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Fletcher C, Hoon E, Gialamas A, Dekker G, Lynch J, Smithers L. Isolation, marginalisation and disempowerment - understanding how interactions with health providers can influence smoking cessation in pregnancy. BMC Pregnancy Childbirth 2022; 22:396. [PMID: 35538450 PMCID: PMC9086664 DOI: 10.1186/s12884-022-04720-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 04/20/2022] [Indexed: 11/26/2022] Open
Abstract
Background Maternal smoking during pregnancy can lead to serious adverse health outcomes for both women and their infants. While smoking in pregnancy has declined over time, it remains consistently higher in women with lower socioeconomic circumstances. Furthermore, fewer women in this group will successfully quit during pregnancy. Aim This study explores the barriers to smoking cessation experienced by socially disadvantaged pregnant women and investigates how interactions with health providers can influence their smoking cessation journey. Methods Women (either pregnant or birthed in the previous 10 years, who smoked or quit smoking in pregnancy) were recruited from a metropolitan public hospital antenatal clinic in South Australia and community organisations in surrounding suburbs. Seventeen women participated in qualitative semi-structured small focus groups or interviews. The focus groups and interviews were recorded, transcribed and thematically analysed. Findings Four interconnected themes were identified: 1) smoking embedded in women’s challenging lives and pregnancies, 2) cyclic isolation and marginalisation, 3) feeling disempowered, and 4) autonomy and self-determination. Themes 3 and 4 are characterised as being two sides of a single coin in that they coexist simultaneously and are inseparable. A key finding is a strong unanimous desire for smoking cessation in pregnancy but women felt they did not have the necessary support from health providers or confidence and self-efficacy to be successful. Conclusion Women would like improvements to antenatal care that increase health practitioners’ understanding of the social and contextual healthcare barriers faced by women who smoke in pregnancy. They seek improved interventions from health providers to make informed choices about smoking cessation and would like women-centred care. Women feel that with greater support, more options for cessation strategies and consistency and encouragement from health providers they could be more successful at antenatal smoking cessation. If such changes were made, then South Australian practice could align more with best practice international guidelines for addressing smoking cessation in pregnancy, and potentially improve outcomes for women and their children. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04720-0.
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Affiliation(s)
- Cherise Fletcher
- School of Public Health, Faculty of Health & Medical Sciences, University of Adelaide, Level 5, 50 Rundle Mall, Rundle Mall Plaza, Adelaide, SA, 5005, Australia.,The Robinson Research Institute, Norwich Centre, Ground Floor, 55 King William Road, North Adelaide, SA, 5006, Australia
| | - Elizabeth Hoon
- School of Public Health, Faculty of Health & Medical Sciences, University of Adelaide, Level 5, 50 Rundle Mall, Rundle Mall Plaza, Adelaide, SA, 5005, Australia.,Discipline of General Practice, Faculty of Health & Medical Sciences, University of Adelaide, Adelaide, SA, 5005, Australia
| | - Angela Gialamas
- School of Public Health, Faculty of Health & Medical Sciences, University of Adelaide, Level 5, 50 Rundle Mall, Rundle Mall Plaza, Adelaide, SA, 5005, Australia.,The Robinson Research Institute, Norwich Centre, Ground Floor, 55 King William Road, North Adelaide, SA, 5006, Australia
| | - Gustaaf Dekker
- The Robinson Research Institute, Norwich Centre, Ground Floor, 55 King William Road, North Adelaide, SA, 5006, Australia.,Obstetrics and Gynaecology Department, Lyell McEwin Hospital, University of Adelaide, Adelaide, Australia
| | - John Lynch
- School of Public Health, Faculty of Health & Medical Sciences, University of Adelaide, Level 5, 50 Rundle Mall, Rundle Mall Plaza, Adelaide, SA, 5005, Australia.,The Robinson Research Institute, Norwich Centre, Ground Floor, 55 King William Road, North Adelaide, SA, 5006, Australia.,Population Health Sciences, University of Bristol, Bristol, UK
| | - Lisa Smithers
- School of Public Health, Faculty of Health & Medical Sciences, University of Adelaide, Level 5, 50 Rundle Mall, Rundle Mall Plaza, Adelaide, SA, 5005, Australia. .,The Robinson Research Institute, Norwich Centre, Ground Floor, 55 King William Road, North Adelaide, SA, 5006, Australia. .,School of Health & Society, Faculty of Arts, Social Sciences & Humanities, University of Wollongong, Wollongong, NSW, 2522, Australia. .,The Illawarra Health and Medical Research Institute, University of Wollongong, Northfields Avenue, Wollongong, NSW, 2522, Australia.
