Tag Archives: Prenatal care fact sheet

Inserm and Pierre and Marie Curie University study: Early exposure to tobacco can cause behavioral problems in children

28 Sep

There are numerous reasons why smoking is considered bad for an individual and there are numerous research studies which list the reasons. Studies are showing how bad second hand smoke is for children. A MNT article, Smoking During Pregnancy May Lower Your Child’s Reading Scores:

Babies born to mothers who smoke more than a pack of cigarettes a day while pregnant have lower reading scores and a harder time with reading tests, compared with children whose mothers do not smoke.
This is the conclusion of a recent study conducted by researchers at Yale School of Medicine and published in The Journal of Pediatrics in November 2012. The reading tests measured how well children read out loud and understood what they were reading.

This isn’t the first study to suggest that smoking in pregnancy may affect a child’s future health and development. A study released in August 2012 said that smoking during pregnancy increases a child’s risk of asthma. In addition, a 2009 study linked smoking during pregnancy to behavioral problems among 3 and 4 year olds boys.

Jeffrey Gruen, M.D., professor of pediatrics and genetics at Yale and his team examined data from over 5,000 kids enrolled in the Avon Longitudinal Study of Parents and Children (ALSPAC), which is an extensive trial of 15,211 kids from the years 1990 to 1992 at the University of Bristol in the U.K.

The experts compared 7 different areas with smoking during pregnancy:
• single-word identification
• reading speed
• spelling
• accuracy
• reading comprehension
• real reading
• non-word reading

The researchers adjusted for socioeconomic status, how the mother and child interacted with one another, and 14 other impacting factors.

This latest study is another in a line of studies suggesting that giving up smoking could play an important role in your child’s future health and wellbeing.

Experts discovered through their experiments that the children whose mothers smoked at least one pack a day while pregnant, had reading scores that were 21% lower than the children whose mothers did not smoke while pregnant. The reading tests were given to the kids when they were 7 years old, and again when they were 9.

On average, kids who were born to mothers who smoked during pregnancy were ranked 7 spots lower in terms of reading accuracy and capability to comprehend reading material than their classmates whose mothers did not smoke…. http://www.medicalnewstoday.com/articles/253100.php

An Inserm and Pierre and Marie Curie University study adds behavior problems to the list of woes children of smokers suffer.

Science Daily reported in Early exposure to tobacco can cause behavioral problems in children:

Researchers from Inserm and Pierre and Marie Curie University (UPMC), in collaboration with the university hospitals of 6 French cities, have analysed data on pre- and postnatal exposure to tobacco in the homes of 5,200 primary school children. They show that this exposure is associated with a risk of behavioural disorders in children, particularly emotional and conduct disorders. The association is stronger when exposure takes place both during pregnancy and after birth. These data show the risk associated with smoking in early life and its behavioural repercussions when the child is of school-going age.These results are published in the journal PLOS ONE.

The consequences of tobacco exposure are widely documented. It leads to many illnesses, including asthma. However, the potential role of environmental tobacco smoke (ETS) is much less well known in terms of its link to behavioural problems in children. In this context, the team led by Isabella Annesi-Maesano, Inserm Research Director at Unit 1136, “Pierre Louis Public Health Institute” (Inserm/UPMC) examined the association between pre- and postnatal ETS exposure and behavioural problems in children….

These data come from the 6 Cities Study (see box), which targeted 5,221 primary school children. Prenatal (in utero smoking) and postnatal exposure to tobacco smoke in the home was assessed using a standardised questionnaire completed by the parents. Behavioural disorders were assessed via the Strengths and Difficulties Questionnaire (SDQ) used to assess the behavioural and psychosocial functioning of the children, which was also completed by the parents.

In greater detail, emotional disorders are associated with exposure to ETS during both the prenatal and postnatal periods, which concerns 21% of the children in the study. Conduct disorders are also associated with ETS exposure in these children. The association also exists in cases of prenatal or postnatal exposure alone, but is less pronounced.

These observations seem to confirm those carried out in animals, i.e. that the nicotine contained in tobacco smoke may have a neurotoxic effect on the brain. During pregnancy, nicotine in tobacco smoke stimulates acetylcholine receptors, and causes structural changes in the brain. In the first months of life, exposure to tobacco smoke generates a protein imbalance that leads to altered neuronal growth….. http://www.sciencedaily.com/releases/2015/09/150928103029.htm?utm_source=dlvr.it&utm_medium=facebook


Early exposure to tobacco can cause behavioral problems in children
Date: September 28, 2015

Source: INSERM

Researchers have analyzed data on pre- and postnatal exposure to tobacco in the homes of 5,200 primary school children, and have found that early exposure to tobacco can lead to behavioral problems in children.

