Skip to main content
eScholarship
Open Access Publications from the University of California

UCSF

UC San Francisco Previously Published Works bannerUCSF

Childhood Secondhand Smoke Exposure and ADHD‐Attributable Costs to the Health and Education System

Abstract

Background

Children exposed to secondhand smoke (SHS) have higher rates of behavioral and cognitive effects, including attention deficit hyperactivity disorder (ADHD), but the costs to the health care and education systems have not been estimated. We estimate these costs for school-aged children aged 5-15.

Methods

The relative risk (RR) of ADHD from SHS exposure was obtained from our previous work. SHS exposure was measured using 2 alternative approaches--reported exposure and serum cotinine-measured exposure. RRs and SHS exposure were used to determine the number of children with SHS-attributable ADHD, and mean costs of ADHD-related health care and education services were applied to obtain SHS-attributable health care and education costs.

Results

Annual health care costs of SHS-attributable ADHD ranged from $644 million (using reported SHS exposure) to $2.05 billion (using cotinine-measured exposure). SHS-attributable costs to the education system ranged from $2.90 to $9.23 billion.

Conclusions

The costs of SHS-attributable ADHD to the education system may total more than 4 times the costs for health care. The huge economic impact of SHS exposure on the education system has not been documented previously, and suggests that reducing childhood exposure to tobacco smoke will release substantial funds that could be used for general education of all children.

Many UC-authored scholarly publications are freely available on this site because of the UC's open access policies. Let us know how this access is important for you.

Main Content
For improved accessibility of PDF content, download the file to your device.
Current View