Pediatrics

The attention of pediatricians continues to be called to the harmful effects of cigarette smoke in children. Maternal smoking during pregnancy is associated with higher rates of spontaneous abortion, premature rupture of membranes, stillbirth, low birth weight, and sudden infant death syndrome. During infancy and childhood, exposure to environmental tobacco smoke increases the risk of upper respiratory tract infection, middle-ear effusion, asthma, and lower respiratory tract infection. Children with asthma have more severe manifestations of disease when exposed to environmental tobacco smoke. During later childhood and adolescence, children themselves may begin to smoke, assuming risks of long-term pulmonary dysfunction and lung cancer similar to those observed in adults.1 In the United States, 27% of women in their childbearing years smoke cigarettes.2 Previous attempts have been made to relate neurodevelopmental deficits to maternal cigarette smoking during pregnancy and early infancy. These studies have been confounded by failure to separate.