Journal Reference:
1. Julie Chastang, Nour Baïz, Jean Sébastien Cadwallader, Sarah Robert, John L Dywer, Denis André Charpin, Denis Caillaud, Frédéric de Blay, Chantal Raherison, François Lavaud, Isabella Annesi-Maesano. Correction: Postnatal Environmental Tobacco Smoke Exposure Related to Behavioral Problems in Children. PLOS ONE, 2015; 10 (9): e0138164 DOI: 10.1371/journal.pone.0138164

Here is the summary of the research from PLOS:

Postnatal Environmental Tobacco Smoke Exposure Related to Behavioral Problems in Children
Julie Chastang,#1,2,3 Nour Baïz,#1,3,* Jean Sébastien Cadwalladder,2 Sarah Robert,2 John Dywer,1 Denis André Charpin,4 Denis Caillaud,5 Frédéric de Blay,6 Chantal Raherison,7 François Lavaud,8 and Isabella Annesi-Maesano1,3
Kenji Hashimoto, Editor
Author information ► Article notes ► Copyright and License information ►
This article has been corrected. See PLoS One. 2015 September 9; 10(9): e0138164.
This article has been cited by other articles in PMC.

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The purpose of this study was to examine the association between pre and post environmental tobacco smoke (ETS) exposure and behavioral problems in schoolchildren.

In the cross-sectional 6 cities Study conducted in France, 5221 primary school children were investigated. Pre- and postnatal exposure to secondhand tobacco smoke at home was assessed using a parent questionnaire. Child’s behavioral outcomes (emotional symptoms and conduct problems) were evaluated by the Strengths and Difficulties Questionnaire (SDQ) completed by the parents.

ETS exposure during the postnatal period and during both pre- and postnatal periods was associated with behavioral problems in children. Abnormal emotional symptoms (internalizing problems) were related to ETS exposure in children who were exposed during the pre- and postnatal periods with an OR of 1.72 (95% Confidence Interval (CI)= 1.36-2.17), whereas the OR was estimated to be 1.38 (95% CI= 1.12-1.69) in the case of postnatal exposure only. Abnormal conduct problems (externalizing problems) were related to ETS exposure in children who were exposed during the pre- and postnatal periods with an OR of 1.94 (95% CI= 1.51-2.50), whereas the OR was estimated to be 1.47 (95% CI=1.17-1.84) in the case of postnatal exposure only. Effect estimates were adjusted for gender, study center, ethnic origin, child age, low parental education, current physician diagnosed asthma, siblings, preterm birth and single parenthood.

Postnatal ETS exposure, alone or in association with prenatal exposure, increases the risk of behavioral problems in school-age children.
Go to:
The consequences of childhood environmental tobacco smoke (ETS) exposure have often been described [1, 2] and include many physical symptoms or diseases such as asthma or sudden infant death syndrome. However, much less is known about the potential role of ETS exposure in the development of behavioral problems in children. Association between behavioral problems and ETS exposure during fetal development has been suggested in several studies [3–5]. Recently, a dose-response relationship was reported between postnatal ETS exposure at home and hyperactivity/inattention as well as conduct problems in preschool children [6]. Furthermore, in a prospective birth cohort study, Tiesler et al. investigates the impact of passive smoking on behavioral problems. In this study, they found that not only maternal smoking during pregnancy but also paternal smoking at home is associated with hyperactivity/inattention problems in children [7].
Few studies have investigated the relationship between postnatal ETS and emotional symptoms or conduct problems. The purpose of this study was to investigate, in a large population-based sample of children and using internationally referenced instruments, the relationships between behavioral problems (emotional symptoms and conduct problems) and exposure to pre- and mostly postnatal ETS exposure.
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Materials and Methods
9615 children were recruited in primary school (CM1 and CM2 in France) in the frame of the French 6 Cities Study (6C Study) according to a protocol described in a previous study [8]. The sample was taken from all pupils in the 401 relevant classes from 108 schools randomly selected in the six French communities (Bordeaux, Clermont-Ferrand, Creteil, Marseille, Strasbourg and Reims), which were chosen for the contrast in their air quality.
7781 questionnaires have been collected. A total of 5221 children (54.3%), for whom complete data on ETS exposure and at least one of the two outcome variables (emotional symptoms or conduct problems) were available, have been included in the present study.

