Children with parents who smoke face higher risk of stunting: WHO

Second-hand smoke and maternal tobacco use put millions of children at risk of stunted growth, WHO report highlights

Children whose parents smoke are at a significantly greater risk of stunting, the World Health Organization (WHO) has cautioned. The UN agency, in its latest findings, said exposure to tobacco before and after birth can hamper growth and development, particularly in low- and middle-income countries.

 

Stunting, a condition reflecting chronic undernutrition, continues to affect nearly 150 million children worldwide.

 

Understanding stunting 

 

Stunting is a condition in which a child’s height-for-age is more than two standard deviations below the median of the WHO Child Growth Standards. Stunted children often experience delayed cognitive development, have weaker immunity, face higher risks of disease and death, and may struggle with learning and long-term health.

 

In 2022, around 148 million children worldwide were stunted. More than 50 per cent of them lived in Asia, while nearly 45 per cent were in Africa.

 

How tobacco exposure causes stunting

 

• Smoking while pregnant is linked to preterm birth, low birth weight and restricted foetal growth, all of which are predictors for stunting by age two.
• Exposure to second-hand smoke (from parents or other sources) increases the risk of respiratory infections, impedes development, and contributes to growth deficits.
• Tobacco smoke contains toxic substances that can harm foetal development and postnatal health. These include chemicals that interfere with nutrition absorption, immune response, and overall metabolic function. 

 

“Studies suggest that pre-pregnancy smoking can affect maternal health, fertility, and early embryonic development. However, there is no definitive evidence that smoking only before conception, without continuing during pregnancy, directly increases the risk of stunting. More research is needed to establish a clear link and reach firm conclusions,” said Dr Tarjnee Tiwari, resident doctor, MD Community Medicine, Sion Hospital, Mumbai.

 

Who is most affected

 

Children in low- and middle-income countries are most at risk, since these regions have both higher prevalence of parental smoking and existing burdens of malnutrition and limited healthcare infrastructure. 

 

Damage from maternal smoking during pregnancy and early childhood exposure has the greatest long-term effect on growth, making unborn babies and infants especially vulnerable. 

   

WHO’s call to action

 

The WHO is urging governments to step up tobacco control by fully implementing the WHO Framework Convention on Tobacco Control (WHO FCTC) and the MPOWER measures (Monitor, Protect, Offer help to quit, Warn, Enforce bans on advertising, and Raise taxes on tobacco). The organisation highlights several priority actions:

 

• Protect pregnant women and children from second-hand smoke
• Expand access to smoking cessation services, with a special focus on expectant mothers
• Ensure all indoor public spaces are completely smoke-free
• Strengthen tobacco regulations, raise public awareness, and use graphic health warnings
• Increase tobacco taxes and strictly ban advertising, promotion, and sponsorship

 

Why is prevention important? 

 

Reducing stunting is part of multiple global and national health goals:

 

• It supports children’s rights to health, growth, and education.
• It helps reduce health burdens (infection, lower immunity), improving survival rates.

 

Taking action on tobacco use not only cuts stunting but also reduces many other tobacco-linked diseases as they are responsible for over seven million deaths annually.

 

 

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This report is for informational purposes only and is not a substitute for professional medical advice.