December 10, 2003
Smoking During Pregnancy Increases Offspring Nicotine Addiction Risks

Harvard School of Public Health Associate Professor of Society, Human Development, and Health Stephen Buka and colleagues have published a study that finds a link between maternal cigarette smoking and later nicotine dependence of offspring.

Participants in the study were the grown children of mothers enrolled in the Providence, Rhode Island site of the National Collaborative Perinatal Project (NCPP), a multi-site study that involved the observation and examination of more than 50,000 pregnancies through the first seven years of life. Participants for the NCPP were enrolled between 1959 and 1966 and were visited regularly by NCPP investigators. Beginning with the first prenatal meeting and in each subsequent meeting until delivery, the mothers in the study were asked if they smoked, and if so, the number of cigarettes per day. From these data the researchers were able to establish the maximum number of cigarettes smoked at any point during the pregnancy. More than 60 percent of the women smoked during their pregnancies; approximately 35 percent smoked more than a pack per day (20 cigarettes) and nearly 25 percent smoked less than a pack per day.

Offspring whose mothers reported smoking a pack or more of cigarettes per day during their pregnancy were significantly more likely to meet DSM criteria for lifetime nicotine dependence than offspring of mothers who never smoked during their pregnancy. Among offspring who tried cigarettes, the odds of progressing to nicotine dependence was almost twice as great for those whose mothers smoked heavily during pregnancy. In contrast, the use of marijuana was not increased among children whose mothers smoked cigarettes during pregnancy. Marijuana use among the adult offspring was of particular interest to the researchers because of its similar route of administration (inhalation) and because research has shown an association between cigarette smoking and marijuana use.

Stephen Buka, lead author of the study and an associate professor in the Department of Society, Human Development and Health at the Harvard School of Public Health said, “More than half a million infants each year are exposed to cigarette smoke before birth. In the short term, this increases the risk of low birthweight and birth defects, and in the longterm, this adds to the likelihood that children will become heavy smokers, dependent on nicotine. Eliminating smoking during pregnancy and afterwards remains a critical challenge for clinicians and for public health practionners.”

The exposure that altered the brain may not necessarily have come during pregnancy. Since women who smoked during pregnancy were likely to smoke after birth the babies might have had their brains modified by the exposure during the period of postnatal brain development.

The lack of an increase in marijuana smoking among children exposed to nicotine during fetal development is not too surprising. The mechanisms for causing craving for different kinds of drugs are not all identical. A predisposition to become addicted to nicotine may not necessarily translate into a predisposition to become addicted to opiates either.

It is very valuable to identify factors that cause brains to develop in ways that predispose people to become addicts of various sorts. For some types of addiction (e.g. heroin) the success rate of getting off and staying off is less than 50%. The kinds of changes that happen to brains of addicts to make them desire drugs are often very long lasting and possibly permanent in many cases. Techniques are sorely needed to be able to change brains in ways that reduce the cravings for addictive drugs.

The initial information for this study was collected before smoking during pregnancy developed a stigma.

In an interview, Buka explained that pregnant women were interviewed many years ago, when people were not yet aware of the health effects of smoking. Consequently, more than 60 percent of the women smoked, and around 35 percent smoked at least one pack on at least one day of their pregnancies.

There are plenty of other reasons why women should not smoke during pregnancy.

These poisonous chemicals pose unique and real threats to the unborn child. Smoking during pregnancy is associated with low birth weight, premature delivery, placenta previa (a complication that could cause bleeding and become a medical emergency), miscarriage and post-delivery death. It has also been associated with a 50 to 70 percent higher chance of delivering babies with a cleft lip or palate, and this risk is believed to increase with the number of cigarettes smoked per day

Share |      Randall Parker, 2003 December 10 11:17 PM  Brain Addiction

Karen Simons said at June 16, 2004 9:00 AM:

My mother allegedly stopped smoking while pregnant with my 2 sisters and myself. She began smoking after each pregnancy. My father smoked also, and I recall the house was always filled with blue smoke 24 hours a day for the first 16 years of my life. I always had and still have sinus problems, frequent ear and sinus infections. My throat was always sore, my ears rang, green mucus ran down my throat and out my nose all the time. We lived in the woods, so we could get outside most of the time in good weather. We slept in an unheated attic area, and in the morning, Mom would open the downstairs door to allow heat to come up so we could get dressed, and there would be the new day's early infustion of smoke coming right along with the heat!

Both parents had horrible sewer breath, and their hands and clothes stunk so badly that I opted out of most affection after I was about 7.

The health problems listed above are still with me, although I do not expose myself to cigarette smoke at least 99.9% of the time. I do not smoke, and I never allowed anyone to smoke in my home, so my children were able to grow up without that stigma.

My mother died at age 70 from lung cancer caused by smoking. My father died at age 75 from emphysema, heart disease, bladder cancer and stroke, with a massive heart attack doing the actual killing event. He had quit smoking some 26 years before, but it got him anyway.

Before she died, my mother began a lawsuit against the cigarette companies, but the time was not right for that. In the process, however, I learned alot about all the horrible things nicotine addiction and cigarettes cause...disease, infant mortality, the total lies of the cigarette companies...

Now, I am 53 and hate it all the more. My next-door neighbor is young, pregnant and apparently seriously addicted to cigarettes. She even gets up in the night and smokes. This is driving me crazy!! If you have other information not contained in this page of your site, please email it to me to share with her. I think she can read...

Thank you so much!

julie tyson said at December 27, 2004 7:11 PM:

I'm trying to find what physical symtoms babies exhibit after birth when the mother has smoked during pregnancy. I'm worried about my niece who is 4 wks. old. She's never calm and jerks her head and arms around. She just doesn't seem normal. Has anyone seen behavior like this in a baby who had 9 months worth of nicotine?

Awoke Eziokwu said at April 25, 2005 3:17 AM:

My mother is a heavy smoker and smoked while pregnant with me. i am 20 yrs old now and i have no medical or physical problems that i know of. The irony of the whole thing is that mum is is now pregnant and she is 7 months gone, she is still smoking heavily and recent scans has shown that the baby is ok. But when i went on internet to know the risk of unborn babies to cigarette i realised that the risk is quite much. please i want some advice that i should give to my mum and the risks involved.
Awoke Eziokwu

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