Title: Meaningful differences in maternal smoking behaviour during pregnancy: Implications for infant behav
1Meaningful differences in maternal smoking
behaviour during pregnancy Implications for
infant behavioural vulnerability
- Kate E. Pickett, Callie Wood, Joy Adamson,
Lalitha DeSouza, Lauren Wakschlag
DEPARTMENT OF HEALTH SCIENCES
2Maternal smoking and offspring behaviour
- Consistent association with risk of problem
behaviour - Disruptive behaviour
- (CD, ODD, co-morbid ADHD)
- Smoking
- Substance use
- Multiple, independent, cross-national samples,
robust to measured confounders
3Correlation or causation?
- Does smoking play an aetiologic role
- Is smoking a marker for intergenerational
transmission processes associated with both - tendency to smoke
- risk of offspring with problem behaviour
4Background work
- A critical review of epidemiological studies
- Empirical work
- Estimate of the population attributable risk
- Patterns and measurement of maternal smoking
- Timing of onset of delinquency
- Early onset of externalizing behaviour problems
in toddlers - Individual and contextual characteristics of
women who smoke, women who quit, women who never
smoke
5Competing Hypotheses
- Is exposure to cigarette smoke associated with an
early risk pathway? - Does it increase the risk of difficult
temperament in infants?
- Is quitting smoking associated with an early
protective pathway? - Does it increase the likelihood of temperamental
robustness in infants?
6Study setting
- Millennium Cohort Study
- 18,263 mother-infant pairs
- 9 months old, born 2000-2001
- Sample selected from a random sample of electoral
wards, stratified to ensure representation of all
four UK countries, deprived areas and areas with
high concentrations of Black and Asian families.
7Measurement of temperament
- 14 questions from Carey Infant Temperament Scale
- 3 dimensions (high scoremore robust)
- Positive mood
- Receptivity to novelty
- Regularity
- Difficult temperament (scores below sample
means) - Lack of positive emotionality
- Wariness
- Irregularity
8Measurement of smoking etc
- Smoking
- Never smoked in pregnancy
- Gave up during pregnancy
- Continuous light smoking (lt 10/day)
- Continuous heavy smoking (10/day)
- Other factors
- Birth weight, length of gestation
- Age
- Alcohol consumption
- History of depression
- History of domestic violence
- Marital status
- Poverty
- Educational attainment
- Social class
- Ethnicity
9Smoking in the MCS
13,038
2,320
2,098
807
10Temperament by smoking
Overall diff. p.01 Quit vs heavy, plt .001 Never
vs heavy, p0.03
11Adjusted effects of smoking on difficult
temperament
P0.01
P0.02
P0.01
12Discussion
- Martin et al (2006) found better temperament
among infants of smokers in Finland, but included
quitters with smokers - More attention needs to be paid to characterizing
differences between pregnancy quitters and
pregnancy smokers - Need to examine development over time and the
unfolding of early vulnerabilities into problem
behaviours
13Adaptive problems related to smoking in the
Family Health and Development Project
Wakschlag LS, Pickett KE, Middlecamp M, Walton L,
Leventhal BLL. Pregnant smokers who quit,
pregnant smokers who cant Does history of
problem behavior make a difference? Social
Science and Medicine 2003562449-2460.