Smoking and Pregnancy

Joined: November 13th, 2008, 2:04 pm

January 30th, 2009, 4:52 pm #1

From: Joel. (Original Message) Sent: 6/7/2001 7:24 AM
I saw yesterday where one member stated she was quitting smoking because she was planning for having a child and another post where a member actually found out she was pregnant. While it is always paramount for long-term success in smoking cessation that the smoker focuses on the fact that he or she is quitting for his or her own primary benefit, this is an area that a woman needs to take a little extra consideration for another life.



There are great risks posed to the unborn child if women smoke while pregnant. There is a greater risk of smaller babies, sicker babies, stillbirths, and more death within the first year of life. Children who grow up in smoking households have more chronic colds and respiratory diseases.



I haven't researched this area for quit sometime, but I know years ago that there were some pretty strong studies that showed that if women quit smoking during the first trimester of pregnancy, the risk of low birth weight babies were reduced back to non-smoking mothers again. It seemed at least at that time that a good part of the danger was induced smoking past that time period.



It is important for women who are in the stage of their lives of family planning take their smoking into consideration. The idea of just quitting to get pregnant or having a baby can pose a risk after the baby is delivered. You can figure now that the risks are now gone, you quit for the important time period. But still keep in mind that even though you did your baby a favor by quitting, you really did yourself the bigger favor.



For not only did you reduce the risk to your baby, you reduced your risk of being sicker throughout your life and eventually dying prematurely--you increased your ability to be active with your baby, throughout his or her life, even when your baby becomes an adult. You increased the odds that you will be around to see your baby eventually have children of his or her own, and even then you can be an active participant in yet another generation, as opposed to an elderly person on oxygen who watches family events from the sidelines, if you can even go to see them at all.



Quitting for pregnancy is a reason to start your quit. Staying off though is more comprehensive than this. There are many other benefits that go along with staying an ex-smoker that will stick with you throughout your entire life. To keep these benefits, always remember that the best way to improve "your" overall health and quality of life is to never take another puff!



Joel



Here is a link to the CDC fact sheet on smoking and pregnancy. There are plenty of other sites that I am sure have similar information too. I just went for the first one that popped up in a search engine.
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Joined: November 13th, 2008, 2:04 pm

January 30th, 2009, 4:55 pm #2

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Recommend Message 2 of 90 in Discussion
From: Amy Jane (Gold) Sent: 6/7/2001 2:36 PM
Joel,

Your post will be a great support to anyone planning to have a baby or already pregnant. I only wish I had had this kind of information when I was pregnant two years ago.


In January of 1999, once I realized I was pregnant, I had no trouble quitting smoking. In fact, it seemed absurbly easy. I was nicotine free all during my pregnancy and for my three months of maternity leave while I was breastfeeding. I never felt tempted to cheat during that almost year long period. But on the very first day on my way back to work, I stopped at a convenience store, bought a pack of smokes and never looked back.
The reason?? I hadn't yet decided to quit for MYSELF. I had only quit smoking to help ensure a healthy baby. In the back of my mind, I think I always knew I would go back to my smoking once I was able to. Now, 20 months later, I'm finally quitting for myself. There are a million other great reasons I'm quitting, too, but my main reason is me. Even though I've only quit for 3 weeks and 4 days, I'm 100 times prouder of this quit than when I quit for 11 months because I'm finally doing it ME.

And as god as my witness, this quit is definitely my last.

So anyone out there quitting because you're pregnant, make sure you read Joel's post again and again and again. It sure would have save me over a year of wasted time smoking.


Amy
Haven't smoked for 3 Weeks 5 Days 38 Minutes 29 Seconds. Cigarettes not smoked: 260. Money saved: $58.69.
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Recommend Message 3 of 90 in Discussion
From: Joel. Sent: 6/7/2001 2:45 PM
Hello Amy Jane:

About quitting while pregnant being absurdly easy. I have known numerous women who spontaneously quit smoking by literally, "losing their taste or stomach" for smoking, only to find out days later that they were in fact pregnant. It seems some women almost have an instinctive knowledge, or at least their bodies instinctively know that smoking and pregnancy don't mix. But it is amazing how fast the desire returns after delivery. I have had a number of women joke with me that as soon as they delivered the baby they were asking when they could have a cigarette even before they asked what the sex of the baby was.

Again, quitting for a baby will help for a nine-month period, but for a longer commitment, a lifelong commitment so to say you have to be quitting for yourself. Again, while others may benefit, even your own children, you are still the primary benefactor.

Thanks for sharing your input here. To make this quit last through all the births you ever encounter, whether it be your own children, your children's children, or all your future descendants, always remember for yourself to be smoke free for the rest of your life you must never take another puff!

Joel
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Recommend Message 4 of 90 in Discussion
From: Joel. Sent: 9/9/2001 10:05 PM
For Maggie
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Recommend Message 5 of 90 in Discussion
From: Joel. Sent: 10/22/2001 1:16 PM
Hello again Maggie. I see we already covered this, but it can't hurt pointing it out again.

Joel
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Recommend Message 6 of 90 in Discussion
From: happycamper-67 Sent: 10/22/2001 1:25 PM
excellent
thanks!!!

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Recommend Message 7 of 90 in Discussion
From: John (Gold) Sent: 10/30/2001 2:13 PM
European Journal of Public Health, Volume 11, Issue 3, pp. 334-339: Abstract.

October 30, 2001

Postpartum return to smoking among usual smokers who quit during pregnancy N Lelongz, M Kaminski, M-J Saurel-Cubizolles, and M-H Bouvier-Colle

INSERM Unit 149, Epidemiological Research on Women's Health and Perinatal Health, 16 Avenue Paul Vaillant Couturier, 94807 Villejuif cedex, France
zCorresponding author
Tel: +33 1 45 595002
Fax: +33 1 45 595089

Background. Many women stop smoking while they are pregnant, but the majority resume smoking in the postpartum. The objective is to describe postpartum tobacco use of women who quit during pregnancy and factors predicting postpartum smoking relapse.

Method. Secondary analysis of two surveys of new mothers. Survey A conducted in three maternity hospitals, including 685 women interviewed after birth and who answered a postal questionnaire at 5 months postpartum; survey B conducted in four 'départements' (administrative areas), including 636 women who answered a postal questionnaire at 6 months postpartum. Response rates were respectively 90% and 68%. smoking status was recorded for three time periods: before pregnancy, during pregnancy, and at 5-6 months. Social and those who had not, and among quitters, who had resumed smoking postpartum and those who had not.

Results. In survey A, 37% were smokers before pregnancy, 34% of them stopped during pregnancy, and among the latter, 48% had resumed smoking 5-6 months after delivery. In survey B, the percentages were respectively 43, 54 and 57%. The most predictive factor of postpartum smoking relapse was the partner's smoking behaviour.

Conclusion. Return to smoking after delivery is frequent, but nearly half of the regular smokers who had stopped during pregnancy were still non-smokers 5-6 months after the birth. However, to increase this proportion, interventions need to include partners, especially if they are smokers.

Keywords: Postpartum, pregnancy, smoking partners, tobacco smoking

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Recommend Message 8 of 90 in Discussion
From: Kinzismom (green) Sent: 10/30/2001 4:09 PM
This is my story! I quit smoking the day I found out I was pregnant and didn't smoke until I had weaned my daughter. I started right back up the first chance I got!