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Kim S, Selya A, Wakschlag LS, Dierker L, Rose JS, Hedeker D, Mermelstein RJ. Estimating causal and time-varying effects of maternal smoking on youth smoking. Addict Behav 2021; 120:106982. [PMID: 34022755 PMCID: PMC8194413 DOI: 10.1016/j.addbeh.2021.106982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 04/29/2021] [Accepted: 05/03/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Maternal smoking is a well-known risk factor for youth smoking, yet whether this relationship is causal remains unresolved. This study utilizes propensity score methods for causal inference to robustly account for shared risk factors between maternal and offspring smoking. METHODS An 8-year longitudinal cohort of 900 adolescents in the Chicago area were followed starting from approximately age 15.6. The effects of maternal lifetime smoking (MLS) and prenatal tobacco exposure (PTE) (among participants reporting MLS) on offspring's past 30-day smoking, daily smoking status and smoking frequency were examined using logistic regression and Poisson regression after nearest-neighbor propensity matching. Age dependency of this relationship was then examined across the age range of 15-25 using time-varying effect modeling. RESULTS Propensity matching yielded 438 and 132 pairs for MLS and PTE study samples, respectively. MLS demonstrated significant associations with past 30-day smoking (RR 1.09; 95% CI 1.04-1.14), daily smoking (RR 1.08; 95% CI 1.05-1.12), and smoking frequency of offspring (RR 1.32; 95% CI 1.15-1.52), with stable effects across age. Among participants reporting MLS, having PTE showed significant additional effects on daily smoking (RR 1.09; 95% CI 1.02-1.17) and age-dependency that showed significance during young adulthood but not adolescence. CONCLUSION The relationship between maternal and offspring smoking was not fully accounted for by shared risk factors, suggesting possible causation with PTE having a delayed effect across age. Targeted prevention efforts should be made on maternal smoking-exposed adolescents to mitigate their risks of developing heavy smoking habits in adulthood.
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Affiliation(s)
- Sooyong Kim
- Behavioral Sciences Group, Sanford Research, Sioux Falls, SD, United States; PinneyAssociates, Inc., Pittsburgh, PA, United States
| | - Arielle Selya
- Behavioral Sciences Group, Sanford Research, Sioux Falls, SD, United States; PinneyAssociates, Inc., Pittsburgh, PA, United States; Department of Pediatrics, University of South Dakota Sanford School of Medicine, Sioux Falls, SD, United States.
| | - Lauren S Wakschlag
- Department of Medical Social Sciences, Feinberg School of Medicine and Institute for Innovations in Developmental Sciences, Northwestern University Chicago, IL, United States
| | - Lisa Dierker
- Department of Psychology, Wesleyan University, Middletown, CT, United States
| | - Jennifer S Rose
- Department of Psychology, Wesleyan University, Middletown, CT, United States
| | - Don Hedeker
- Department of Public Health Sciences, University of Chicago, Chicago, IL, United States
| | - Robin J Mermelstein
- Institute for Health Research and Policy, University of Illinois-Chicago, Chicago, IL, United States
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Chadi N, Ahun MN, Laporte C, Boivin M, Tremblay RE, Côté SM, Orri M. Pre- and postnatal maternal smoking and offspring smoking trajectories: Evidence from a 20-year birth cohort. Prev Med 2021; 147:106499. [PMID: 33667469 DOI: 10.1016/j.ypmed.2021.106499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 01/27/2021] [Accepted: 02/27/2021] [Indexed: 10/22/2022]
Abstract
Maternal smoking is associated with increased risk of smoking in the offspring. However, it remains unclear whether this association depends on the timing of exposure to maternal smoking. We investigated the association between prenatal and/or postnatal maternal smoking and offspring smoking during adolescence. Participants (N = 1661) were from the Québec Longitudinal Study of Child Development cohort. We identified longitudinal trajectories of maternal smoking from before pregnancy to child age 12 years using group-based trajectory modeling (GBTM). Adolescent (12-19 years) smoking trajectories were also identified using GBTM. Associations between maternal smoking and offspring smoking trajectories were estimated using multinomial logistic regressions. We used propensity score inverse probability weighting (IPW) to account for the differential distribution of maternal and familial characteristics across exposure groups. We identified four distinct groups for maternal smoking: no (66.1%), decreasing (5.6%), increasing (9.5%) and persistent (18.8%) smoking, and three adolescent smoking trajectories: abstinent, early-onset (before age 15) and late-onset (after age 15). In IPW-adjusted models, youth with mothers with decreasing, increasing and persistent smoking had higher risk of being early-onset smokers compared with youth with mothers in the non-smoking group. We also found that only youth whose mothers were persistent smokers had an increased risk of late-onset smoking. Regardless of timing, offspring exposure to maternal smoking is associated with increased risk of smoking during adolescence. More research is needed on how to create effective smoking cessation campaigns that span preconception, prenatal, and postnatal periods to help prevent intergenerational transmission of smoking behaviors.
