AUGUST 1, 2026 - A new study from Clalit-Soroka University Medical Center and Ben-Gurion University of the Negev indicates that parents who smoke outdoors, such as on balconies or near open windows, may still expose their children to harmful tobacco smoke residues. Published in the journal Scientific Reports, the research titled "Environmental tobacco smoke and sleep fragmentation in children with suspected sleep apnea" sheds light on the risks associated with smoking around children.
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Prof. Ariel Tarasiuk, director of the sleep disorders unit at the hospital and an expert in sleep apnea, explained that residues from tobacco smoke can transfer indoors via clothing and hair, leading to ongoing exposure for children even when smoking occurs outside. Continuous sleep is vital for childhood brain development, and repeated sleep fragmentation may impair cognitive and behavioral functioning. He emphasized that the only effective way to safeguard children is to maintain completely smoke-free homes and vehicles.
The study found measurable urinary cotinine, a nicotine metabolite, in children whose parents claimed to smoke only outdoors. Residues from tobacco cling not only to clothing but also to hair and skin, making hand washing and changing clothes insufficient for eliminating exposure. Researchers observed that children exposed to cigarette smoke experienced poorer sleep quality, shorter durations of sleep, and significantly more nighttime awakenings. Contrary to parental beliefs, about 60% of parents reported that their children were not exposed to smoke, while urine tests indicated otherwise.
The findings highlight the issue of third-hand smoke—toxins remaining on surfaces and personal items long after smoking. The study included children aged one to 12, nearly half of whom lived in households with at least one smoking parent. The researchers combined sleep evaluations in a lab setting with cotinine testing, establishing a connection between nicotine exposure and sleep disruption.
Children with higher cotinine levels exhibited reduced sleep efficiency and 67% more nighttime awakenings. The implications of fragmented sleep are serious, being linked to learning difficulties, behavioral issues, and obesity. Sleep-disordered breathing, affecting up to 5% of children, can also be exacerbated by such exposure. The researchers recommend healthcare providers routinely inquire about household smoking during evaluations of children with sleep disorders.
Regarding vaping, Tarasiuk noted that their study focused solely on conventional tobacco smoke exposure and could not address the impact of e-cigarettes on children's health. Previous evidence links e-cigarette use to disrupted sleep and respiratory harm, raising concerns over potential risks to children's sleep quality.
The researchers stress the need for public health campaigns to address the dangers of third-hand smoke more prominently and acknowledge that their findings call for further research to better understand the broader population implications.