estimate adjusted odds of exposure. RESULTS: In 2007, 7.6% of US children, or 5.5 million children, lived in households where someone smoked inside the home. The prevalence varied from a low of 1.1% for Utah and 1.9% for California to a high of 17.9% for West Virginia and 17.6% in Kentucky. After adjustment for sociodemographic factors, children in Ohio, West Virginia, Kentucky, and Pennsylvania had 12 times higher odds and those in Wisconsin, Missouri, Delaware, and the District of Columbia had 10 times higher odds of being exposed to ETS than children in Utah. Compared with children from higher socioeconomic backgrounds, Hispanic ethnicity, and non-English-speaking households, children from lower socioeconomic backgrounds had 7.3 to 10.6 times higher adjusted odds; non-Hispanic white, black, American Indian, and mixed-race children had 2.0 to 2.6 times higher odds; and children from English-speaking households had 4.1 times higher odds of ETS exposure. CONCLUSIONS: Considerable disparities exist in children's exposure to ETS, with geographic pattern strongly related to home smoking ban. Greater exposure to ETS among children in several states and disadvantaged socioeconomic groups is likely to exacerbate existing health disparities.

Copyright 2010, American Academy of Pediatrics


Singh SP; Gundavarapu S; Pena-Philippides JC; Rir-sima-ah J; Mishra NC; Wilder JA et al. Prenatal secondhand cigarette smoke promotes Th2 polarization and impairs goblet cell differentiation and airway mucus formation. Journal of Immunology 187(9): 4542-4552, 2011. (74 refs.)

Parental, particularly maternal, smoking increases the risk for childhood allergic asthma and infection. Similarly, in a murine allergic asthma model, prenatal plus early postnatal exposure to secondhand cigarette smoke (SS) exacerbates airways hyperre-activity and Th2 responses in the lung. However, the mechanism and contribution of prenatal versus early postnatal SS exposure on allergic asthma remain unresolved. To identify the effects of prenatal and/or early postnatal SS on allergic asthma, BALB/c dams and their offspring were exposed gestationally and/or 8-10 wk postbirth to filtered air or SS. Prenatal, but not postnatal, SS strongly increased methacholine and allergen (Aspergillus)-induced airway resistance, Th2 cytokine levels, and atopy and activated the Th2-polarizing pathway GATA3/Lck/ERK1/2/STAT6. Either prenatal and/or early postnatal SS downregulated the Th1-specific transcription factor T-bet and, surprisingly, despite high levels of IL-4/IL-13, dramatically blocked the allergen-induced mucous cell metaplasia, airway mucus formation, and the expression of mucus-related genes/proteins: Muc5ac, gamma-aminobutyric acid A receptors, and SAM pointed domain-containing Ets-like factor. Given that SS/nicotine exposure of normal adult mice promotes mucus formation, the results suggested that fetal and neonatal lung are highly sensitive to cigarette smoke. Thus, although the gestational SS promotes Th2 polarization/allergic asthma, it may also impair and/or delay the development of fetal and neonatal lung, affecting mucociliary clearance and Th1 responses. Together, this may explain the increased susceptibility of children from smoking parents to allergic asthma and childhood respiratory infections.

Copyright 2011, American Association of Immunologists


Stanger C; Ryan SR; Fu HY; Budney AJ. Parent training plus contingency management for substance abusing families: A Complier Average Causal Effects (CACE) analysis. Drug and Alcohol Dependence 118(2-3): 119-126, 2011. (50 refs.)

Background: Children of substance abusers are at risk for behavioral/emotional problems. To improve outcomes for these children, we developed and tested an intervention that integrated a novel contingency management (CM) program designed to enhance compliance with an empirically-validated parent training curriculum. CM provided incentives for daily monitoring of parenting and child behavior, completion of home practice assignments, and session attendance. Methods: Forty-seven mothers with substance abuse or dependence were randomly assigned to parent training + incentives (PTI) or parent training without incentives (PT). Children were 55% male, ages 2-7 years. Results: Homework completion and session attendance did not differ between PTI and PT mothers, but PTI mothers had higher rates of daily monitoring. PTI children had larger reductions in child externalizing problems in all models. Complier Average Causal Effects (CACE) analyses showed additional significant effects of PTI on child internalizing problems, parent problems and parenting. These effects were not significant in standard Intent-to-Treat analyses. Conclusion: Results suggest our incentive program may offer a method for boosting outcomes.

Copyright 2011, Elsevier Science


Strathearn L; Mayes LC. Cocaine addiction in mothers: Potential effects on maternal care and infant development. Annals of the New York Academy of Sciences. Addiction Reviews 2 1187: 172-183, 2010. (106 refs.)