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Affiliation(s)
- Nicholas Chadi
- Sainte-Justine University Research Centre, Division of Adolescent Medicine, Department of Pediatrics, University of Montreal, 3175 Ch de la Cote Sainte-Catherine, Montreal, QC H3T 1C5, Canada.
| | - Marilyn N Ahun
- Department of Social and Preventive Medicine, University of Montreal School of Public Health and Sainte-Justine University Research Centre, 3175 Ch de la Cote Sainte-Catherine, Montreal, QC, H3T 1C5, Canada.
| | - Catherine Laporte
- Department of General Practice, Faculty of Medicine, EA7280, Clermont-Auvergne University, Clermont Ferrand, F-63001, France; Clinical Research and Innovation Department, Clermont-Ferrant University Hospital, Clermont-Ferrand, F-63001, France.
| | - Michel Boivin
- École de psychologie, Université Laval, 2325 Allée des Bibliothèques, Québec City, QC, G1V 0A6, Canada.
| | - Richard E Tremblay
- School of Public Health, University College Dublin and Sainte-Justine University Research Centre, Departments of Psychology and Pediatrics, University of Montreal, 3175 Ch de la Cote Sainte-Catherine, Montreal, QC H3T 1C5, Canada.
| | - Sylvana M Côté
- Department of Social and Preventive Medicine, University of Montreal School of Public Health and Sainte-Justine University Research Centre, 3175 Ch de la Cote Sainte-Catherine, Montreal, QC, H3T 1C5, Canada; Bordeaux Population Health Research Centre, Inserm U1219, University of Bordeaux, Bordeaux, France.
| | - Massimiliano Orri
- Bordeaux Population Health Research Centre, Inserm U1219, University of Bordeaux, Bordeaux, France; McGill Group for Suicide Studies, Douglas Mental Health University Institute, Department of Psychiatry, McGill University, 6875 Boulevard LaSalle, Verdun, QC, H4H 1R3, Canada.
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Weber TL, Selya A, Wakschlag LS, Dierker L, Rose JS, Hedeker D, Mermelstein RJ. The effect of maternal smoking on offspring smoking is unrelated to heritable personality traits or initial subjective experiences. Nicotine Tob Res 2021; 23:1754-1762. [PMID: 33912956 DOI: 10.1093/ntr/ntab081] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 04/23/2021] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Maternal smoking is a risk factor for offspring smoking. Lifetime maternal smoking vs. prenatal tobacco exposure (PTE) appear to act through different mechanisms. This study tested the hypothesis that maternal smoking measures' effects on offspring smoking could be attributable to hereditary mechanisms: personality traits (novelty-seeking, impulsivity, neuroticism, self-esteem) and initial subjective smoking experiences (pleasurable, unpleasurable, dizziness). METHODS Data were drawn from the Social and Emotional Contexts of Adolescent Smoking Patterns (SECASP) study, an 8-year longitudinal study of 9 th or 10 th graders at baseline (≈age 15) who experiment with smoking (<100 lifetime cigarettes; N=594) at baseline. Young adult smoking frequency at the 8-year follow-up (≈age 23) was examined as a function of baseline characteristics (heritable trait, maternal smoking, PTE, sex) and baseline smoking frequency and nicotine dependence. Structural equation models determined whether inclusion of each heritable trait among offspring confounded the effects of maternal smoking (PTE or maternal smoking) on offspring smoking and nicotine dependence. RESULTS Impulsiveness was associated with intermediate adolescent smoking frequency (B=0.135, SD=0.043 p=0.002) and nicotine dependence (B=0.012, SD=0.003, p<0.001). Unpleasurable first experience (B=0.886, SD=0.374, p=0.018) and dizziness (B=0.629, SD=0.293, p=0.032) showed a trend with intermediate smoking frequency that was non-significant after correcting for multiple comparisons. These traits did not confound maternal smoking's effects. CONCLUSIONS None of the heritable traits examined in this model explained the effect of maternal smoking measures on adolescence or young adulthood offspring smoking. Further research is needed to elucidate the mechanism by which PTE and maternal smoking are linked to offspring smoking.