Behavioral problems
The Strengths and Difficulties Questionnaire (SDQ) is a validated questionnaire used to assess mental and behavioral strengths and difficulties in 3–16 years old children, which has been endorsed in France [9]. All the questionnaires were completed by the parents of the children. Emotional symptoms and conduct problems were measured through the SDQ on childrens’ behavior in the past 6 months. In each scale, five items were scored, using a three-point Likert scale: 0 for « not true », 1 for « somewhat true » or 2 for « very true » and summed up into score ranging from 0 to 10. According to the normative banding method for parent-reported SDQ scores in France [9], the scores were categorized to « normal », « borderline » or « abnormal » using the following cut-off points: 0–3, 4 and 5–10 respectively for emotional problems and 0–2, 3, 4–10 for conduct problems.

Exposure to environmental tobacco smoke (ETS)
Active smoking behavior of the mother, the father and any other household members at home during pregnancy, at 1 year of age and at the moment of the study was reported in the questionnaire. Children were defined as « never » being exposed to ETS when the mother reported no smoking during pregnancy, and when no smoking at home (mother, father and other members) was reported at 1 year of age and at the moment of the study.
Children were classified as being only prenatally exposed to ETS when the mother reported smoking during pregnancy but no smoking at home was reported at 1 year of age and at the moment of the study. Children were classified as being only postnatally exposed to ETS when smoking at home at 1 year of age or at the moment of the study was reported, but when the mother did not smoke during pregnancy. Pre- and postnatal ETS exposure was defined for children whose mothers had smoked during pregnancy and whose family had reported smoking at home at 1 year of age or at the moment of the study.

Statistical analysis
The characteristics of our study population (N = 5221) were compared to the sample of children without complete data (N = 2560), by using Chi-square tests. We also compared these characteristics in children according to their emotional symptoms and conduct problems, using Kruskal-Wallis tests.
In the unadjusted models, a total of 5077 children were included in the analyses of emotional symptoms and of 5126 children in the analyses of conduct problems.
We used a multinomial logistic regression model to analyze the association between behavioral problems and ETS exposure [10]. The dependent variables (emotional symptoms and conduct problems) were classified in three categories (normal, borderline and abnormal). Results are presented as odds ratios (OR) and 95% confidence intervals (95% CI). Covariate selection was based on the statistical significance of comparison tests between our study population and the rest of the population, and based on the known relationships to behavioral problems and/or ETS exposure. Parental education was defined as high if both parents attained tertiary level and low otherwise (primary and/or secondary). Children were considered to have a recent asthma diagnosis if they had been diagnosed by a doctor with asthma in the last 12 months. The variable “siblings” was classified into “presence of one or more siblings” and “no sibling”. Preterm birth was defined as a live birth before 37 completed weeks of gestation.
The final models were adjusted for gender, study center, ethnic origin, child age, low parental education, current physician diagnosed asthma, siblings, preterm birth and single parenthood.
In addition, interactions between ETS exposure and the covariates have been tested.
Dataset used in this work is given in S1 Dataset. All statistical analyses were performed using the statistical software SAS version 9.3 (SAS Institute Inc., Cary, NC, USA).

See, Prenatal care fact sheet http://www.womenshealth.gov/publications/our-publications/fact-sheet/prenatal-care.html

Our goal as a society should be a healthy child in a healthy family who attends a healthy school in a healthy neighborhood. ©


1. A History of Tobacco

2. American Lung Association’s Smoking and Teens Fact Sheet Women and Tobacco Use
African Americans and Tobacco Use
American Indians/Alaska Natives and Tobacco Use
Hispanics and Tobacco Use
Asian Americans/Pacific Islanders and Tobacco Use
Military and Tobacco Use
Children/Teens and Tobacco Use
Older Adults and Tobacco Use

3. Center for Young Women’s Health A Guide for Teens http://www.youngwomenshealth.org/smokeinfo.html

4. Kroger Resources Teens and Smoking


5. Teens Health’s Smoking


6. Quit Smoking Support.com

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