This review discusses the history of electronic cigarettes, user demographics, known health effects, and current legislative efforts to protect minors from exposure.
To examine the association between objectively assessed secondhand smoke (SHS) exposure and mental health in a representative sample of British children.
Community-based population sample from the 2003 Scottish Health Survey.
Nine hundred one nonsmoking children (mean [SD] age, 8.3 [2.5] years).
Exposure to SHS was determined from salivary cotinine level and self-report.
Psychological distress assessed using the Strengths and Difficulties Questionnaire (SDQ).
Forty percent of the sample demonstrated high SHS exposure (cotinine level >0.70 ng/mL). Children with higher cotinine levels were more likely to live in areas of greater socioeconomic deprivation. Participants in the highest cotinine quartile (>0.70 ng/mL) had significantly higher total SDQ scores compared with those in the lowest quartile (age- and sex-adjusted mean difference = 2.8; 95% confidence interval, 1.6 to 3.9). There was evidence of a dose-response effect across the cotinine group (P trend = .001). Of the SDQ subscales, the strongest associations with cotinine levels emerged for hyperactivity and conduct disorder. These associations remained statistically significant after adjustment for possible confounders including social deprivation, single-parent status, body mass index, chronic illness, and physical activity.
Objectively assessed SHS exposure was associated with poorer mental health among children.