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Affiliation(s)
- Tess L Weber
- Behavioral Sciences Group, Sanford Research, Sioux Falls, SD
| | - Arielle Selya
- Behavioral Sciences Group, Sanford Research, Sioux Falls, SD.,Department of Pediatrics, University of South Dakota Sanford School of Medicine, Sioux Falls, SD.,Pinney Associates, Inc., Pittsburgh, PA
| | - Lauren S Wakschlag
- Department of Medical Social Sciences, Feinberg School of Medicine and Institute for Innovations in Developmental Sciences, Northwestern University Chicago, IL
| | - Lisa Dierker
- Department of Psychology, Wesleyan University, Middletown, CT
| | - Jennifer S Rose
- Department of Psychology, Wesleyan University, Middletown, CT
| | - Don Hedeker
- Department of Public Health Sciences, University of Chicago, Chicago, IL
| | - Robin J Mermelstein
- Institute for Health Research and Policy, University of Illinois-Chicago, Chicago, IL
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5
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Selya AS, Cannon DS, Weiss RB, Wakschlag LS, Rose JS, Dierker L, Hedeker D, Mermelstein RJ. The role of nicotinic receptor genes (CHRN) in the pathways of prenatal tobacco exposure on smoking behavior among young adult light smokers. Addict Behav 2018; 84:231-237. [PMID: 29751336 DOI: 10.1016/j.addbeh.2018.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 04/27/2018] [Accepted: 05/01/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND Prenatal tobacco exposure (PTE) is associated with more frequent smoking among young, light smokers. Little is known about how nicotinic acetylcholine receptor (CHRN) genes may contribute to this relationship. METHODS Data were drawn from a longitudinal cohort of young light smokers of European ancestry (N = 511). Three single nucleotide polymorphisms (SNPs) among offspring, rs16969968 and rs6495308 in CHRNA5A3B4 and rs2304297 in CHRNB3A6, were analyzed with respect to whether they 1) predict PTE status; 2) confound the previously-reported effects of PTE on future smoking; 3) have effects on youth smoking frequency that are mediated through PTE; and 4) have effects that are moderated by PTE. RESULTS rs2304297 and rs6495308 were associated with increased likelihood and severity of PTE, respectively. In a path analysis, rs16969968 directly predicted more frequent smoking in young adulthood (B = 1.50, p = .044); this association was independent of, and not mediated by, PTE. The risk of rs16969968 (IRR = 1.07, p = .015) and the protective effect of rs2304297 (IRR = 0.84, p < .001) on smoking frequency were not moderated by PTE. PTE moderated the effect of rs6495308, such that these alleles were protective against later smoking frequency only among non-exposed youth (IRR = 0.85, p < .001). CONCLUSIONS The association between offspring CHRNB3A6 and PTE is a novel finding. The risk of rs16969968 on youth smoking is independent and unrelated to that of PTE among young, light smokers. PTE moderates the protective effect of rs6495308 on youth smoking frequency. However, PTE's pathway to youth smoking behavior was not explained by these genetic factors, leaving its mechanism(s) of action unclear.