I do have a question though~ I have heard that pregnant women shouldn't quit cold turkey? Is this true??

Tracie
One week, one day, 16 hours, 11 minutes and 41 seconds. 173 cigarettes not smoked, saving $28.19. Life saved: 14 hours, 25 minutes.
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Recommend Message 9 of 90 in Discussion
From: John (Gold) Sent: 10/30/2001 6:35 PM
Kinzismom, I'm sure your question comes as a bit strange to most here at Freedom as we fully admit that we are nicotine addicts so there is no other way to QUIT using nicotine than to quit using nicotine. Anything else isn't quitting.

It could be that you're referring to the potential harm to the fetus from being put into withdrawal but I've yet to see any study on specifically addressing the issue. In my last live two week clinic I had a mother who was seven months pregnant and still smoking. We spent lots of time talking about her baby being born addicted to nicotine and spending its very first day alone on earth going through physical nicotine withdrawal but to no avail. Eleven of 14 graduated, including her sister, but she wasn't among them. I think we all felt bad.
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Recommend Message 10 of 90 in Discussion
From: John (Gold) Sent: 10/30/2001 6:39 PM
Correction, 9 of 14 graduated - I'm just a dreamer : )
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Recommend Message 11 of 90 in Discussion
From: Joel. Sent: 10/31/2001 5:06 AM
Hello Kinzismom:

Sorry I didn't get to this yesterday although John has it covered already. There are people out there who will tell you that quitting cold turkey is too hard for all people and NRT and other pharmaceutical products will lessen the impact and improve your success. But as you see at Freedom, cold turkey is not too hard considering everyone here has pulled it off and if you talk to ex-smokers here and elsewhere who have successfully quit cold turkey and had used other miracle products in the past--that the cold turkey quit was likely no worse and in many cases even easier than the previous pharmaceutically aided attempts. But even most NRT advocates don't push the products to pregnant women leaving cold turkey the basic method of choice by most.

As far as being cold turkey possibly being too hard on your system--the short-term effects of withdrawal are nothing compared to the chronic assault of nicotine and carbon monoxide on the fetus. The risks of not quitting are real and as can be seen by the article and link above, if you are worried about the health of your baby and then your ability to be a parent to your child for a longer and healthier lifetime always remember to never take another puff!

Joel
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Recommend Message 12 of 90 in Discussion
From: marty (gold) Sent: 10/31/2001 7:56 AM
On the subject of pregnancy, I just heard a headline on the radio this morning (in the UK) that new medical research shows that smoking has a contraceptive effect. In the study, smoking women took on average two months longer to conceive than non-smokers. If I read any more detailed info, I'll post it.
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Recommend Message 13 of 90 in Discussion
From: Joel. Sent: 10/31/2001 8:49 AM
Hello Marty:

This is not a new revelation. Here is a Fact Sheet produced by ASH in the United Kingdom. (Your hometown )

FACT SHEET NO. 7

July 2001

SMOKING, SEX & REPRODUCTION

Introduction

Cigarette smoking can affect women's fertility; men's fertility; sexual function in men; pregnant women's health; the health of an unborn child; and the health of young children.

Fertility

Women who smoke may have reduced fertility. One study found that 38% of non-smokers conceived in their first cycle compared with 28% of smokers. Smokers were 3.4 times more likely than non-smokers to have taken more than one year to conceive. It was estimated that the fertility of smoking women was 72% that of non-smokers.[1] A recent British study found that both active and passive smoking was associated with delayed conception.[2] Cigarette smoking may also affect male fertility: spermatozoa from smokers has been found to be decreased in density and motility compared with that of non-smokers.[3]

Male sexual impotence

Impotence, or penile erectile dysfuntion, is the repeated inability to have or maintain an erection. One US study of men between the ages of 31 and 49 showed a 50% increase in the risk of impotence among smokers compared with men who had never smoked.[4] Another US study, of patients attending an impotence clinic, found that the number of current and ex-smokers (81%) was significantly higher than would be expected in the general population (58%).[5]

Overall smoking increases the risk of impotence by around 50% for men in their 30s and 40s. ASH and the British Medical Association have calculated that around 120,000 UK men in this age group are needlessly impotent as a result of smoking.[6]

Smoking and oral contraceptives

For younger women, smoking and the use of oral contraceptives increases the risk of a heart attack, stroke or other cardiovascular disease by tenfold. This effect is even more marked in women over 45.[7] It is therefore important that all women who take the contraceptive pill be advised not to smoke.

Smoking and pregnancy

Approximately one-quarter of pregnant women in the UK smoke. Women who smoke in pregnancy are more likely to be younger, single, of lower educational achievement and in unskilled occupations. The male partner is more likely to smoke. Only one in four women who smoke succeed in stopping at some time during pregnancy. Almost two-thirds of women who succeed in stopping smoking in pregnancy restart again after the birth of their baby.[8] In December 1998, the Government set a target to reduce the percentage of women who smoked during pregnancy from 23% to 15% by the year 2010, with a fall to 18% by 2005.[9] This will mean approximately 55,000 fewer women in England who smoke during pregnancy.

Foetal growth and birth weight

Babies born to women who smoke are on average 200 grams (8 ozs) lighter than babies born to comparable non-smoking mothers. Furthermore, the more cigarettes a woman smokes during pregnancy, the greater the probable reduction in birth weight. Low birth weight is associated with higher risks of death and disease in infancy and early childhood. The adverse effects of smoking in pregnancy are due mainly to smoking in the second and third trimesters. Therefore, if a woman stops smoking within the first three months of pregnancy, her risk of having a low‑weight baby will be similar to that of a non-smoker. 8

Spontaneous abortion

The rate of spontaneous abortion (miscarriage) is substantially higher in women who smoke. This is the case even when other factors have been taken into account.8

Other complications of pregnancy

On average, smokers have more complications of pregnancy and labour which can include bleeding during pregnancy, premature detachment of the placenta and premature rupture of the membranes.[10] Some studies have also revealed a link between smoking and ectopic pregnancy 10 and congenital defects in the offspring of smokers.[11]

Perinatal mortality

Perinatal mortality (defined as still‑birth or death of an infant within the first week of life) is increased by about one-third in babies of smokers. This is equivalent to approximately 420 deaths per year in England and Wales. The increased perinatal mortality in smoking mothers occurs particularly among manual socio-economic groups and in groups that are already at high risk of perinatal death, such as older mothers or those who have had a previous perinatal death. More than one-quarter of the risk of death due to Sudden Infant Death Syndrome (cot death) is attributable to maternal smoking (equivalent to 365 deaths per year in England and Wales).8

Passive smoking and pregnancy

Exposure by the mother to passive smoking has also been associated with lower birth weight, a higher risk of perinatal mortality and spontaneous abortion.[12]

Breast feeding

Research has shown that smoking cigarettes may contribute to inadequate breast milk production. In one study, fat concentrations were found to be lower in the milk from mothers who smoked and milk volumes were lower.[13]

