Environmental Tobacco Smoke Exposure and Children’s Intelligence at 8–11 Years of Age

BACKGROUND Evidence supporting a link between postnatal environmental tobacco smoke (ETS) exposure and cognitive problems among children is mounting, but inconsistent. OBJECTIVES We examined the relationship between ETS exposure, measured using urine cotinine, and IQ scores in Korean school-aged children. METHODS The participants were 996 children 8-11 years of age recruited from five administrative regions in South Korea. We performed a cross-sectional analysis of urinary cotinine concentrations and IQ scores obtained using the abbreviated form of a Korean version of the Wechsler Intelligence Scales for Children. Associations were adjusted for potential confounders, and estimates were derived with and without adjustment for mother's Full-Scale IQ (FSIQ) score. RESULTS After adjusting for sociodemographic and developmental covariates, urinary cotinine concentrations were inversely associated with FSIQ, Verbal IQ (VIQ), Performance IQ (PIQ), vocabulary, math, and block design scores. Following further adjustment for maternal IQ, only the VIQ scores remained significantly associated with urinary cotinine concentration (B = -0.31; 95% CI: -0.60, -0.03 for a 1-unit increase in natural log-transformed urine cotinine concentration; p = 0.03). CONCLUSION Urine cotinine concentrations were inversely associated with children's VIQ scores before and after adjusting for maternal IQ. Further prospective studies with serial measurements of cotinine are needed to confirm our findings.