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Kawabata T, Tomari Y, Takemura J. Factors Related to Smoking Initiation by Adolescents and a Causal Model for Early Smoking Initiation. Health (London) 2017. [DOI: 10.4236/health.2017.98082] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Selya AS, Dierker L, Rose JS, Hedeker D, Mermelstein RJ. Early-Emerging Nicotine Dependence Has Lasting and Time-Varying Effects on Adolescent Smoking Behavior. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2016; 17:743-50. [PMID: 27312479 PMCID: PMC5270552 DOI: 10.1007/s11121-016-0673-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Novice and light adolescent smokers can develop symptoms of nicotine dependence, which predicts smoking behavior several years into the future. However, little is known about how the association between these early - emerging symptoms and later smoker behaviors may change across time from early adolescence into young adulthood. Data were drawn from a 7-year longitudinal study of experimental (<100 cigarettes/lifetime; N = 594) and light (100+ cigarettes/lifetime, but ≤5 cigarettes/day; N = 152) adolescent smokers. Time-varying effect models were used to examine the relationship between baseline nicotine dependence (assessed at age 15 ± 2 years) and future smoking frequency through age 24, after controlling for concurrent smoking heaviness. Baseline smoking status, race, and sex were examined as potential moderators of this relationship. Nicotine dependence symptoms assessed at approximately age 15 significantly predicted smoking frequency through age 24, over and above concurrent smoking heaviness, though it showed declining trends at older ages. Predictive validity was weaker among experimenters at young ages (<16), but stronger at older ages (20-23), relative to light smokers. Additionally, nicotine dependence was a stronger predictor of smoking frequency for white smokers around baseline (ages 14.5-16), relative to nonwhite smokers. Nicotine dependence assessed in mid-adolescence predicts smoking frequency well into early adulthood, over and above concurrent smoking heaviness, especially among novice smokers and nonwhite smokers. Early-emerging nicotine dependence is a promising marker for screening and interventions aimed at preventing smoking progression.
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Affiliation(s)
- Arielle S Selya
- Department of Population Health, University of North Dakota, 1301 N. Columbia Rd., Stop 9037, Grand Forks, ND, 58202, USA.
| | - Lisa Dierker
- Psychology Department, Wesleyan University, Middletown, CT, USA
| | - Jennifer S Rose
- Psychology Department, Wesleyan University, Middletown, CT, USA
| | - Donald Hedeker
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
| | - Robin J Mermelstein
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
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Schoenfelder EN, Faraone SV, Kollins SH. Stimulant treatment of ADHD and cigarette smoking: a meta-analysis. Pediatrics 2014; 133:1070-80. [PMID: 24819571 PMCID: PMC4531271 DOI: 10.1542/peds.2014-0179] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Individuals with attention-deficit/hyperactivity disorder (ADHD) have a significantly higher risk of cigarette smoking. The nature of the relationship between smoking and psychostimulant medications commonly used to treat ADHD is controversial. Our objective was to examine the relationship between stimulant treatment of ADHD and cigarette smoking by using meta-analysis, and to identify study and sample characteristics that moderate this relationship. METHODS Literature searches on PubMed and PsycInfo databases identified published studies for inclusion. Included studies compared cigarette smoking outcomes for stimulant-treated and untreated ADHD individuals. Seventeen studies met inclusion criteria, and 14 (total n = 2360) contained sufficient statistical information for inclusion in the meta-analysis. Two authors extracted odds ratios or frequencies of smokers in the treatment or nontreatment groups, and coded study characteristics including sample source, percentage of male participants, follow-up length, treatment consistency, type of smoking measure, prospective study, and controlling for comorbidities. RESULTS Meta-analysis revealed a significant association between stimulant treatment and lower smoking rates. Meta-regression indicated that effect sizes were larger for studies that used clinical samples, included more women, measured smoking in adolescence rather than adulthood, conceptualized stimulant treatment as consistent over time, and accounted for comorbid conduct disorder. CONCLUSIONS Nearly all studies were naturalistic, precluding causal inferences. Available data were insufficient to examine additional influences of patient demographics, treatment effectiveness, or other comorbidities. Consistent stimulant treatment of ADHD may reduce smoking risk; the effect was larger in samples with more severe psychopathology. Implications for further research, treatment of ADHD, and smoking prevention are discussed.
