# Secondhand smoke exposure among United States children with functional disabilities: National Health and Nutrition Examination Survey, 2021–2023

## TL;DR

This study finds that U.S. children with functional disabilities are more likely to be exposed to secondhand smoke at home, with disparities linked to race and education level.

## Contribution

The study identifies higher odds of secondhand smoke exposure among children with functional disabilities and highlights disparities by race and education.

## Key findings

- Over 3 million U.S. children with functional disabilities were exposed to secondhand smoke.
- Children with functional disabilities had 1.79 times higher odds of SHSe compared to those without disabilities.
- Hispanic children with disabilities had lower odds of SHSe compared to non-Hispanic White children.

## Abstract

Secondhand smoke exposure (SHSe) poses significant health problems. This study aims to examine the prevalence and factors associated with SHSe among 5–17 years old U.S. children with functional disabilities.

NHANES 2021–2023 applied Child Functioning Module to assess functional disabilities among 5–17 years old U.S. children. SHSe was defined as living in the same household with a person who is a tobacco smoker.

Over three million (32.9 %) children with functional disabilities were exposed to SHS. Children with functional disabilities had higher odds of SHSe compared with children without functional disabilities (Adjusted Odds Ratio “AOR” =1.79, 95 % CI = 1.45, 2.23). Among children with functional disabilities, Hispanic children had lower odds of SHSe compared with non-Hispanic White children (AOR = 0.36, 95 % CI = 0.18, 0.72). The odds of SHSe among children with functional disabilities were negatively associated with the household reference person's educational level (less than high school: AOR = 11.86, 95 % CI = 3.26, 43.16; high school/general educational development/some college: AOR = 6.36, 95 % CI = 2.53, 15.98; ≥ college degree as the reference).

Disparities in SHSe at home by education level and race/ethnicity among U.S. children with functional disabilities are noted and warrant tailored interventions to reduce SHSe.