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MATERNAL SMOKING AND ACUTE RESPIRATORY INFECTION SYMPTOMS AMONG YOUNG CHILDREN IN NEPAL: MULTILEVEL ANALYSIS

Published online by Cambridge University Press:  29 June 2009

GOVINDA P. DAHAL
Affiliation:
Division of Social Statistics, University of Southampton & Centre for Nepal Studies, UK
FIIFI AMOAKO JOHNSON
Affiliation:
GeoData Institute and Centre for Global Health, Population, Poverty and Policy, University of Southampton, UK
SABU S. PADMADAS
Affiliation:
Division of Social Statistics and Centre for Global Health, Population, Poverty and Policy, University of Southampton, UK

Summary

The association between maternal smoking and adverse child health outcomes has not been systematically explored in less developed countries, especially in Nepal where over a quarter of women of reproductive age smoke tobacco products. This study aims to quantify the effect of maternal smoking on acute respiratory infection (ARI) symptoms among children aged below five years, using the 2001 Nepal Demographic and Health Survey. It is hypothesized that children born to mothers who smoke frequently are at higher risk of developing ARI symptoms. Four-level random intercept logistic regression models were used to disentangle the independent effect of maternal smoking on children's ARI symptoms, controlling for potential biological, socioeconomic, seasonal and spatial variables. Maternal smoking status had a significant effect on children's ARI symptoms; the effects were significantly higher (adjusted OR 1.41; 95% CI 1.02–1.96) among those born to mothers who smoked more frequently than their counterparts. Furthermore, a strong spatial pattern was evident in the prevalence of ARI symptoms, after adjusting for maternal smoking and relevant control variables. The findings underscore the importance of designing exclusive public health intervention measures to prevent tobacco smoking within households, for example through awareness campaigns highlighting the adverse effect of maternal smoking on child health.

Type
Research Article
Copyright
Copyright © Cambridge University Press 2009

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References

Cook, D. G., Whincup, P. H., Jarvis, M. J., Strachan, D. P., Papcosta, O. & Bryan, A. (1994) Passive exposure to tobacco smoke in children aged 5–7 years: individual, family and community factors. British Medical Journal 308, 384389.CrossRefGoogle ScholarPubMed
de Meer, K., Heymans, H. S. A. & Zijlstra, W. G. (1995) Physical adaptation of children to life at high altitude. European Journal of Pediatrics 154, 263272.CrossRefGoogle ScholarPubMed
Department of Health Services (2003) Annual Report 2002–03. Ministry of Health, Kathmandu.Google Scholar
Dhakal, A., Drone, D. R., Risal, B., Ale, D. & Khanal, A. (2004) Millennium Development Goals: Monitoring Report of Civil Society, Nepal. Forum of Environmental Journalists & Nepal Network for Sustainable Development, Kathmandu.Google Scholar
DiFranza, J. R., Aligne, C. A. & Weitzman, M. (2004) Prenatal and postnatal environmental tobacco smoke exposure and children's health. Pediatrics 113, 10071015.CrossRefGoogle ScholarPubMed
Environmental Law Alliance Worldwide Advocate (2006) Nepal Bans Smoking in Public Places. E-LAW. URL: http://www.elaw.org/node/1258 (accessed 2nd August 2008).Google Scholar
Gabry, A. L., Ledoux, X., Mozziconacci, M. & Martin, C. (2003) High-altitude pulmonary edema at moderate altitude (<2400 m; 7870 feet): a series of 52 patients. Chest 123, 4953.CrossRefGoogle Scholar
Graham, N. M. (1990) The epidemiology of acute respiratory infections in children and adults: a global perspective. Epidemiological Review 12, 149178.CrossRefGoogle ScholarPubMed
Hofhuis, W., de Jongste, J. C. & Merkus, P. J. (2003) Adverse health effects of prenatal and postnatal tobacco smoke exposure on children. Archives of Diseases in Childhood 88, 10861090.CrossRefGoogle ScholarPubMed
Johnston, I. D., Strachan, D. P. & Anderson, H. R. (1998) Effect of pneumonia and whooping cough in childhood on adult lung function. New England Journal of Medicine 338, 581587.CrossRefGoogle ScholarPubMed
Mannino, D. M., Moorman, J., Kingsley, B., Rose, D. & Repace, J. (2001) Health effects related to environmental tobacco smoke exposure in children in the United States. Archives of Pediatric and Adolescent Medicine 155, 3641.CrossRefGoogle ScholarPubMed
Martiniuk, A. L. C., Lee, C. M. Y., Lam, T. H., Huxley, R., Suh, I., Jamrozik, K., Gu, D. F. & Woodward, M. (2006) The fraction of ischaemic heart disease and stroke attributable to smoking in the WHO Western Pacific and South-East Asian regions. Tobacco Control 15, 181188.CrossRefGoogle ScholarPubMed
Melsom, T., Brinch, L., Hessen, J. O., Schei, M. A., Kolstrup, N., Jacobsen, B. K., Svanes, C. & Pandey, M. R. (2001) Asthma and indoor environment in Nepal. Thorax 56, 477481.CrossRefGoogle ScholarPubMed
Ministry of Health (Nepal), New ERA & ORC Macro (2002) Nepal Demographic and Health Survey 2001. Family Health Division, Ministry of Health; New ERA and ORC Macro, Caverlton, MD, USA.Google Scholar
Mishra, V. (2003) Indoor air pollution from biomass combustion and acute respiratory illness in preschool age children in Zimbabwe. International Journal of Epidemiology 32, 847853.CrossRefGoogle ScholarPubMed
Nafstad, P., Kongerud, J., Botten, G., Hagen, J. A. & Jaakkola, J. J. (1997) The role of passive smoking in the development of bronchial obstruction during the first 2 years of life. Epidemiology 8, 293297.CrossRefGoogle ScholarPubMed
Polanska, K., Hanke, W., Ronchetti, R., van den Hazel, P., Zuurbier, M., Koppe, J. G. & Bartonova, A. (2006) Environmental tobacco smoke exposure and children's health. Acta Paediatrica Supplement 95, 8692.CrossRefGoogle ScholarPubMed
Rashbash, J., Steele, F., Browne, W. & Prosser, B. (2005) A User Guide to MLWin Version 2.0. Centre for Multilevel Modelling, University of Bristol, UK.Google Scholar
Shrestha, I. L. & Shrestha, S. L. (2005) Indoor air pollution from biomass fuels and respiratory health of the exposed population in Nepalese households. International Journal of Occupational and Environmental Health 11, 150160.CrossRefGoogle ScholarPubMed
Smith, K. R., Samet, J. M., Romieu, I. & Bruce, N. (2000) Indoor air pollution in developing countries and acute lower respiratory infections in children. Thorax 55, 518532.CrossRefGoogle ScholarPubMed
Steyn, K., de Wet, T., Saloojee, Y., Nel, H. & Yach, D. (2006) The influence of maternal cigarette smoking, snuff use and passive smoking on pregnancy outcomes: the Birth to Ten Study. Paediatric and Perinatal Epidemiology 20, 9099.CrossRefGoogle ScholarPubMed
UNDP (2004) Nepal Human Development Report 2004: Empowerment and Poverty Reduction. United Nations Development Programme, Kathmandu.Google Scholar
Wennergren, G., Amark, M., Amark, K., Oskarsdottir, S. & Sten, G. (1997) Wheezing bronchitis reinvestigated at the age of 10 years. Acta Paediatrica 86, 351355.CrossRefGoogle ScholarPubMed