Health and long‑term growth

Infants of parents who smoke are twice as likely to suffer from serious respiratory infection than the children of non-smokers. (See also Fact Sheet No. 8, Passive Smoking.) Smoking in pregnancy may also have implications for the long term physical growth and intellectual development of the child. It has been associated with a reduced height of children of smoking mothers as compared with non-smoking mothers, with lower attainments in reading and mathematics up to age 16 and even with the highest qualification achieved by the age of 23.[14] One study has demonstrated a link between maternal smoking during pregnancy and adult male crime.[15] There is also evidence that smoking interferes with women's hormonal balance during pregnancy and that this may have long-term consequences on the reproductive organs of her children.[16]

Smoking and cervical cancer

Epidemiological studies have found that women who smoke have up to four times higher risk of developing cervical cancer than non-smokers and that the risk increases with duration of smoking. Studies have demonstrated biochemical evidence that smoking is a causal factor in cervical cancer.[17][18]

Smoking and the menopause

The natural menopause occurs up to two years earlier in smokers. The likelihood of an earlier menopause is related to the number of cigarettes smoked, with those smoking more than ten cigarettes a day having an increased risk of an early menopause.[19] New research suggests that polycyclic aromatic hydrocarbons found in tobacco smoke can trigger premature egg cell death which may in turn lead to earlier menopause. [20]

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Joined: November 13th, 2008, 2:04 pm

January 30th, 2009, 4:56 pm #3

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Recommend Message 17 of 90 in Discussion
From: John (Gold) Sent: 12/9/2001 10:57 AM
Mothers who smoke may be
hearing from colicky babies

Ronald Kotulak and Jon Van
Chicago Tribune
Published December 9, 2001

One way to reduce the risk of having a colicky baby is not to smoke during pregnancy.

When Danish researchers at Aarhus University Hospital studied 1,820 women and their newborns, they found that women who smoked 15 or more cigarettes per day during pregnancy were twice as likely to have a colicky baby than mothers who didn't smoke.

About 1 of 10 infants are colicky at birth, a condition marked by excessive crying that usually subsides by the age of 3 or 4 months.

Prenatal smoking is known to inhibit fetal growth, and it may be that it promotes colic by delaying the development of the central nervous system, Dr. Charlotte Sendergaard reported in Pediatrics, a journal of the American Academy of Pediatrics.
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Recommend Message 18 of 90 in Discussion
From: John (Gold) Sent: 12/20/2001 5:37 AM
THE JOURNAL OF PHARMACOLOGY AND EXPERIMENTAL THERAPEUTICS
Vol. 300, Issue 1, 124-133, January 2002

Prenatal Nicotine Exposure Evokes Alterations of Cell Structure in Hippocampus and Somatosensory Cortex <NOWRAP>Tara Sankar Roy,<WBR> Frederic J. Seidler and<WBR> Theodore A. Slotkin </NOWRAP>

Department of Pharmacology and Cancer Biology, Duke University Medical Center, Durham, North Carolina <ABS>

Offspring of women who smoke during pregnancy show behavioral abnormalities, including increased incidence of attentional deficit, learning disabilities, and cognitive dysfunction. Animal models indicate that nicotine elicits changes in neural cell replication and differentiation, leading to deficits in synaptic neurochemistry and behavioral performance, many of which first emerge at adolescence. We evaluated cellular morphology and regional architecture in the juvenile and adolescent hippocampus and the somatosensory cortex in rats exposed to nicotine prenatally. Pregnant rats were given nicotine throughout gestation via minipump infusion of 2 mg/kg/day, a regimen that elicits nicotine plasma levels comparable with those found in smokers. On postnatal days 21 and 30, brains were perfusion-fixed, coronal slices were taken between the anterior commissure and median eminence, and the morphology of the dorsal hippocampus and somatosensory cortex was characterized. In the hippocampal CA3 region and dentate gyrus, we found a substantial decrease in cell size, with corresponding decrements in cell layer thickness, and increments in cell packing density. Smaller, transient changes were seen in CA1. In layer 5 of the somatosensory cortex, although there was no significant decrement in the average cell size, there was a reduction in the proportion of medium-sized pyramidal neurons, and an increase in the proportion of smaller, nonpyramidal cells. All regions showed elevated numbers of glia. Taken together with previous work on neurochemical and functional defects, these data demonstrate that prenatal nicotine exposure compromises neuronal maturation, leading to long-lasting alterations in the structure of key brain regions involved in cognition, learning, and memory.
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Recommend Message 19 of 90 in Discussion
From: Joel. Sent: 3/22/2002 5:17 PM
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From: Joel. Sent: 4/6/2002 3:16 AM
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From: Joel. Sent: 4/6/2002 4:25 PM
For Mirigirl
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From: Joel. Sent: 4/26/2002 5:48 AM
For Triin
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From: Joel. Sent: 5/29/2002 11:51 PM
For Kate
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Recommend Message 24 of 90 in Discussion
From: John (Gold) Sent: 7/5/2002 8:12 AM
Nicotinic receptor expression following nicotine exposure via maternal milk.

Narayanan U, Birru S, Vaglenova J, Breese CR.


Neuroreport 2002 May 24;13(7):961-3

http://www.ncbi.nlm.nih.g...2004199&dopt=Abstract

Department of Pharmacal Sciences, Auburn University, Harrison School of Pharmacy, 401 Walker Building, Auburn, AL 36849, USA.

Studies have shown nicotine is excreted into maternal milk, so that suckling offspring would be a target of the drug during the pre-weaning period. Since nicotine exposure leads to an upregulation of neuronal nicotinic receptors, this study examines the hypothesis that nicotine delivered via maternal milk is capable of altering neuronal nicotinic receptor regulation in the drug-exposed rat pups. The present study showed that postnatal nicotine exposure via maternal milk was sufficient to induce an upregulation in brain nicotinic receptors similar to that seen in adults that smoke. Such exposure may result in altered neuronal development and synaptic activity and structure, potentially leading to long-term behavioral, learning, and memory deficits.

PMID: 12004199 [PubMed - in process]
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Recommend Message 25 of 90 in Discussion
From: John (Gold) Sent: 7/13/2002 10:29 AM
Fetal Nicotine Exposure Tied to Breathing Problems
Fri Jul 12, 1:35 PM ET
NEW YORK (Reuters Health) - Nicotine exposure in the womb, even in the absence of other substances present in tobacco smoke, may lead to breathing difficulties in newborns, results of an animal study suggest.
The findings indicate that nicotine can have lasting harmful effects on developing fetal lungs, according to Dr. Hakan Sundell and colleagues of Vanderbilt University School of Medicine in Nashville, Tennessee.
"The issue is of clinical significance, because nicotine replacement for pregnant women is often regarded as a safe alternative in smoking cessation programs," they write in the American Journal of Respiratory and Critical Care Medicine.
The study involved a group of lambs that were exposed during their last trimester in the womb to nicotine through pumps that had been implanted in their mothers. The level of nicotine was equivalent to what a human fetus would be exposed to if a pregnant woman smoked mildly to moderately, the report indicates. A second group of lambs was not exposed to nicotine.
For a 5-week period after the lambs were born, various lung function tests showed that the animals exposed to nicotine in the womb had faster and more shallow breathing than those that had not been subjected to nicotine, according to the report.
"Prenatal nicotine exposure appears to have long-term effects on the postnatal breathing pattern, suggesting altered lung function," Sundell and colleagues write. "These changes are most marked close to birth but persist during the initial postnatal period."
Nicotine easily passes through the human placenta to a developing fetus, the researchers point out. And concentrations of nicotine in the fetus can be equal to or higher than in the mother, they add.
SOURCE: American Journal of Respiratory and Critical Care Medicine 2002;166:92-97.
Copyright © 2002 Reuters Limited. All rights reserved
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Recommend Message 26 of 90 in Discussion
From: John (Gold) Sent: 7/13/2002 10:34 AM
American Journal of Respiratory and Critical Care Medicine
Vol 166. pp. 92-97, (2002)
© 2002
American Thoracic Society