Maternal cocaine addiction is a significant public health issue particularly affecting children, with high rates of reported abuse, neglect, and foster care placement. This review examines both preclinical and clinical evidence for how cocaine abuse may affect maternal care and infant development, exploring brain, behavioral, and neuroendocrine mechanisms. There is evidence that cocaine affects infant development both directly, via in utero exposure, and indirectly via alterations in maternal care. Two neural systems known to play an important role in both maternal care and cocaine addiction are the oxytocin and dopamine systems, mediating social and reward-related behaviors and stress reactivity. These same neural mechanisms may also be involved in the infant's development of vulnerability to addiction. Understanding the neuroendocrine pathways involved in maternal behavior and addiction may help facilitate earlier, more effective interventions to help substance-abusing mothers provide adequate care for their infant and perhaps prevent the intergenerational transmission of risk.

Copyright 2010, New York Academy of Sciences


Sullivan KM; Bottorff J; Reid C. Does mother's smoking influence girls' smoking more than boys' smoking? A 20-year review of the literature using a sex- and gender-based analysis. (review). Substance Use & Misuse 46(5): 656-668, 2011. (72 refs.)

A systematic literature review was conducted to examine whether mother's smoking influences girls' smoking more than boys' smoking. Fifty-seven studies, published between 1989 and 2009, were analyzed using a sex and gender lens. Results indicate that mother's prenatal and postnatal smoking influences girls' smoking more than boys' smoking. Despite evidence that sex and gender are important determinants of smoking among adolescents when examined in relation to mother's smoking, the theoretical understanding of why girls are more likely to smoke if prenatally and postnatally exposed to mother's smoking remains unclear. Implications for future research are discussed.

Copyright 2011, Informa Healthcare


Templeton L; Novak C; Wall S. Young people's views on services to help them deal with parental substance misuse. Drugs: Education, Prevention and Policy 18(3): 172-178, 2011. (21 refs.)

Aim: Services for children of parental substance misusers are in their infancy. There is a dearth of research which has heard from children about how they view and benefit from such services. The aim of this article is to present qualitative data from children and young people who have attended three new family-focused services. Methods: As part of the evaluations of three new services for children and families of parental substance misusers, interviews were conducted with young people. Qualitative interview data from 23 young people were thematically analysed. Findings: Young people benefitted through meeting other people and having an opportunity to talk and share experiences, learning about addiction and understanding and controlling their emotions. Their families became safer, healthier and more cohesive. Conclusions: Children living with parental substance misuse need specific support; all three services are excellent examples of service development in this area.

Copyright 2011, Taylor & Francis


Templeton L. Meeting the needs of children with the 5-Step Method. Drugs: Education, Prevention and Policy 17(special issue): 113-128, 2010. (71 refs.)

The stress-strain-coping-support model of how adult family members are affected by a relative's substance misuse is equally relevant to children who live with parental or familial substance misuse. To date, the main beneficiaries of the 5-Step Method have been adult family members, yet children can benefit from familial intervention generally and the 5-Step Method specifically. This article will consider the implications of the 5-Step Method for children in two ways. First, there will be a summary, based on the analysis of qualitative data from 5-Step research studies, of how the method can benefit children following delivery with an adult family member. Second, there will be a discussion of how the 5-Step Method can be extended so that children might benefit further from this intervention. The opportunities which this extension could bring, as well as implications for practice and research, will be discussed. The focus of this article will be the UK, but international research as well as the potential for the wider reach of the 5-Step Method to children across the world, will be discussed.

Copyright 2010, Taylor & Francis


Twomey JE; Caldwell D; Soave R; Fontaine LA; Lester BM. Vulnerable infants program of Rhode Island: Promoting permanency for substance-exposed infants. Child Welfare 89(3): 121-U4, 2010. (40 refs.)

The Vulnerable Infants Program of Rhode Island is a care coordination program to promote permanency for substance-exposed infants by addressing parental needs and increasing collaboration among social service agencies. Over the first four years of the program, there was a decrease in time spent in the newborn nursery beyond medical necessity and identification of permanent placements by 12 months for 84% of infants, with the majority of infants (78%) placed with biological parents or relatives.

Copyright 2010, Child Welfare League


Woolfall K; Sumnall H. Evaluating interventions for children of substance using parents: A review of outcome measures. Addiction Research & Theory 18(3): 326-343, 2010. (62 refs.)

Method: A comprehensive literature search identified outcome measures suitable for research with this vulnerable population. This included measures for both children and their parents to ensure that outcomes are contextualised in relation to parental behaviour and home environment. Results: Seventeen outcome measures suitable for use with children and seven measures for use with substance using parents are presented. Issues relating to measurement selection are then discussed. Conclusions: This article highlights the need for the use of better measures to assess community based interventions in the UK to inform the development of services for children affected by parental substance use.

