Tobacco smoke exposure and sleep duration among U.S. adolescents

Abstract

Background: Tobacco smoke exposure (TSE) and poor sleep are two public health problems with their own set of consequences.

Aims and Objectives: This study assessed whether TSE was associated with sleep duration among U.S. adolescents.

Methods: We conducted a secondary analysis of 2013-2018 National Health and Nutrition Examination Survey data including 914 nontobacco-using adolescents ages 16-19 years. TSE measures included the nicotine metabolite of serum cotinine and self-reported home TSE groups: no home TSE (did not live with smokers), home thirdhand smoke (THS) exposure (lived with ≥1 smoker who did not smoke indoors), and home secondhand smoke (SHS)+THS exposure (lived with ≥1 smoker who smoked indoors). Sleep duration was assessed categorically based on the National Sleep Foundation’s age-specific guidelines. Weighted multinomial regression models were conducted with recommended sleep hours as the reference category while adjusting for age, sex, race/ethnicity, income, body mass index z-score, sedentary activity, and caffeine intake.

Results: Adolescents with higher cotinine levels were at reduced odds to sleep <recommended hours (AOR=0.88, 95%CI=0.87-0.89), but were at increased odds to sleep >recommended hours (AOR=1.43, 95%CI=1.42-1.44). Compared to adolescents with no home TSE, adolescents with home THS exposure and home SHS+THS exposure were at increased odds to sleep <recommended hours (AOR=2.26, 95%CI=2.25-2.28; AOR=2.80, 95%CI=2.77-2.82, respectively) and >recommended hours (AOR=1.78, 95%CI=1.76-1.79; AOR=4.98, 95%CI=4.93-5.03, respectively).

Conclusions: TSE may affect insufficient and excess sleep duration among U.S. adolescents. Eliminating TSE may promote adolescent respiratory and sleep health.