Press Releases

2003 Releases

Pregnant Women Who Smoke Heavily Increase the Risk That Their Children Will Also Smoke Heavily Later in Life

For immediate release:  November 01, 2003

Audio clips featuring lead author Stephen Buka can be found below

Boston, MA— In the first long-term study to assess the effect of maternal smoking during pregnancy and risk for nicotine dependence among offspring, researchers from the Harvard School of Public Health and Brown Medical School in Providence, Rhode Island, have found that offspring of mothers who smoked a pack or more of cigarettes per day during pregnancy had a higher risk for developing nicotine dependence compared to children whose mothers didn’t smoke during pregnancy. The results of the study appear in the November issue of the American Journal of Psychiatry ( 

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.”  

Ray Niaura, PhD, Professor, Centers for Behavioral and Preventive Medicine, Brown Medical School/The Miriam Hospital explains the importance of these findings for clinicians, "According to the PHS Guidelines for Smoking Cessation, health care providers must take advantage of every opportunity to ask, advise and assist patients in efforts to quit smoking. Healthy baby prenatal visits, labor and delivery, and post-natal care visits are golden opportunities for providers to offer assistance to quit smoking and prevent relapse, thereby reducing risk of children progressing to nicotine dependence, and preventing exposure to toxic environmental tobacco smoke."

Stephen Buka outlines the take home message of the study: 


Stephen Buka discusses what surprised him about the study findings:

This research was conducted within the Transdisciplinary Tobacco Use Research Center: New England Family Study, which investigates multiple factors associated with nicotine dependence across the lifespan and across generations.  Seven Transdisciplinary Tobacco Use Research Centers (TTURC) are funded by the National Cancer Institute and the National Institute on Drug Abuse to investigate new ways of combating tobacco use and nicotine addiction, using an innovative, integrated approach.

For further information, please contact:

Robin Herman
Office of Communications
Harvard School of Public Health
677 Huntington Ave.,
Boston, MA 02115