Copyright 2010, Taylor & Francis


Wyszynski CM; Bricker JB; Comstock BA. Parental smoking cessation and child daily smoking: A 9-year longitudinal study of mediation by child cognitions about smoking. Health Psychology 30(2): 171-176, 2011. (28 refs.)

Objective: This study investigated to what extent the prospective relationship between parental smoking cessation and child daily smoking is mediated by child cognitions about smoking. Design: The study drew its sample from the 40 Washington State school districts involved in the Hutchinson Smoking Prevention Project. The predictor variable of parental smoking cessation was measured during third grade. The mediator measures, consistent with the Theory of Planned Behavior and Social Cognitive Theory, were measured during ninth grade, and the smoking status outcome was measured during twelfth grade. Main Outcome Measures: Smoking status at twelfth grade. Results: Negative general attitudes toward smoking, attitude that cigarette smoke is bothersome, and tobacco refusal self-efficacy together significantly mediated 49% of the prospective relationship between parental smoking cessation and child daily smoking. Conclusion: Parental smoking cessation before children reach third grade may lead children to develop more negative cognitions about smoking, and, in turn, reduce their risk of smoking.

Copyright 2011, American Psychological Association


Xian H; Scherrer JF; Pergadia ML; Madden PAF; Grant JD; Sartor CE et al. Contribution of parental psychopathology to offspring smoking and nicotine dependence in a genetically informative design. Journal of Studies on Alcohol and Drugs 71(5): 664-673, 2010. (34 refs.)

Objective: It is not known if parental psychiatric disorders have an independent effect on offspring smoking after controlling for genetic and environmental vulnerability to nicotine dependence. We tested if parental alcohol, drug, or conduct disorders; antisocial personality disorder; depression; and anxiety disorders remained significant predictors of offspring smoking initiation, regular smoking, and nicotine dependence before and after adjusting for genetic and environmental risk for nicotine dependence. Method: Data were obtained via semi-structured interviews with 1,107 twin fathers, 1,919 offspring between the ages of 12 and 32, and 1,023 mothers. Genetic and environmental liability for smoking outcomes was defined by paternal and maternal nicotine dependence. Multinomial logistic regression models were computed to estimate the risk for offspring trying cigarettes, regular smoking, and the Fagerstrom Test for Nicotine Dependence (FTND) as a function of parental psychopathology and sociodemographics before and after adjusting for genetic and environmental vulnerability to nicotine dependence. Results: Before adjusting for genetic and environmental risk for nicotine dependence, ever trying cigarettes was associated with maternal depression, regular smoking was associated with maternal alcohol dependence and maternal conduct disorder, and FTND was associated with paternal and maternal conduct disorder and antisocial personality disorder. No parental psychopathology remained significantly associated with regular smoking and FTND after adjusting for genetic and environmental vulnerability to nicotine dependence in a multivariate model. Conclusions: The association between parental psychopathology and offspring smoking outcomes is partly explained by genetic and environmental risk for nicotine dependence. Point estimates suggest a trend for an association between parental antisocial personality disorder and offspring regular smoking and nicotine dependence after adjusting for genetic and environmental vulnerability. Studies in larger samples are warranted.

Copyright 2010, Alcohol Reearch Documentation


Yolton K; Xu YY; Khoury J; Succop P; Lanphear B; Beebe DW; Owens J. Associations between secondhand smoke exposure and sleep patterns in children. Pediatrics 125(2): E261-E268, 2010. (55 refs.)

OBJECTIVES: The objective of this study was to investigate the relationship between exposure to secondhand smoke (SHS) and child sleep patterns among a group of children with asthma who were exposed regularly to tobacco smoke at home. METHODS: We studied 219 children who were enrolled in an asthma intervention trial and were exposed regularly to SHS. Serum cotinine levels were used to measure exposure to tobacco smoke, and sleep patterns were assessed through parent reports using the Children's Sleep Habits Questionnaire. Covariates in adjusted analyses included gender, age, race, maternal marital status, education, and income, prenatal tobacco exposure, maternal depression, Home Observation for Measurement of the Environment total score, household density, asthma severity, and use of asthma medications. RESULTS: Exposure to SHS was associated with sleep problems, including longer sleep-onset delay (P = .004), sleep-disordered breathing (P = .02), parasomnias (P = .002), daytime sleepiness (P = .022), and overall sleep disturbance (P = .0002). CONCLUSIONS: We conclude that exposure to SHS is associated with increased sleep problems among children with asthma.

Copyright 2010, American Academic Pediatrics