Paternal smoking is associated with increased risk of child malnutrition among poor urban families in Indonesia

  • Semba R
  • Kalm L
  • De Pee S
 et al. 
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OBJECTIVE: Paternal smoking is highly prevalent in Asia, and tobacco may account for a large proportion of household expenditures among poor families. We sought to characterise the relationship between paternal smoking, child malnutrition and food expenditures.

DESIGN: Data on smoking, household expenditures and child malnutrition were examined in a stratified multistage cluster sample of households in the Indonesia nutrition surveillance system. Main outcome measures were child wasting (weight-for-height Z-score < - 2), underweight (weight-for-age Z-score < - 2) and stunting (height-for-age Z-score < - 2), and severe wasting, underweight and stunting (defined by respective Z-scores < - 3).

SETTING: In total, 175,583 households from urban slum areas in Indonesia.

SUBJECTS: Children 0-59 months of age.

RESULTS: The prevalence of paternal smoking was 73.8%. After adjusting for child gender and age, maternal age and education, and weekly per capita household expenditures, paternal smoking was associated with child stunting (odds ratio (OR) = 1.11, 95% confidence interval (CI) 1.08-1.14, P < 0.0001), severe wasting (OR = 1.17, 95% CI 1.03-1.33, P = 0.018) and severe stunting (OR = 1.09, 95% CI 1.04-1.15, P < 0.001). In households where the father was a smoker, tobacco accounted for 22% of weekly per capita household expenditures, with less money spent on food compared with households in which the father was a non-smoker.

CONCLUSIONS: Among poor families in urban slum areas of Indonesia, paternal smoking diverts household money from food to tobacco and exacerbates child malnutrition.

Author-supplied keywords

  • Food
  • Malnutrition
  • Poverty
  • Smoking
  • Tobacco

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  • Richard D. Semba

  • Leah M. Kalm

  • Saskia De Pee

  • Michelle O. Ricks

  • Mayang Sari

  • Martin W. Bloem

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