There is a wealth of literature describing the adverse health effects of smoking. Over the last three decades public health and research has turned its attention to the impact of gestational smoke exposure on offspring outcomes. This literature base continues to expand, with epidemiological and case-control studies identifying the complex interaction of factors that produce both proximal and distal effects following gestational smoke exposure. It is now evident that cigarette smoking represents one of the more controllable environmental risk factors to the overall health of the fetus.
Prior to the late 1950s there was little concern about gestational smoke exposure. With few exceptions, the medical consensus was that the womb protected the developing fetus from environmental insult. However, the thalidomide tragedy that occurred during the late 1950s represented a cognitive shift in the conceptualization of the importance of the prenatal period (Lenz 1962). Following that event, scientists began rigorous investigation of the environmental factors that could adversely effect gestational development. Tobacco and its by-products are some of the most frequently studied teratogens. Gestational cigarette exposure studies have investigated the effect of exposure across multiple stages of development including infancy, childhood, adolescence and adulthood. Overall, these investigations provide evidence that gestational cigarette exposure has an adverse impact on development that persists throughout the early lifespan.
Simpson (1957) sparked interest in gestational smoking research following his report of the increased prevalence of prematurity and low birth weight in infants born to mothers who smoked during pregnancy. Since then, epidemiological studies have consistently demonstrated that gestational smoke exposure is associated with a 150 to 250 gram reduction in birthweight (Stein and Kline 1983), and a strong dose-response relationship. Prenatal smoking research has expanded beyond investigating the association with low birth weight to include psychological and behavioral outcomes. In recent years research has turned its gaze toward the relationship with antisocial behavior, conduct disorder and criminality.
KeywordsCigarette Smoke Maternal Smoking Prenatal Exposure Conduct Disorder Risk Tolerance
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