Exposure to parental smoking and children being overweight: residence as an effect modifier

Aim: The influence of parental smoking on overweight condition of children in Indonesia is poorly understood. We assessed the association between parental smoking and child being overweight (including obesity) in urban and rural areas. Subject and methods: We performed a secondary analysis on the 2013 Riskesdas (or Basic Health Research), a cross-sectional, nationally representative survey of the Indonesian population. Height, weight, information regarding parental smoking, and basic characteristics of the study population were collected from parents with children aged 0 to 5 years (n = 63,237) in 2013. Results: Using logistic regression model adjusted for covariates, the odds ratios for smoking fathers, smoking mothers, and both parents smoking showed an association with a risk of overweight in their children. From the stratified analyses, children of smoking fathers, smoking mothers, and both parents smoking in urban areas (odds ratio (OR) (95% confidence interval (CI)): 1.28 (1.17–1.40), 20.30 (8.93–46.16), 2.40 (1.71–3.37), respectively) were associated with higher odds of overweight than those in rural areas. Conclusion: Residence was found to be an effect modifier of the relationship between parental smoking and child being overweight. Smoking cessation/intervention program ought to be put in place for adults and prioritized to areas with increased likelihood of children being overweight.