HealthDay News — Exposure to secondhand smoke more than doubled the risk for invasive meningococcal disease in children, results of a meta-analysis show.

“Interventions to prevent second hand smoke exposure from parents and other household members […] remain an urgent priority,” Rachael L. Murray, from the University of Nottingham in the United Kingdom, and colleagues reported in BMC Public Health.

Previous studies have shown that passive smoke may play a role in the development of invasive meningococcal disease. In order to provide a comprehensive estimate of the magnitude of this effect, Murray and colleagues analyzed data from 18 studies to determine how smoking by any household member, by individual family members, and maternal smoking before and after birth affected risk for the disease in children.

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Maternal smoking during pregnancy nearly tripled the risk of invasive meningococcal disease (OR 2.93, 95% CI: 1.52-5.66), whereas smoking after birth doubled the risk (OR 2.26, 95% CI: 1.54-3.31), the researchers found. The effect of secondhand smoke was strongest in children younger than 5 years (OR, 2.48).

About 20.6% of pediatric meningococcal disease is likely attributable smoke exposure in the home, the researchers estimated using 2007 data from health surveys in England, and the 2.18 pooled odds ratio for household smoking from the current meta-analysis.

“It is likely that an extra 630 cases of invasive meningococcal disease annually in children under 16 are directly attributable to secondhand smoke exposure in UK homes,” the researchers wrote.

Study limitations include inability to adjust for a full range of potential confounders due to large variations in the published papers.

In an accompanying editorial, Harunor Rashid and Robert Booy, both of  the University of Sydney in New South Wales, Australia, said the study findings highlight the importance of promoting smoking cessation in parents.

However, they acknowledged that quitting rates in a recent large survey that included 3 billion people from 16 countries were low at less than 20%.

Vaccinating children with conjugate meningococcal vaccines (as well as the newly licensed meningococcal B vaccine) could be an appropriate strategy to protect the children, and hopefully also their adult smoker contacts (through herd immunity),” they wrote.

Other interventions, such as health education, close monitoring of children for meningococcal disease, tighter tobacco legislation and targeted interventions for quitting smoking in pregnancy, may also be useful.


  1. Murray RL et al. BMC Public Health. 2012;12:1062.
  2. Booy R, Rashid H. BMC Public Health. 2012;10:160.