Environmental tobacco smoke exposure and risk of habitual snoring in children: a meta-analysis

Sun, Ke; Zhang, Yue; Tian, Yue; Jiang, Xiubo

doi:10.1136/jech-2018-210820

Cited by 21 publications

(8 citation statements)

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“…Passive smoking might induce upper airway inflammation and the narrowing of the pharynx, thus resulting in habitual snoring [9]. In spite of some contradictory results on whether there is a significant association between exposure to SHS and an increased OR for SDB [37,38], a meta-analytic study reported a significant positive association between exposure to SHS and habitual snoring, with an increased OR for habitual snoring of 1.46 for household smoking, 1.45 for paternal smoking, 1.87 for mater-nal smoking, and 1.95 for prenatal tobacco smoking exposure [9]. The authors also reported a linear dose-response association between household smoke exposure and habitual snoring.…”

Section: Discussionmentioning

confidence: 99%

“…While adenotonsillar hypertrophy is the most common cause of SDB due to the obstruction of the upper airway, with a peak at age 3 to 5 years [2], multiple risk factors such as obesity [6], asthma [7], race [8], and exposure to secondhand smoking (SHS) [9] have been reported to contribute to the development of SDB.…”

Section: Introductionmentioning

confidence: 99%

“…Exposure to SHS has also been reported as a risk factor for SDB, due to the possibility of chronic upper airway inflammation. Sun and colleagues [9] reported an odds ratio (OR) of habitual snoring in children exposed to SHS of 1.46, 1.45, and 1.87 for household, paternal, and maternal smoking exposure, respectively, and an OR of 1.95 for prenatal exposure to SHS. Breastfeeding during infancy has been reported as another risk factor of SDB [11,12].…”

Section: Introductionmentioning

confidence: 99%

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Associations among High Risk for Sleep-disordered Breathing, Related Risk Factors, and Attention Deficit/Hyperactivity Symptoms in Elementary School Children

Kim

et al. 2020

Clin Psychopharmacol Neurosci

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Objective Habitual snoring is a common problem in children. We evaluated the association between a high risk for sleep-disordered breathing and attention deficit/hyperactivity symptoms. Methods Parents of 13,560 children aged 6 to 12 years responded to questionnaires including items on habitual snoring and the Korean attention deficit/hyperactivity disorder rating scale. The snoring score comprised the number of “yes” responses to habitual-snoring items, and a high risk for sleep-disordered breathing was defined as a snoring score ≥ 2. Results The odds ratio (OR) of a high risk for sleep-disordered breathing was significantly higher in boys (OR = 1.47; p < 0.001), overweight children (OR = 2.20; p < 0.001), and children with current secondhand-smoking exposure (OR = 1.38; p < 0.001). The Korean attention deficit/hyperactivity disorder rating scale score increased significantly with the snoring score (0 vs. 1, B = 1.56, p < 0.001; 0 vs. 2, B = 2.44, p < 0.001; 0 vs. 3, B = 2.48, p < 0.001; 0 vs. 4, B = 3.95; p < 0.001). Conclusion Our study confirms several risk factors of sleep-disordered breathing, namely male sex, overweight, and exposure to tobacco smoking, and found a positive association between habitual snoring and attention deficit/hyperactivity symptoms.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Associations among High Risk for Sleep-disordered Breathing, Related Risk Factors, and Attention Deficit/Hyperactivity Symptoms in Elementary School Children

Kim

et al. 2020

Clin Psychopharmacol Neurosci

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“…In addition to these detrimental outcomes of exposure to smoking in utero, epidemiological observational evidence links prenatal smoking to increased risks of obesity, behavioral problems, conduct disorder, attention-deficit/hyperactivity disorder (ADHD), and cognitive issues in children. [53][54][55][56][57][58][59] Recent research has revealed a dose-response relationship between maternal cotinine concentrations (indicating nicotine exposure) during pregnancy and presence of ADHD in children. 60 These associations remain even after controlling for confounding factors, such as maternal income and education and maternal and paternal ADHD diagnoses, and are linked to poor health and lower educational attainment.…”

