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Cigarette smoking is harmful for children, especially for unborn children. Researchers found that prenatal tobacco and childhood lead exposures are associated with increased risks of attention deficit hyperactivity disorder (ADHD). Tanya Froehlich, MD, of the Cincinnati Children's Hospital Medical Center, and colleagues explained that exposure to cigarette smoke can produce an ADHD risk increase that is greater than the product of the risk factors for lead and tobacco individually. Previous studies found that about 60 percent of American children ages 4-11 are exposed to secondhand smoke at home. Studies have shown that children (especially infants) of parents who smoke have more lung illnesses, such as bronchitis and pneumonia, and can develop asthma. And because smoking parents are more likely to cough and spread germs, their children are more likely to develop chest illnesses. Researchers found between 22.5% and 47% of ADHD cases in the U.S. The findings were obtained using data from the U.S. population, the 2001-2004 National Health and Nutrition Examination Survey. In the study were investigated 3,907 children, ages 8 to 15, of whom 3,077 had data concerning ADHD diagnostic status, and 2,588 had complete data regarding lead exposure, smoke exposure, and additional predictors. At the end of the investigation they found that 8.7% of the children met ADHD criteria in the year before the survey. The proportion is equal to 2.4 million children in the U.S., the researchers added. In general ADHD depends on whether the mother had smoked during pregnancy. Blood lead utility were measured by graphite furnace atomic absorption spectrophotometry and results were divided into thirds, with a low value being 0.8 micrograms per deciliter or less and a high value being greater than 1.3 micrograms per deciliter. Researchers concluded that in the study sample, 7.7% of the children had both prenatal tobacco exposure and current lead concentrations in the highest tertile (high risk family environment and behaviors), but they accounted for 24.4% of ADHD cases. The researchers also calculated what proportion of cases might be censured on the exposures if they are in fact causing the condition. And they found that the so-called population imputable portion for prenatal tobacco exposure was 21.7%, which would coincide to 510,000 cases of ADHD in U.S. children ages 8 to 15. They also added that the population attributable fraction for both was considered at 38.2% (with a 95% certitude interval from 22.5% to 47.0 Marketing Manager
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, which would correspond to about 900,000 cases. Because of its design, the study was unable to conclude causality, the researchers warned. Another restriction was the use of a yes or no inconstant for prenatal exposure, which made it incredible to measure dose-response and timing effects.