{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T15:50:36Z","timestamp":1787932236589,"version":"build-2784847793"},"reference-count":79,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T00:00:00Z","timestamp":1750896000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82173605"],"award-info":[{"award-number":["82173605"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["20240420"],"award-info":[{"award-number":["20240420"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Sun Yat-sen University Innovation Training Program for College Students","award":["82173605"],"award-info":[{"award-number":["82173605"]}]},{"name":"Sun Yat-sen University Innovation Training Program for College Students","award":["20240420"],"award-info":[{"award-number":["20240420"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxics"],"abstract":"<jats:p>Environmental tobacco smoke (ETS) exposure is a public health concern linked to neurodevelopmental disorders like attention deficit hyperactivity disorder (ADHD). Prior studies link ETS to ADHD, but gaps remain regarding gender differences, critical exposure windows, and dose\u2013response relationships. This study assessed ETS exposure\u2019s association with ADHD-like behaviors in Chinese preschoolers, evaluating overall risk, critical periods, dose\u2013response relationships, and gender differences. Analyzing data from 64,472 preschoolers, ETS exposure (prenatal; infancy, 0\u20131; and early childhood, 1\u20133 years) was assessed via parent questionnaires, and ADHD-like behaviors were measured using the Conners\u2019 Parent Rating Scale-Revised, with associations examined via logistic regression. ETS-exposed children had a 49% higher ADHD-like behavior risk (AOR = 1.49, 95% CI: 1.38\u20131.62, p &lt; 0.001), with dose\u2013response effects: The risk increased from AOR = 1.25 (95% CI: 1.10\u20131.40) at low exposure to 2.24 (95% CI: 1.63\u20133.01) at high exposure. Prenatal (AOR = 1.42, 95% CI: 1.17\u20131.71) and infancy exposures (AOR = 1.43, 95% CI: 1.05\u20131.90) showed the strongest associations, while early childhood exposure (1\u20133 years) was non-significant (AOR = 1.04, 95% CI: 0.82\u20131.29). No gender-specific differences were observed. Early-life ETS exposure, particularly prenatally and in infancy, elevates ADHD-like behavior risk in preschoolers, demonstrating dose\u2013response trends without gender disparity, highlighting the need for universal strategies to reduce such exposures.<\/jats:p>","DOI":"10.3390\/toxics13070534","type":"journal-article","created":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T06:55:13Z","timestamp":1750920913000},"page":"534","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Association Between Environmental Smoke Exposure in Early Life and ADHD-like Behaviors in Chinese Preschoolers: Findings from Population Survey in Shenzhen"],"prefix":"10.3390","volume":"13","author":[{"given":"Yu-Liang","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Shenzhen 518107, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei-Kang","family":"Yang","sequence":"additional","affiliation":[{"name":"Shenzhen Longhua Maternity and Child Healthcare Hospital, Shenzhen 518000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7149-6395","authenticated-orcid":false,"given":"Esben","family":"Strodl","sequence":"additional","affiliation":[{"name":"School of Psychology and Counselling, Queensland University of Technology, Brisbane, QLD 4000, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mao-Lin","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Health Management, Xinhua College of Guangzhou, Guangzhou 510520, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3877-0794","authenticated-orcid":false,"given":"Wei-Qing","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Shenzhen 518107, China"},{"name":"School of Health Management, Xinhua College of Guangzhou, Guangzhou 510520, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Gao, Y., Wang, T., Duan, Z.Z., Pu, Y.P., and Zhang, J. 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