Altered Breathing Pattern after Prenatal Nicotine Exposure in the Young Lamb </NOBR><NOBR>Ola Hafström</NOBR>, <NOBR>Joseph Milerad</NOBR> and <NOBR>Håkan W. Sundell</NOBR>
Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee[/size]

Correspondence: Correspondence and requests for reprints should be addressed to Håkan W. Sundell, M.D., Professor of Pediatrics, Vanderbilt University School of Medicine, U-1212, MCN, Nashville, Tennessee 37232-2585. E-mail: [url=mailto:hakan.sundell@mcmail.vanderbilt.edu]hakan.sundell@mcmail.vanderbilt.edu[/url][/size]

Maternal smoking during pregnancy is a risk factor for sudden fetal and infant death as well as obstructive airway disease in childhood. Fetal nicotine exposure affects organ development. The aim of the present study was to investigate effects of fetal nicotine exposure on lung function in young lambs. Nine unanesthetized, awake, prenatally nicotine-exposed lambs (N) (approximate maternal dose: 0.5 mg/kg) and 12 nonexposed control lambs (C) were studied repeatedly for 5 weeks after birth using a pneumotachograph and a computerized method for breath-by-breath determinations. N and C lambs had similar minute ventilation but a markedly different breathing pattern. At both 5 and 21 days, average age, N lambs had significantly lower tidal volumes and higher respiratory rates than C lambs. Inspiratory drive (P0.1) and effective impedance were significantly higher in N lambs compared with C lambs only at 5 days. Prenatal nicotine exposure appears to have long-term effects on the postnatal breathing pattern, suggesting altered lung function, e.g., increased airway resistance, decreased lung compliance, or both. The increased inspiratory drive is most likely secondary to increased impedance of the respiratory system. These changes are most marked close to birth but persist during the initial postnatal period.

Key Words: respiration • respiratory mechanics • nicotine • prenatal exposure delayed effects • tobacco
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Recommend Message 27 of 90 in Discussion
From: John (Gold) Sent: 7/30/2002 6:56 AM

SMOKING MOMS BOOST UNBORN
BABIES' AUTISM RISK: DOCS
By BILL HOFFMANN
N.Y. Post

July 29, 2002 --- If you're pregnant and still hooked on cigarettes, here's another reason to quit - smoking may increase your baby's risk of developing autism.


Researchers at the Karolinska Institute in Sweden found that pregnant women who smoke regularly are 40 percent more likely to have autistic kids.

The study of 2,000 kids and their mothers found that smoking appears to restrict growth in the womb, contributing to the condition.

Dr. Christina Hultman said similar research on animals revealed that exposure to nicotine while in the womb has physical and behavioral effects that leads to problems with brain function.

Autism is a developmental disability that affects the way a person communicates and interacts with other people.

People with autism cannot relate to others in a meaningful way, and they also have trouble making sense of the world at large.

As a result, their ability to develop friendships is impaired and they have a limited capacity to understand other people's feelings. Autism is also often also associated with learning disabilities.

Smoking during pregnancy has also been linked to other problems in kids, including stunted growth and respiratory problems.

Pregnant women who smoke are urged immediately to contact their doctor to get on a cessation program.
Copyright 2002 NYP Holdings, Inc. All rights reserved.
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Recommend Message 28 of 90 in Discussion
From: John (Gold) Sent: 8/17/2002 6:11 AM

<FONT=-1>Fri Aug 16 10:01:32 2002 Pacific Time

When Moms Smoke, Certain Kids Are More Vulnerable to Respiratory Disease; Children With Key Common Genetic Variation Are More Susceptible to Asthma and Other Breathing Problems If Exposed to Tobacco in Womb LOS ANGELES, Aug. 16 (AScribe Newswire) -- Certain children appear especially susceptible to respiratory problems if their mothers smoked during their pregnancy, according to preventive medicine researchers at the Keck School of Medicine of USC.

Children with a common genetic variant who were exposed to maternal cigarette smoke in the womb were significantly more likely to have asthma, wheezing and emergency room visits due to breathing problems than other similar children, according to a study in the Aug. 15 issue of the American Journal of Respiratory and Critical Care Medicine.

Frank D. Gilliland, M.D., Ph.D., professor of preventive medicine, and colleagues conducted their study with 2,950 school children in 4th, 7th and 10th grades in Southern California. They asked parents about maternal smoking while pregnant and about respiratory health problems currently or previously experienced by children.

The children were participants in the expansive Children's Health Study, led by USC researchers. Scientists have monitored levels of major pollutants in 12 Southern California communities since 1993 while carefully following the respiratory health of thousands of children in these areas.

Previous research has shown that environmental tobacco smoke impairs lung growth and development in children, and recent reports have suggested exposure in the womb is associated with deficits in lung function at birth that may persist into young adulthood.

This study pinpoints for the first time a group of children who appear genetically susceptible to the effects of smoke from their very beginnings.

"The study illustrates that experiences during the period in the womb are very important for long term health, especially among genetically susceptible children, and emphasize the importance of pregnant women not smoking," Gilliland said.

Researchers collected cell samples from the mouth of each child and analyzed their DNA. They looked for variation in a gene called glutathione S-transferase M1, or GSTM1. This gene is responsible for creating an enzyme the lung uses to protect itself from pollutants. It helps the lungs detoxify some of the products of tobacco and it defuses oxidants before they can cause damage to delicate lung tissue.

This gene occurs in two common forms in the population-either present or null. Differences between present and null genes are small, but they mean a lot. When children are born with two of the null form of the gene, known as the GSTM1 null genotype, their bodies cannot produce the protective enzyme at all.

Among children in the study, more than 16 percent had a mother who smoked while the child was still in the womb. More than 45 percent of all children had the GSTM1 null variant genotype.

When researchers looked only at children with the GSTM1 null genotype, they found that in utero exposure to smoke was associated with increased prevalence of numerous respiratory symptoms:

- 3.7-fold risk increased risk for emergency room visits during the past year;

- 2.2-fold and 2.1-fold increased risks for wheezing with exercise and wheezing requiring medication, respectively;

- 80 percent increased risk for lifetime history of wheezing; and

- 70 percent and 60 percent increased risks for asthma with current symptoms and early onset asthma, respectively.

In contrast, researchers found no increased risk for respiratory problems among exposed children with the GSTM1 present genotype (at least one copy of the GSTM1 present allele).

Researchers warn that further studies are needed to confirm findings. The group hopes to examine links between other genes and respiratory disease risk. They already have shown that a variant in the glutathione S-transferase P1 gene is linked to decreased risk of respiratory illness-related school absences.

"Findings show that exposure to smoke in the womb for certain genetically susceptible children may have long-term health effects," Gilliland says. "Maternal smoking is common, and the null genotype is found in nearly half of the population, so this high-risk group might be an important population to target for prevention."

