Parental tobacco use and child death: Analysis of data from demographic and health surveys from South and South East Asian countries

Abstract

Background Child mortality is a public health challenge in developing countries, and exposure to second-hand smoke and prenatal exposure to smokeless tobacco are risk factors for child death. We determined the associations between parental tobacco use and child death under the age of five in eight South and South East Asian countries. Methods We analysed cross-sectional demographic and health survey data collected between 2005 and 2016, using multiple logistic regressions to estimate the unadjusted and adjusted associations between parental tobacco use and child death, accounting for demographic and economic covariates. Results Overall prevalence of tobacco smoking was 46.8% for fathers and 2.7% for mothers, smokeless tobacco use was 32.6% for fathers and 7.8% for mothers and any tobacco use was 67.1% for fathers and 10.1% for mothers. Adjusted for demographic and economic covariates, child death was significantly associated with fathers' [odds ratio: 1.10; 95% confidence interval (CI): 1.03, 1.17] and mothers' (1.44; 1.23, 1.70) smoking tobacco, fathers' (1.25; 1.17, 1.34) and mothers' (1.11; 1.00, 1.23) use of smokeless tobacco and fathers' (1.21; 1.13, 1.29) and mothers' (1.24; 1.12, 1.36) use of any tobacco. Conclusions Both smoked tobacco and smokeless tobacco policies should be aggressively implemented in public places and workplaces in developing countries, because they stimulate voluntary smoke and smokeless tobacco-free policies in homes.