The World Health Organization (WHO) has recently published a new document that highlights the harmful role of tobacco use in child stunting, a condition that affects nearly 150 million children worldwide – mostly in Africa and Asia – and that increases the risk of disease, delayed development, and even death. This publication is the eleventh in a series of tobacco knowledge summaries and recaps the current evidence on the topic. It is intended for health professionals, policy-makers, and public health advocates.
In the document, WHO calls on governments to strengthen tobacco control policies and protect children's health by reducing their exposure to tobacco smoke, especially while in the womb.
"Stunting robs children of their right to grow, learn and thrive," said Dr Etienne Krug, Director of the Department of Health Determinants, Promotion and Prevention at WHO. "Children with parents who smoke face a higher risk of stunting."
Tobacco's impact on child growth
- Children whose parents smoke face a higher risk of stunted growth, with risks increasing the more they are exposed.
- Maternal smoking during pregnancy is strongly linked to preterm birth, low birth weight and restricted fetal growth – all predictors of stunting by age two.
- Heavy smoking during pregnancy harms the baby, with stronger effects the more the mother smokes. The harm can persist well beyond infancy.
- Evidence shows that quitting smoking during pregnancy improves child growth outcomes.
Stunting impairs growth and development and occurs when a child's height-for-age is more than two standard deviations below the WHO Child Growth Standards.
A preventable risk
Tobacco smoke contains thousands of toxic chemicals that harm fetal and child development. Exposure during pregnancy contributes to growth restriction, congenital anomalies and later chronic diseases. Second-hand smoke exposure after birth worsens respiratory infections and development problems, further raising the risk of stunting.
WHO calls for urgent action
WHO urges countries to fully implement the WHO Framework Convention on Tobacco Control (WHO FCTC) and its MPOWER measures – proven strategies to cut tobacco use and protect health. This includes:
- protecting pregnant women and children from second-hand smoke;
- supporting tobacco cessation services, especially for expectant mothers; and
- enforcing smoke-free environments in all indoor public spaces.
Looking ahead
While strong evidence already links tobacco exposure to impaired child growth, WHO calls for further research to deepen understanding of the mechanisms and the benefits of cessation on stunting reduction.
Protecting pregnant women and reducing their exposure to tobacco smoke is critical to reducing stunting, improving survival and development, and advancing global health goals.