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Affiliation(s)
- Erin N. Schoenfelder
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Duke University, Durham, North Carolina; and
| | - Stephen V. Faraone
- Departments of Psychiatry and of Neuroscience and Physiology, State University of New York Upstate Medical University, Syracuse, New York
| | - Scott H. Kollins
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Duke University, Durham, North Carolina; and
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Taylor AE, Howe LD, Heron JE, Ware JJ, Hickman M, Munafò MR. Maternal smoking during pregnancy and offspring smoking initiation: assessing the role of intrauterine exposure. Addiction 2014; 109:1013-21. [PMID: 24521169 PMCID: PMC4114534 DOI: 10.1111/add.12514] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Revised: 11/04/2013] [Accepted: 01/31/2014] [Indexed: 11/29/2022]
Abstract
AIMS To assess whether associations between maternal smoking during pregnancy and offspring smoking initiation are due to intrauterine mechanisms. DESIGN Comparison of associations of maternal and partner smoking behaviour during pregnancy with offspring smoking initiation using partner smoking as a negative control (n = 6484) and a Mendelian randomization analysis (n = 1020), using a genetic variant in the mothers as a proxy for smoking cessation during pregnancy. SETTING A longitudinal birth cohort in South West England. PARTICIPANTS Participants of the Avon Longitudinal Study of Parents and Children (ALSPAC). MEASUREMENTS Smoking status during pregnancy was self-reported by mother and partner in questionnaires administered at pregnancy. Latent classes of offspring smoking initiation (non-smokers, experimenters, late-onset regular smokers and early-onset regular smokers) were previously developed from questionnaires administered at 14-16 years. A genetic variant, rs1051730, was genotyped in the mothers. FINDINGS Both mother and partner smoking were similarly positively associated with offspring smoking initiation classes, even after adjustment for confounders. Odds ratios (OR) [95% confidence interval (CI)] for class membership compared with non-smokers were: experimenters: mother OR = 1.33 (95% CI = 1.06, 1.67), partner OR = 1.28 (95% CI = 1.06, 1.55), late-onset regular smokers: mother OR = 1.80 (95% CI = 1.43, 2.26), partner OR = 1.86 (95% CI = 1.52, 2.28) and early-onset regular smokers: mother OR = 2.89 (95% CI = 2.12, 3.94), partner OR = 2.50 (95% CI = 1.85, 3.37). There was no clear evidence for a dose-response effect of either mother or partner smoking heaviness on class membership. Maternal rs1051730 genotype was not clearly associated with offspring smoking initiation class in pre-pregnancy smokers (P = 0.35). CONCLUSION The association between smoking during pregnancy and offspring smoking initiation does not appear to operate through intrauterine mechanisms.
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Affiliation(s)
- Amy E Taylor
- MRC Integrative Epidemiology Unit (IEU) at the University of Bristol, UK Centre for Tobacco and Alcohol Studies, School of Experimental Psychology, University of Bristol, Bristol, UK
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Stroud LR, Papandonatos G, Shenassa E, Rodriguez D, Niaura R, LeWinn K, Lipsitt LP, Buka SL. Prenatal glucocorticoids and maternal smoking during pregnancy independently program adult nicotine dependence in daughters: a 40-year prospective study. Biol Psychiatry 2014; 75:47-55. [PMID: 24034414 PMCID: PMC3858529 DOI: 10.1016/j.biopsych.2013.07.024] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Revised: 06/25/2013] [Accepted: 07/12/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Maternal smoking during pregnancy (MSDP) is an independent risk factor for offspring nicotine dependence (ND), but mechanisms remain unknown. We investigated prenatal glucocorticoid (cortisol) and androgen (testosterone) associations with offspring ND over 40 years and the possibility that prenatal glucocorticoids and androgens would mediate links between MSDP and offspring ND. METHODS Participants were 1086 mother-adult offspring pairs (59% female) from the New England Family Study, a 40-year longitudinal follow-up of the Collaborative Perinatal Project. MSDP was assessed prospectively at each prenatal visit. Maternal cortisol, testosterone, and cotinine (nicotine metabolite) were assayed from third trimester maternal sera. Offspring lifetime ND was assessed via structured interview. RESULTS Significant bivariate associations emerged for: 1) MSDP/cotinine and lifetime ND; and 2) maternal cortisol and lifetime ND, for daughters only. In multivariate models, maternal cortisol and MSDP/cotinine remained significantly and independently associated with increased odds of lifetime ND of daughters. However, cortisol did not mediate the MSDP-lifetime ND relation. No associations emerged between maternal testosterone and offspring ND. CONCLUSIONS Results provide the first evidence in support of prenatal glucocorticoid programming of adult ND over 40 years in daughters only. Our study highlights two independent prenatal pathways leading to increased risk for ND in daughters: elevated prenatal glucocorticoids and MSDP/nicotine exposure. Daughter-specific effects of glucocorticoid and MSDP programming over 40 years highlight the breadth and persistence of sexually dimorphic programming effects in humans. Results do not support androgen programming of offspring ND.
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Affiliation(s)
- Laura R. Stroud
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University
| | | | - Edmond Shenassa
- Program in Maternal-Child Health, School of Public Health, University of Maryland
| | - Daniel Rodriguez
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University
| | - Raymond Niaura
- Schroeder Institute for Tobacco Research and Policy Studies, American Legacy Foundation
| | - Kaja LeWinn
- Department of Psychiatry, University of California, San Francisco
| | | | - Stephen L. Buka
- Department of Epidemiology, School of Public Health, Brown University
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