School of Economics, College of Business and Economics, University of Johannesburg, Johannesburg, South Africa.
PLoS One. 2023 Feb 9;18(2):e0268313. doi: 10.1371/journal.pone.0268313. eCollection 2023.
Tobacco use and obesity are major public health problems and part of the leading causes of preventable disease and death worldwide. The prevalence of overweight children has escalated over the years; making the weight gain in children a critical issue for health professionals and academics alike. This study examines the association between maternal tobacco use and body weight abnormalities among South African children.
The study uses data from the National Income Dynamics Study (NIDS), conducted from 2008 to 2017. The survey is available in five waves which have been merged into a panel dataset of 211,718 children aged between 0 to 5 years old, drawn from a nationally representative sample of households followed across time. Thus, the subgroup of children aged between 6 and 15 years old was excluded from the analysis. The empirical investigation employs a logistic regression model to estimate the marginal effect of maternal smoking on childhood overweight prevalence measured by three anthropometric based proxies, namely risk of child overweight, child overweight and child obesity. This framework assumes unobserved child characteristics to be uncorrelated with independent variables (random effect assumption); hence allowing to control for time-invariant sociodemographic factors which are likely to affect child nutritional health.
In addition to sociodemographic and health characteristics of mothers, empirical findings suggest that maternal smoking exhibits a significant odds and/ or probability of weight abnormalities in children. Notably, children of smoking mothers are likely to be obese, overweight, or at risk of becoming overweight with a possible coexistence of mother-child overweight. Similarly, weight irregularities in children are likely to increase with mother's age. Conversely, married mothers although associated with increased odds of children having high BMI, display a reduced probability of children being abnormally weighted. Finally, child support grant has the potential to improve children nutritional health as children whose mothers are recipient of such grant have a negative probability of having high BMI.
Overall, maternal smoking contributes to child overweight and/or obesity in south Africa; suggesting that maternal healthy lifestyle could be an alternative strategic tool to fight against overweight in children. However, mothers' inability to remain and/or follow a healthy life style is plausible as age increases, with spillover effect on child care. Thus, policymakers should prioritize programs to reduce smoking, especially amongst pregnant women and caregivers, to minimise the risk of overweight in children. Promoting the consumption of healthy foods accompanied by physical activity may reduce mothers' stress levels and their incentive to self-medicate using tobacco substances. In addition, comprehensive action programs including child support grant and recommendations for treatment plans that address the problems of children who are already suffering from overweight, remain essential.
吸烟和肥胖是主要的公共卫生问题，也是全球可预防疾病和死亡的主要原因之一。超重儿童的比例逐年上升；因此，儿童体重增加是健康专业人员和学者都关注的一个关键问题。本研究调查了南非儿童中母亲吸烟与体重异常之间的关系。
本研究使用了 2008 年至 2017 年期间进行的国家收入动态研究（NIDS）的数据。该调查有五个波次，已合并为一个面板数据集，其中包含了来自全国代表性家庭的 211718 名 0 至 5 岁的儿童，这些儿童在时间上进行了跟踪。因此，排除了 6 至 15 岁的儿童亚组进行分析。实证研究采用逻辑回归模型来估计母亲吸烟对通过三种基于人体测量学的指标（即儿童超重风险、儿童超重和儿童肥胖）测量的儿童超重流行率的边际效应。该框架假设不可观察的儿童特征与自变量不相关（随机效应假设）；因此，允许控制可能影响儿童营养健康的时间不变的社会人口因素。
除了母亲的社会人口和健康特征外，实证结果表明，母亲吸烟对儿童的体重异常有显著的几率和/或可能性。值得注意的是，吸烟母亲的孩子更有可能肥胖、超重，或者有超重的风险，而且可能存在母子同时超重的情况。同样，儿童的体重异常也可能随着母亲年龄的增长而增加。相反，虽然已婚母亲与孩子 BMI 较高的几率增加有关，但她们的孩子体重异常的可能性较低。最后，儿童抚养补助金有可能改善儿童的营养健康，因为接受这种补助金的母亲的孩子不太可能有较高的 BMI。
总的来说，母亲吸烟会导致南非儿童超重和/或肥胖；这表明，母亲健康的生活方式可能是对抗儿童超重的另一种战略工具。然而，随着年龄的增长，母亲可能无法保持和/或遵循健康的生活方式，这种情况会对儿童的照顾产生溢出效应。因此，政策制定者应优先考虑减少吸烟的计划，特别是在孕妇和照顾者中，以尽量减少儿童超重的风险。推广健康食品的消费和身体活动可能会降低母亲的压力水平，减少她们用烟草物质自我治疗的动机。此外，仍然需要综合行动方案，包括儿童抚养补助金和针对已经超重的儿童的治疗计划建议。