The research was funded by the California Air Resources Board, the National Institute of Environmental Health Sciences, the Environmental Protection Agency, the National Heart, Lung and Blood Institute and the Hastings Foundation.

Frank D. Gilliland, Yu-Fen Li, Louis Dubeau, Kiros Berhane, Edward Avol, Rob McConnell, W. James Gauderman and John Peters. "Effects of GSTM1, Maternal Smoking during Pregnancy, and Environmental Tobacco Smoke on Asthma and Wheezing in Children," American Journal of Respiratory and Critical Care Medicine, Aug. 15, 2002, Vol. 166, No. 3.

-30-
AScribe - The Public Interest Newswire / 510-653-9400
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Recommend Message 29 of 90 in Discussion
From: Joel. Sent: 8/28/2002 4:47 PM
For Susan
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Recommend Message 30 of 90 in Discussion
From: John (Gold) Sent: 9/3/2002 6:49 PM
Study Suggests Why Cigarette Smoke a SIDS Risk
Tuesday Sep 3, 2002
BERLIN (Reuters Health) - Italian researchers have found a possible explanation for why exposure to cigarette smoke during pregnancy may increase a baby's risk of sudden infant death syndrome or SIDS.

In a study presented here at the European Society of Cardiology annual conference, Professor Alessandro Mugelli from the University of Florence and colleagues found that exposing rats to carbon monoxide, a component of cigarette smoke, can interfere with the maturation of heart cells in the developing fetus.

"We found that there is an alteration which may explain the link between smoking and SIDS, so the message is, don't smoke if you are pregnant, and don't smoke in a room where there is a baby," Mugelli said.

The researchers exposed pregnant rats to carbon monoxide at a concentration of 150 parts per million, which simulates the levels experienced by a cigarette smoker.

The exposure delayed the maturation of some properties in heart cells that affect the QT interval. The QT interval is one portion of an electrocardiogram, or ECG, the tracing of the heart's electrical activity.

Babies who have a long QT interval have a higher risk of irregular heartbeats, and this may predispose these newborns to sudden death, Mugelli said.

"We knew that smoking is a risk-factor for SIDS, but we didn't know the mechanism," Mugelli told Reuters Health.

SIDS is the most common cause of death among newborns, Mugelli said. Placing a baby on his or her stomach rather than the back to sleep can greatly increase the risk of SIDS. Overheated rooms, secondhand smoke and fluffy bedding are also a risk.
Copyright © 2002 Reuters Limited. All rights reserved
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Recommend Message 31 of 90 in Discussion
From: OBob-Gold Sent: 9/4/2002 3:45 PM
A question:

Have there been any studies on nicotine in mother's milk? Several months ago, we had a conversation about how quickly we became addicted, and tried to informally relate that to whether or not our mothers smoked. Reading another post here, it occurred to me that perhaps nicotine could (?) be transferred through breast milk, and that perhaps children of mothers who smoke become more susceptible to rapid addiction than others because of this?

Just curious if any studies exist.

Bob
Quote
Like
Share

Joined: November 13th, 2008, 2:04 pm

January 30th, 2009, 4:56 pm #4

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Recommend Message 32 of 90 in Discussion
From: Changingmyname(SILVER!!) Sent: 9/4/2002 4:07 PM
Mmmmm, Bob, being a nursing mother I've researched this as much as I could (at first to justify continuing smoking, and then to educate myself and motivate myself to quit) and there have been some studies on breastmilk and smoking, but I think I've only seen one long-term study done to show how easily a child is addicted later in life. There are some real problems with all of the variables; the level of consumption, the exposure of the infant to second-hand smoke (whether in the air or on clothes), smoking in pregnancy, and the constantly changing nature of breastmilk. I know Le Leche League states that a consumption of 15 per day is fine, and this is based on not smoking AROUND your child. However, so many studies don't take into consideration whether or not the mother DOES smoke outside or not.

Anyway, you're aware of all this already, I'm sure, but I'm curious...am I allowed to post links to outside sites here?
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Recommend Message 33 of 90 in Discussion
From: Changingmyname(SILVER!!) Sent: 9/4/2002 4:08 PM
That last is from me, Theresa. I realized I wanted my screen name to be a bit more annonymous.

Theresa, 11 days strong!
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Recommend Message 34 of 90 in Discussion
From: OBob-Gold Sent: 9/4/2002 4:22 PM
I copied this from the Courtesies thread. You might email the managers to double check whether or not you can post a specific link.


SOLICITING or SPAMMING - Both practices are prohibited. If you'd like to post an external link that will encourage our members to visit a site outside the confines of WhyQuit.com, please clear it through any Freedom Manager first. Thanks!
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Recommend Message 35 of 90 in Discussion
From: Changingmyname(SILVER!!) Sent: 9/4/2002 5:19 PM
Thanks, Bob, I did send off an email. By the way, in all my 'just quit' babbling (I find I babble far more these days) I forgot to mention that the one study I saw showed higher levels of addiction, but of course could not say whether or not it is due to the modeling involved rather than the activation of a physical trigger. I'm going to pull out my physiology book tonight to take a look :-)

Theresa
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Recommend Message 36 of 90 in Discussion
From: Joel. Sent: 9/29/2002 11:20 AM
For Tulip:

You had mentioned that you didn't exactly count your quits when being pregnant as being real quits. In a sense it is true. The quits were real and were a benefit to your children, but they were not quits that were destined to last if you worked on the basis that you were quitting mainly for your children's benefit or as I think you realized, that you quit smoking at those times because cigarettes became aversive to you while you were pregnant. While pregnancy may be the impetus for some women starting a quit, more ammunition needs to be developed and worked on for these women to sustain their quits. Long-term abstinences is going to require that the ex-smoker is truly sustaining his or her quit for himself or herself. You are the primary benefactor of your quit and to keep the benefits is as simple as always remembering to never take another puff!

Joel
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Recommend Message 37 of 90 in Discussion
From: Joel. Sent: 10/3/2002 7:07 AM
For MSF:

You will see from the post above, there are women who just seem to lose interest in smoking when pregnant. It is interesting because some of these women lose all desire for cigarettes before they actually even knew they were pregnant, as if their bodies just knew not to smoke. Unfortunately, if these same women do not work on establishing good reasons to stay off of smoking, they often relapse shortly after delivery. Back in the days when smoking was allowed in hospitals, some of these women relapsed almost instantly. I used to joke about it in clinics, to illustrate how strong the desire would be to these women I would say that they almost asked for a cigarette before they would ask what was the sex of the baby. Many women in my groups nodded and said they knew exactly what I was saying from their past experiences.

So as I said to Tulip up above, while pregnancy may be the impetus for some women starting a quit, more ammunition needs to be developed and worked on for these women to sustain their quits. Long-term abstinences is going to require that the ex-smoker is truly sustaining his or her quit for himself or herself. You are the primary benefactor of your quit and to keep the benefits is as simple as always remembering to never take another puff!
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Recommend Message 38 of 90 in Discussion
From: John (Gold) Sent: 11/15/2002 1:35 PM
Dangers of smoking while pregnant need
to be emphasized by health care providers
The Daily Telegram
Last Updated: Friday, November 15th, 2002 10:57:46 AM
It's bad enough that many pregnant women in Wisconsin would risk the health of their newborns by smoking. But a recent survey raises troubling questions about whether doctors and other health care providers are doing enough to get these women to stop.

