Secondhand Smoke Exposure and Subsequent Academic Performance Among U.S. Youth


      Previous research shows the associations between secondhand smoke exposure and health consequences among youth, but less is known about its effect on academic performance. This study examines a dose–response relationship between secondhand smoke exposure and subsequent academic performance among U.S. youth.


      Data were from a nationally representative sample of youth non–tobacco users (aged 12–16 years) in Wave 2 (2014–2015) who completed Wave 3 (2015–2016) of the Population Assessment of Tobacco and Health Study (n=9,020). Past-7-day number of hours exposed to secondhand smoke at Wave 2 and academic performance at Wave 3 (1=Mostly As to 9=Mostly Fs) were assessed. Weighted multivariable linear regression models were used to examine the association between hours of self-reported secondhand smoke exposure at Wave 2 and academic performance at Wave 3 (1=Mostly Fs, 9=Mostly As), adjusting for covariates including sociodemographics, prior academic performance, internalizing and externalizing problems, and substance use problems. Analyses were conducted in 2019.


      More than 30% of U.S. youth non–tobacco users were exposed to secondhand smoke in the past 7 days. Compared with unexposed youth at Wave 2, those who were exposed for 1–9 hours had poorer academic performance at Wave 3 (adjusted regression coefficient= −0.11, 95% CI= −0.18, −0.04), and those who were exposed for ≥10 hours at Wave 2 had even poorer academic performance (adjusted regression coefficient = −0.31, 95% CI= −0.45, −0.18).


      A dose–response relationship was observed between secondhand smoke exposure and academic performance among U.S. youth. Reducing youth secondhand smoke exposure may promote academic performance and subsequent educational attainment.
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