Children who live in households where they are exposed to tobacco smoke miss more days of school than do children living in smoke-free homes, according to a new study appearing in Pediatrics. The study further finds that these children have higher rates of respiratory illnesses that can be caused by second-hand smoke and details the probably economic costs of their increased school absence.

The researchers found that among children ages 6 to 11 who live with smokers, one quarter to one third of school absences are due to household smoking. Nationally, these absences result in $227 million in lost wages and time for caregivers and their employers.

While earlier studies that looked at the relationship between lost school days and household smoking focused on local populations and did not evaluate the severity of the problem’s impact, this study looked at households nationwide, analyzing data from the 2005 National Health Information Study.

Of the 3,087 children whose information was analyzed for this study, more than 14% lived in a home with at least one person who smoked in the house—8% lived with one household smoker and 6% with two or more—representing 2.6 million children nationwide. Children living with one in-home smoker had an average of 1.06 more days absent, and those living with two or more had 1.54 more days absent than did children living in homes where no one smoked indoors.

Illnesses associated with exposure to tobacco smoke—including ear infections and chest colds—accounted for 24% of absences in children living in homes where one person smoked indoors and 34% of those living in homes with at least two in-home smokers. Household smoking did not increase gastrointestinal illness, and while there also was no association with an asthma diagnosis or asthma attacks, the study sample may have included too few children with asthma to reflect smoke exposure’s known role as an asthma trigger.

Calculating the potential costs associated with the need to care for children absent from school due to smoke-exposure related illness (including lost income for parents without paid time off, the costs to employers of the lost work, and the inability of caregivers not employed outside the home to take care of usual household tasks), the researchers found the absences resulted in $227 million in lost wages and time for families and employers. The researchers pointed out that since almost half the smoking households in the study had low incomes, the impact of such financial loss may be strongest on households least able to afford it.

Source: Massachusetts General Hospital