A survey released this week by the Center for Tobacco Research and Intervention at the University of Wisconsin Medical School offers some chilling numbers: 48 percent of women smokers said they continued to smoke after learning they were pregnant, and that's hardly improved since the 1960s when the number was 52 percent. The 2000-2001 survey found that 31 percent said they were able to stop for at least a week, compared with 10 percent who quit at least that long during the 1960s. While there's been some improvement over the years, the problem is continued smoking - pregnancies last much longer than a week or so.

This is a major health issue that requires an active role from doctors. Instead, the center's research found that 88 percent of doctors and other health providers asked pregnant patients about smoking, and 78 that percent advised their patients to quit. That begs the question, why aren't the other doctors raising the issue? And why did only 78 percent urge these pregnant smokers to quit? Not pushing the issue is irresponsible and failing the patients and their unborn babies.

Smoking during pregnancy is serious because it raises the risk of premature birth, sudden infant death syndrome and lower birth rate, and also causes a higher rate of infant deaths. Yet the survey of state residents showed that only 20 percent of pregnant smokers over the past 10 years were encouraged to set a date for quitting; and only one in 10 were offered referral to smoking-cessation programs.

To be fair, it's likely that many doctors do talk to pregnant smokers about the risks. And it probably doesn't take a lot of face-to-face office time to emphasize the need to quit and to offer suggestions on how to get help. Because people generally look up to their doctors, doctors can influence their patients if they take the time. Education ought to be an essential part of care for the mother and child, whether it concerns nutrition or dangerous behavior such as drinking and smoking.

According to Dr. Michael Fiore, director of the center, "The health effects for both the woman and her baby are extraordinary. We know that benefits begin literally the day of quitting."
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Recommend Message 39 of 90 in Discussion
From: John (Gold) Sent: 11/22/2002 9:34 AM
A reexamination of smoking
before, during, and after pregnacy

Source: American Journal of Public Health
Publication date: 2002-11-01
Arrival time: 2002-11-20


Objectives. This study examined the patterns and correlates of maternal smoking before, during, and after pregnancy.
Methods. We examined socioeconomic, demographic, and clinical risk factors associated with maternal smoking in a nationally representative cohort of women (n = 8285) who were surveyed 175 months and again 355 months after delivery.

Results. Smoking rates among women with a college degree decreased 30% from before pregnancy to 35 months postpartum but did not change among the least educated women. Risk factors clustered, and a gradient linked the number of risk factors (0, 2, 4) to the percentage smoking (6%, 31%, 58%, P<.0001).

Conclusions. The period of pregnancy and early parenthood is associated with worsening education-related disparities in smoking as well as substantial clustering of risk factors. These observations could influence the targeting and design of maternal smoking interventions. (Am J Public Health. 2002;92:1801-1808)

Smoking poses a significant threat to women's health.1 Women are more likely to stop smoking during pregnancy than at other times,1 yet the majority who quit are smoking again within 1 year postpartum.2-8 The lack of sustained benefit from interventions during pregnancy and postpartum9-16 suggests that our understanding of the determinants of smoking before, during, and after pregnancy remains inadequate.

In the only national population-based longitudinal study to examine this issue, Fingerhut et al.2 found that although 39% of smokers quit during pregnancy, 70% of them relapsed within 1 year postpartum. The lowest quitting rates were among those who smoked most before pregnancy and who had the least education. No significant risk factors for smoking relapse were identified. Although this was an important early contribution to smoking cessation research, the study included only White women, had a small sample size for examining relapse rates (n= 191 quitters), and did not assess potentially important risk factors, such as income17 and the presence of other household smokers.3,5-7,18 A populationbased, cross-sectional study found similar quitting and relapse rates but also identified African American race, parity, stressful events, and pregnancy weight gain as predictors.8 Other studies have found additional significant factors, including marital status,19 alcohol use,12 and breastfeeding.3,4 Surprisingly few studies have examined maternal depression despite the link between depression and smoking outside the context of pregnancy20-26 and its prevalence among women with young children.27,28

This prior research offers a detailed but fragmented picture of the factors associated with maternal smoking. First the relative importance of any given risk factor is difficult to interpret, because past studies each examined different sets of covariates. Second, important clinical (e.g., depressive symptoms) and social (e.g., income) risk factors remain inadequately studied. Third, no study has examined the clustering of these risk factors or assessed their cumulative effects.29-31 Finally, small sample sizes,3,5-7 sample homogeneity,2 and a lack of longitudinal data17 have further limited interpretation. The present study used data from the 1988 National Maternal and Infant Health Survey (NMIHS) and 1991 Longitudinal Follow-Up (LF), a national cohort study designed to identify factors related to poor pregnancy outcomes.32,33 We investigated factors associated with maternal smoking trends over the course of pregnancy and the first 3 years postpartum. We examined a more comprehensive set of clinical and social factors than has been analyzed to date, for both their individual and their cumulative associations with maternal smoking behaviors.

METHODS

Sample

The 1988 NMIHS was a population-based survey of 9953 women giving birth in 1988. Sampling was based on birth certificates from 48 states and the District of Columbia; Black mothers and the mothers of low- and very low birthweight infants were oversampled. The 1988 NMIHS was administered 175 months after delivery, and questions about pregnancy behaviors were based on maternal recall. The 1991 LF was administered 355 months after delivery. Eighty-eight percent (n=82 85) of the women completed the LF, and these women constitute the sample for this study. Additional information on the NMIHS has been published elsewhere.34,35

Measures

Outcomes. We examined four outcome measures. The first three of these outcomes came from the 1988 NMIHS and were determined by the mother's response to the following questions: "Did you smoke cigarettes during the 12 months before delivery?"; "Did you quit smoking for at least a week during your pregnancy?"; and "Do you smoke cigarettes now?" The fourth outcome, smoking at the time of the 1991 LF (355 months postpartum), was determined by the question "Do you smoke cigarettes now at all?" All responses were dichotomous. The predictor variables that follow were recoded to accommodate nonlinear relationships, skewed distributions, and prior approaches in the literature.

Socioeconomic and demographic variables. Maternal education (< 12 years, 12 years, 13 to 15 years, >= 16 years), total household income (<$10 000, $10,000 to $19 999, $20000 to $34 999, $35 000 to $49 999, and >=$50,000), Hispanic ethnicity, and marital status (currently married, never married, formerly married) were reported by the mother in the 1988 NMIHS. Maternal age (<20, 20 to 29, >=30 years) and race came from the birth certificate. Race and ethnicity data were combined to create 4 groups (White, non-Hispanic; Black, non-Hispanic; Hispanic; other).

Clinical variables. Additional self-report measures from the 1988 NMIHS included amount smoked during the 3 months before conception (< 1, >=1 pack/day), number of drinks per week before learning of pregnancy (< 1, 1 to 2, >=3), number of drinks per week after learning of pregnancy (< 1, >=1), pregnancy intention (wanted to become pregnant at that time, did not want to become pregnant at that time), and being currently pregnant (at the time of the 1988 NMIHS). Parity (1, >=2) and infant birthweight (<2500 g, >=2500 g) also came from the birth certificate.