Section: Smoking During Pregnancy Perpetuates Disparitiesmentioning

confidence: 99%

Health Disparities in Tobacco Use and Exposure: A Structural Competency Approach

et al. 2021

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Fourteen percent of US adults use tobacco products. Because many of those who use tobacco are parents and/or caregivers, children are disproportionately exposed to tobacco smoke. People who use tobacco products often become addicted to nicotine, resulting in tobacco dependence, a chronic, relapsing disease. Tobacco use and exposure are more likely to occur in vulnerable and marginalized groups, including those living in poverty. Although some view tobacco use as a personal choice, evidence suggests that structural forces play an important role in tobacco uptake, subsequent nicotine addiction, and perpetuation of use. Viewing tobacco use and tobacco dependence through a structural competency lens promotes recognition of the larger systemic forces perpetuating tobacco use, including deliberate targeting of groups by the tobacco industry, lack of enforcement of age-for-sale laws, inferior access to health insurance and health care, poor access to cessation resources, and economic stress. Each of these forces perpetuates tobacco initiation and use; in turn, tobacco use perpetuates the user’s adverse health and economic conditions. Pediatricians are urged to view family tobacco use as a social determinant of health. In addition to screening adolescents for tobacco use and providing resources and treatment of tobacco dependence, pediatricians are encouraged to systematically screen children for secondhand smoke exposure and support family members who smoke with tobacco cessation. Additionally, pediatricians can address the structural issues perpetuating tobacco use by becoming involved in policy and advocacy initiatives.

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“…HS is caused by interactions between genetic and environmental factors such as family history of snoring, adenotonsillar hypertrophy, passive smoking, and overweight or obese status (Kent & Soose, ; Schwengel, Dalesio, & Stierer, ; Sun, Zhang, Tian, & Jiang, ). Many investigators have researched varieties of possible factors associated with HS.…”

Section: Introductionmentioning

confidence: 99%

Breastfeeding and risk of habitual snoring in children: A meta‐analysis

Sun

Guo

Zhang

et al. 2019

Maternal & Child Nutrition

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Research regarding the effects of breastfeeding on habitual snoring in children has yielded conflicting results. Therefore, a meta-analysis was carried out to evaluate the effect of breastfeeding on the risk of habitual snoring in children. Relevant studies published in English or Chinese were identified by a search of PubMed, Embase, Web of Science, Chinese National Knowledge Infrastructure, China Biology Medical literature, and Wanfang databases up to October 2018. Random effects model was used to pool the findings, and results were expressed as odds ratios (OR) with 95% CIs.Eleven studies with 71,622 participants were included in the present meta-analysis.The pooled OR of habitual snoring for more versus less breastfeeding (duration) was 0.74 (95% CI [0.62, 0.90]), and the result remained significant in cohort studies (OR, 0.74; 95%CI [0.66, 0.84]). We found no evidence of publication bias. This meta-analysis of observational studies indicates that breastfeeding for a long time is associated with reduced risk of habitual snoring in children. The finding needs to be investigated in well-designed prospective studies.

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Environmental tobacco smoke exposure and risk of habitual snoring in children: a meta-analysis

Abstract: This meta-analysis of observational studies indicates that exposure to ETS, in particularly prenatal tobacco smoke exposure and maternal smoking, is associated with an increased risk of HS.

Cited by 21 publications

References 50 publications

Associations among High Risk for Sleep-disordered Breathing, Related Risk Factors, and Attention Deficit/Hyperactivity Symptoms in Elementary School Children

Associations among High Risk for Sleep-disordered Breathing, Related Risk Factors, and Attention Deficit/Hyperactivity Symptoms in Elementary School Children

Health Disparities in Tobacco Use and Exposure: A Structural Competency Approach

Breastfeeding and risk of habitual snoring in children: A meta‐analysis

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