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Meaningful differences in maternal smoking behaviour during pregnancy: Implications for infant behavioural vulnerabilit

Maternal smoking and offspring behaviour. Consistent association with risk of problem behaviour:Disruptive behaviour(CD, ODD, co-morbid ADHD)SmokingSubstance useMultiple, independent, cross-national samples, robust to measured confounders. Correlation or causation?. Does smoking play an aetiologic roleIs smoking a marker for intergenerational transmission processes associated with both:tendency to smokerisk of offspring with problem behaviour.

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Meaningful differences in maternal smoking behaviour during pregnancy: Implications for infant behavioural vulnerabilit

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    1. Meaningful differences in maternal smoking behaviour during pregnancy: Implications for infant behavioural vulnerability Kate E. Pickett, Callie Wood, Joy Adamson, Lalitha DeSouza, Lauren Wakschlag

    3. Correlation 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 Seven studies in TEN paper, all find same answer but there are still questions 5 prospective, population-based studies 3 CD, 4 criminal offending US, Scandinavia, New Zealand No question about robustness, no question that finding a prenatal, potentially modifiable etiological factor would be important Is it a teratologic effect? Is it due to confounding? Is this effect modified by other risk factors for CD (eg: genetics, parenting)Seven studies in TEN paper, all find same answer but there are still questions 5 prospective, population-based studies 3 CD, 4 criminal offending US, Scandinavia, New Zealand No question about robustness, no question that finding a prenatal, potentially modifiable etiological factor would be important Is it a teratologic effect? Is it due to confounding? Is this effect modified by other risk factors for CD (eg: genetics, parenting)

    4. Background 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

    5. “Competing” 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?

    6. Study 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.

    7. Measurement of temperament 14 questions from Carey Infant Temperament Scale 3 dimensions (high score=more robust) Positive mood Receptivity to novelty Regularity “Difficult” temperament (scores below sample means) Lack of positive emotionality Wariness Irregularity

    8. Measurement of smoking etc Smoking Never smoked in pregnancy Gave up during pregnancy Continuous light smoking (< 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

    9. Smoking in the MCS

    10. Temperament by smoking

    11. Adjusted effects of smoking on difficult temperament

    12. Discussion 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

    13. Adaptive problems related to smoking in the Family Health and Development Project

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