We used any intention to breastfeed as a predictor for quitting during pregnancy, and ever breastfeeding as a predictor for smoking relapse after pregnancy.4 Maternal weight gain during pregnancy was constructed from the self-report of maternal weight before pregnancy and before delivery and was coded as either in the top quartile (>=40 lb) or below the top quartile.8 Maternal depression was determined by the Center for Epidemiologic Studies Depression Scale, a 20-item selfreport instrument included in the 1988 NMIHS. Women who scored 16 or above (out of a possible 60) were classified as having significant depressive symptoms.36

Contextual variables. The number of smokers (0, >=1) living with the mother during pregnancy and the number of smokers (0,

FIGURE 1.

>=1) living with the mother at 175 months postpartum were ascertained in the 1988 NMIHS.

Analysis

In the cross-sectional bivariate and multivariate analyses of each outcome, we used all women with available data. In the description of maternal smoking patterns over time (Figure 1) and in our longitudinal analysis, we used only those women who had outcome data available at all 4 points in time. Therefore, there is slight variation in the reported prevalence of smoking at each time point. For cross-sectional analyses, associations between independent variables and smoking outcomes were first examined in bivariate analyses. Significance was determined by the X^sup 2^ statistic and associated P value. Multivariate logistic regression analyses were used to determine the independent associations of the covariates on smoking outcomes. In longitudinal analyses, we examined the association of depressive symptoms at 175 months postpartum with the change in smoking status between 175 and 355 months (i.e., between the 1988 and 1991 surveys). We report adjusted odds ratios (ORs) and 95% confidence intervals (CIs). All variables that were significant in the prior literature were included in the regression models and were maintained in the adjusted analyses.

We weighted analyses to reflect US women who had a live birth in 1988, using data provided by the National Center for Health Sta tistics. We used SAS Version 8.1 (SAS Institute Inc, Cary, NC) and SAS-callable SUDAAN Version 7.5.4A (Research Triangle Institute, Research Triangle Park, NC).

RESULTS

Twenty-nine percent of the women smoked during the 12 months before delivery, 56% quit smoking for at least 1 week during pregnancy, and the majority (72%) of women who quit were smoking again at 17+/5 months postpartum (Figure 1). At 355 months, an additional 367 women (approximately 17% of all 1991 LF smokers) reported smoking, despite reporting no history of smoking in the 12 months before delivery. The net result was that the prevalence of smoking decreased slightly, from 29% within the 12 months before delivery to 26% at 355 months postpartum.

Smoking During the 12 Months Before Delivery

Compared with women who had graduated from college, women who had not graduated from high school were more than 4 timesas likely to smoke during the 12 months before delivery, adjusting for covariates (Table 1). The presence of other household smokers and increased alcohol consumption had similarly strong, independent associations with increased smoking. Lower family income, unmarried status, White race, and increased maternal age were also significant predictors of smoking.

Quitting During Pregnancy

Women who had not completed high school were one third as likely to quit smoking during pregnancy compared with women who had graduated from college, after adjusting for covariates (Table 2). Consuming 1 or more drinks per week during pregnancy, greater parity, no intention to breastfeed, and presence of other smokers in household were all independently associated with a lower likelihood of quitting during pregnancy.

TABLE 1

Relapsing After Pregnancy

Women who lived with another smoker were 4 times as likely to relapse as women who did not live with another smoker (Table 3). Low income and less education were also significant predictors of relapse. Neither breastfeeding nor the experience of having a low- birthweight infant conferred protection against relapse. In contrast to their significant association with quitting, the amount smoked before delivery and prenatal alcohol consumption were not significant predictors of relapse. Pregnancy weight gain also had no association with relapse.

Summary of Predictors

Maternal education and household smoking had significant adverse associations with all three outcomes (Table 4). Income also had consistent, but more modest, associations across all outcomes. Black race was associated with a reduced likelihood of smoking during the 12 months before delivery but was not associated with increased quitting or lower relapse.

Depressive Symptoms and Maternal Smoking

Twenty-four percent of women screened positive for depression at 175 months postpartum. Depressive symptoms were significantly associated with concurrent smoking (odds ratio [OR] = 1.2; 95% confidence interval [CI] = 1.0, 1.4). However, they were not associated with any change in smoking status between 175 and 35+/ -5 months (the 1988 NMIHS and 1991 LF). Among women who were not smoking at 175 months (n=5746), depressive symptoms at that time did not predict smoking initiation (n = 307) between the 2 surveys (OR=0.9; 95% CI=0.6, 1.4). Similarly, among women who were smoking at 175 months, depressive symptoms were not associated with continued smoking between the 2 surveys (OR= 1.1; 95% CI=0.8, 1.7).

Disparities in Smoking Over Time and Across Risk Factors

Education-related disparities in smoking rates increased over time. This increasing disparity was the result of the independent association of low education with both reduced likelihood of quitting and increased likelihood of later relapse. Smoking rates among women with a college degree decreased 30% from within 12 months before delivery to 355 months postpartum (11.7%1.1 % to 8.3%+/1.0%). In contrast, smoking rates among women with less than a high school degree did not decrease (39.9%1.7% to 41.1%+/1.80%). The net effect, therefore, was an increase in the relative disparity in smoking over the approximately 4-year window of time.

We examined the clustering of 5 risk factors found to be independently associated with current smoking at the time of the 1988 NMIHS. The risk factors were low income (<$20,000/year), less education (<=high school), living with another smoker, depressive symptoms (Center for Epidemiclogic Studies-Depression Scale score >=16), and alcohol consumption (>=3 drinks/week). Twenty-seven percent of all women had 2 risk factors, 18% had 3, and 7% had 4 or 5. A more detailed examination of smokers with depressive symptoms (n= 849), for example, showed that 57% lived in households with another smoker, 67% lived in low-income households, and 83% had no education beyond high school. Women with 0, 2, and 4 of these risk factors smoked at rates of 5.7%, 30.7%, and 58.10% (P< .00001), respectively.

DISCUSSION

Using a national sample with comprehensive demographic and clinical data, this study offers the fullest accounting to date of the patterns and correlates of smoking before, during, and after pregnancy. Three central findings emerge from this study relating to (1) the salient independent predictors of smoking outcomes, (2) the surprising lack of association between depressive symptoms and a change in smoking status, and (3) the disparities in smoking rates over time and across risk factors.

Predictors of Smoking Outcomes

Women with less education were more likely to smoke before delivery, less likely to quit during pregnancy, and more likely to relapse after delivery. The strengths of these relationships were striking even after adjustment for household income and other demographic covariates. Fingerhut et al.2 found associations of a similar magnitude between education levels and smoking rates before pregnancy as well as quitting rates but, in contrast, did not find that education levels predicted a postpartum relapse. This discrepancy may be due to power differences between their study and the current one. Given that in 1988 approximately 75% of all women smokers with young children had a 12th-grade education or less, future intervention trials should include a greater focus on these women, ensuring representation in study samples and appropriate educational materials.

