Associations of household tobacco smoking status with childhood temperament among U.S. preschool-aged children

Background: This study investigated the association between household tobacco smoking status and temperament among U.S. 3–5-year-olds. Methods: A secondary analysis of 2019–2020 National Survey of Children's Health data (N = 11,100) was conducted. Temperament dimensions of effortful control (characterized by attention focusing), negative affectivity (characterized by anger and soothability), and surgency (characterized by activity level and shyness) were assessed. Weighted ordinal regression models were conducted while adjusting for child and family covariates. Results: Approximately 13 % of children lived with smokers. Compared to children who did not live with smokers, children living with smokers displayed behaviors of poorer effortful control and were more likely to be easily distracted (AOR = 1.59, 95%CI = 1.24–2.04) and less likely to keep working on tasks until finished (AOR = 0.56, 95%CI = 0.44–0.71). Children living with smokers displayed behaviors of greater negative affectivity and were at increased odds of being angry or anxious when transitioning between activities (AOR = 1.50, 95%CI = 1.13–1.98) and losing their temper when things did not go their way (AOR = 1.53, 95%CI = 1.20–1.96), and were at decreased odds of calming down quickly when excited (AOR = 0.54, 95%CI = 0.42–0.70). Children living with smokers displayed behaviors of poorer surgency and were less likely to play well with others (AOR = 0.58, 95%CI = 0.45–0.76) and sit still compared to same-aged children (AOR = 0.56, 95%CI = 0.44–0.71). Limitations: The NSCH uses a cross-sectional survey design; longitudinal associations and objective measures could not be assessed. However, the NSCH is nationally representative and results are generalizable to U.S. 3–5-year-olds. Conclusions: Findings suggest household tobacco smoking influences temperament in early childhood. Results signify the need to promote household tobacco cessation.