Tobacco Smoke Exposure, School Engagement, School Success, and Afterschool Activity Participation Among US Children

Ashley L. Merianos, Wura Jacobs, Afolakemi C. Olaniyan, Matthew Lee Smith, E. Melinda Mahabee-Gittens

Research output: Contribution to journalArticlepeer-review


BACKGROUND: Tobacco smoke exposure (TSE), defined as secondhand smoke (SHS) and thirdhand smoke (THS), is associated with negative health consequences. This study's objective was to assess the associations between home TSE status and school engagement, school success, and afterschool activity participation among school-aged children. METHODS: We conducted a secondary analysis of 2018-2019 National Survey of Children's Health cross-sectional data. Children ages 6-11 years (N = 17,466) were categorized into home TSE groups: no home TSE; THS exposure only; and SHS and THS exposure. Weighted logistic and Poisson regression models were built. RESULTS: Compared to children with no home TSE, children with home THS exposure only and SHS and THS exposure were at decreased odds of being engaged in school (AOR = 0.69, 95%CI = 0.57, 0.83; AOR = 0.63, 95%CI = 0.41, 0.97, respectively), and at increased odds of having ≥1 school-to-home contact about child problems in school (AOR = 1.83, 95%CI = 1.50, 2.23; AOR = 1.58, 95%CI = 1.05, 2.37, respectively). Children with THS exposure only were at increased odds of missing ≥1 school day (AOR = 1.43, 95%CI = 1.13, 1.81). Children with THS exposure only (ARR = 0.90, 95%CI = 0.83, 0.96) and SHS and THS exposure (ARR = 0.74, 95%CI = 0.61, 0.89) were at reduced likelihood of participating in a higher number of afterschool activities. CONCLUSIONS: Children exposed to home tobacco smoke are at unique risk for poorer school engagement and success.

Original languageEnglish (US)
Pages (from-to)1202-1213
Number of pages12
JournalJournal of School Health
Issue number12
StatePublished - Dec 2022


  • alcohol
  • and other drugs
  • child
  • environmental health
  • school engagement
  • school success
  • tobacco
  • tobacco smoke pollution

ASJC Scopus subject areas

  • Education
  • Philosophy
  • Public Health, Environmental and Occupational Health


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