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Childhood physical, alcohol abuse up risk of prenatal, next-generation youth smoking

Tristan Manalac
08 Jul 2017

Childhood physical abuse and household alcohol abuse were associated with higher risks of prenatal smoking and child smoking before 18 years of age, according to a new longitudinal study.

“Mothers in this national sample who experienced adversity in childhood are more likely to smoke during pregnancy and their offspring are more likely to initiate smoking before age 18,” the researchers said.

Mothers that experienced physical abuse during childhood (adjusted risk ratio [aRR], 1.39; 95 percent CI, 1.19 to 1.62; p<0.001) and household alcohol abuse (aRR, 1.20; 1.03 to 1.38; p<0.05) suffered from a 39- and 20-percent greater chance of prenatal smoking, respectively. [Nictone Tob Res 2017;19:623-630]

The risk of the offspring smoking before the age of 18 was also significantly higher for mothers with histories of childhood physical abuse (aRR, 1.20; 1.10 to 1.32; <0.001) and household alcohol abuse (aRR, 1.17; 1.08 to 1.27; p<0.001).

Exposure to household mental health conditions did not significantly impact the risk of prenatal smoking or next-generation youth smoking.

“In this sample, maternal exposure to childhood physical abuse was a risk factor for smoking during pregnancy, regardless of race/ethnicity. This is consistent with a previous finding that physical abuse is associated with smoking during pregnancy in a primarily white sample of German women,” investigators said. [Am J Prev Med 2014;46:249-258]

The risk of the offspring initiating smoking during childhood was significantly higher for mothers that smoked during pregnancy (aRR, 1.18; 1.11 to 1.26).

Moreover, children of prenatal smokers with (aRR, 1.25; 1.13 to 1.38)or without (aRR, 1.21; 1.13 to 1.31) a history of household alcoholism during childhood had higher risks of childhood smoking compared with children of nonsmokers without histories of household alcohol abuse.

Notably, children of nonsmoking mothers with a history of childhood household alcohol abuse also suffered from an increased risk of childhood smoking (aRR, 1.13; 1.03 to 1.24).

This particular finding corroborates the findings of a previous study that made use of data from the Growing Up Today Study and Nurses Health Study II.

“Roberts et al found that mothers with severe childhood physical, emotional or sexual abuse (measured with questions from the Childhood Trauma Questionnaire) were more likely to have offspring who followed the most dangerous smoking trajectories of early initiation and high consumption,” the investigators said.

Stratification by ethnicity showed that children of White (aRR, 1.72; 1.53 to 1.94;p0.001) and Hispanic (aRR, 1.67; 1.41 to 1.99; p≤0.001) prenatal smokers with histories of household alcohol abuse had higher risks of childhood smoking.This risk was not present in children of Black mothers with the same background (aRR, 1.16; 0.89 to 1.50; p>0.05).

“Our finding that household alcohol abuse, race/ethnicity, and smoking during pregnancy had a significant three-way interaction underscores the importance of incorporating intersectionality into the way we study and understand health, especially in marginalized populations,” the researchers argued.

The study included 2,999 women and 6,596 corresponding offspring enrolled in the National Longitudinal Survey of Youth 1979 (NLSY79). The survey included questions about adverse childhood experiences of the mother and smoking behaviours during pregnancy.

Offspring were included in the NLSY79 Children and Young Adults survey (NSLSYCYA), which included questions about smoking behaviours.

“These findings support the importance of a life-course approach to understanding prenatal and intergenerational smoking, and suggest that maternal early-life history is a potentially important risk factor that could be targeted with screening and interventions to reduce smoking in pregnant women and their children,” according to the researchers.

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