The economic impact of early life environmental tobacco smoke exposure: Early intervention for developmental delay

Thaddeus Miller, Virginia A. Rauh, Sherry A.M. Glied, Dale Hattis, Andrew Rundle, Howard Andrews, Frederica P. Perera

Research output: Contribution to journalArticlepeer-review

18 Scopus citations


Background and Objectives: Early-life exposure to environmental tobacco smoke (ETS) can result in developmental delay as well as childhood asthma and increased risk of cancer. The high cost of childhood asthma related to ETS exposure has been widely recognized; however, the economic impact of ETS-related developmental delay has been less well understood. Methods and Results: The Columbia Center for Children's Environmental Health (CCCEH) has reported adverse effects of prenatal ETS exposure on child development in a cohort of minority women and children in New York City (odds ratio of developmental delay = 2.36; 95% confidence interval 1.22-4.58). Using the environmentally attributable fraction (EAF) approach, we estimated the annual cost of one aspect of ETS-related developmental delay: Early Intervention Services. The estimated cost of these services per year due to ETS exposure is > $50 million per year for New York City Medical births and $99 million per year for all New York City births. Conclusion: The high annual cost of just one aspect of developmental delay due to prenatal exposure to ETS provides further impetus for increased prevention efforts such as educational programs to promote smoke-free homes, additional cigarette taxes, and subsidizing of smoking cessation programs.

Original languageEnglish (US)
Pages (from-to)1585-1588
Number of pages4
JournalEnvironmental health perspectives
Issue number10
StatePublished - Oct 2006
Externally publishedYes


  • Asthma
  • Children
  • Developmental delay
  • Environmental tobacco smoke

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis


Dive into the research topics of 'The economic impact of early life environmental tobacco smoke exposure: Early intervention for developmental delay'. Together they form a unique fingerprint.

Cite this