A strong relationship was confirmed between the presence of other household smokers and an increased risk of postpartum relapse. The effect of partner smoking has been documented in prior studies,3,5- 7,12,15,18 and the more complete accounting for covariates in this study made little difference to the estimated effect. Studies in the general adult population have shown that such contextual smoking cues produce a desire to smoke.37 Recent animal research and human neuroimaging studies of addiction have suggested that the contextual cues themselves become directly associated with powerful neurobiological responses.38,39 The association of household smokers with postpartum relapse stands in some contrast to the weaker association of household smokers with quitting. It is not surprising that factors uniquely related to quitting may play a moderating role. For example, other smokers' support for the woman's quitting during pregnancy is likely stronger than their support for relapse prevention after delivery.5,18 Intervention research directed at changing the behavior of other household smokers appears to be an important area for future work.

TABLE 2

TABLE 3.

Neither parity nor birthweight was associated with protective effects. Presumably, multiparous mothers have had increased contact with health providers and therefore an increased "dose" of health education about smoking. However, consistent with Cnattingius and Thorslund's results,19 increased parity was associated with a lower rate of quitting. Perhaps a third factor, such as a woman's attitude of diminished investment toward her own reproductive health and toward the health of the fetus, increases parity and reduces quitting. However, controlling for unintended pregnancy had no effect in the model of quitting. Women who have previously delivered a healthy infant despite smoking may also be less motivated to quit in subsequent pregnancies.

Having a low-birthweight infant did not protect against relapse, despite presumed contact with physicians after the pregnancy. One difficulty may lie in the relative elevation of prenatal quitting messages over messages that emphasize the risk associated with smoking outside the context of pregnancy. Women who deliver low- birthweight infants despite quitting (for at least a week) may have been given little reason to "stay quit" after pregnancy. The stress of caring for a low-birthweight baby may also promote relapse. Alternatively, women with a low-birthweight infant may be more inclined to overreport having quit during pregnancy; thus, these women would appear to have higher relapse rates. In contrast to other studies, this study did not find that postpartum breastfeeding4 protected against postpartum relapse and did not find that excessive pregnancy weight gain8 had an adverse effect on postpartum relapse. Controlling for a larger number of covariates in our analyses (e.g., including other household smokers) may in part explain the different findings.

Lack of Association Between Depressive Symptoms and Change in Postpartum Smoking Status

Maternal depressive symptoms were assodated with concurrent smoking status. Surprisingly, they were not associated with a change in smoking status. These results contrast with those of Anda et al.,20 who found that in the general population, depressive symptoms significantly decrease the likelihood of subsequent quitting. Studies focusing on the relationship between depression and smoking cessation during pregnancy have had mixed results.40-42 A postpartum relapse prevention trial found that poor mental health 12 months after delivery was associated with having relapsed.15 Hanna et al.,43 using the 1988 NMIHS data, suggested that depressive symptoms influence smoking during pregnancy, but their study examined fewer covariates than this study, and the depressive symptoms were assessed well after delivery. Nevertheless, the high rates of both postpartum depression and smoking relapse suggest that further additional prospective research is needed to clarify this complex relationship.

Disparities in Smoking Over Time and Across Risk Factors

This study demonstrates that the relative health disadvantage associated with low maternal education is dynamic and continues to accrue over a time period that is rich in health care contacts. The elimination of health disparities is now a major national health goal.44,45 As more efficacious treatments for smoking emerge,46 however, there is a risk that social disparities in smoking rat\es may actually increase if there are persistent differentials in knowledge about and access to these treatments.47 The rising Black- to-White differential in sudden infant death syndrome is one example of an increased health disparity between these groups that has resulted from an intervention (in this case, a campaign to change infants' sleep position).48

TABLE 3

TABLE 4

Our findings support the prior literature in delineating a series of independent risk factors associated with maternal smoking. However, the results also demonstrate that these "independent" risk factors cluster together. This clustering suggests the need for a more comprehensive and integrated approach across women's many health care contacts. It may also suggest the need for a broader notion of "well-women's care" with the goal of maintaining the positive health trajectory achieved during pregnancy. Specifically, the clustering of risk factors suggests that new interventions may be required for long-term success. This may include, for example, removing financial barriers to nicotine replacement therapy, focusing on the treatment of comorbid depression or alcohol problems, and changing the behavior of other household smokers.

Several limitations of this study exist. All smoking behaviors were by maternal selfreport, and behaviors during pregnancy were recalled approximately 17 months after delivery. Social desirability might lead to a biased recall of smoking. For example, underreporting of smoking might be more pronounced among highly educated women or women who had relapsed. However, self-reported smoking status, even well after the pregnancy, is reasonably accurate,49-51 and less educated women may actually be more likely to underreport smoking.52 Another limitation is that the outcomes lack detail. We cannot ascertain in which trimester the women quit smoking, whether the women did not smoke for the remainder of the pregnancy, and indeed whether some women quit before conception. The reported associations are not necessarily causal. An unobserved factor, such as a capacity to delay gratification, may jointly determine both the amount of education and smoking behavior.53 It is also important to note that the prevalence of smoking among pregnant women has decreased substantially since 1988. Nevertheless, the current social patterning of smoking may be as great, if not greater, than in 1988.54 Finally, the 88% response rate for the 1991 LF may bias the findings (e.g., relating to depressive symptoms), although the direction of the potential bias is unclear.

We used a nationally representative longitudinal cohort to examine the risk factors associated with smoking and relapse during the window of pregnancy and early parenthood. Of particular note was the powerful relationship between other household smokers and maternal relapse. In addition, we found that education-related disparities in smoking grew over a time period relatively rich in health care contacts and that the disparities rose sharply with an increasing number of clinical and social risk factors. Comprehensive interventions are needed that promote integration across health care contacts and that address the co-occurring morbidity that may constrain women's efforts to quit.

Copyright American Public Health Association Nov 2002

Publication date: 2002-11-01


© 2002, YellowBrix, Inc.

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Recommend Message 40 of 90 in Discussion
From: Joel. Sent: 11/23/2002 10:20 AM
There are women who just seem to lose interest in smoking when pregnant. It is interesting because some of these women lose all desire for cigarettes before they actually even knew they were pregnant, as if their bodies just knew not to smoke. Unfortunately, if these same women do not work on establishing good reasons to stay off of smoking, they often relapse shortly after delivery. Back in the days when smoking was allowed in hospitals, some of these women relapsed almost instantly. I used to joke about it in clinics, to illustrate how strong the desire would be to these women I would say that they almost asked for a cigarette before they would ask what was the sex of the baby. Many women in my groups nodded and said they knew exactly what I was saying from their past experiences.

While pregnancy may be the impetus for some women starting a quit, more ammunition needs to be developed and worked on for these women to sustain their quits. Long-term abstinences is going to require that the ex-smoker is truly sustaining his or her quit for himself or herself. You are the primary benefactor of your quit and to keep the benefits is as simple as always remembering to never take another puff!
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Recommend Message 41 of 90 in Discussion
From: Joel. Sent: 12/19/2002 12:00 PM
Just thought it would be a good idea to keep these two threads linked together:
Sudden Infant Death Syndrome & Smoking
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Recommend Message 42 of 90 in Discussion
From: Joel. Sent: 2/1/2003 10:34 AM
From Join Together Online:



Many Women Return to Smoking After Pregnancy[/size]

1/31/2003

Although more women are quitting smoking during pregnancy, a new study finds that many return to cigarettes during the post-natal period, Health 24 reported Jan. 27.

The study analyzed surveys conducted from 1993 to 1999 involving 115,000 new mothers from 10 U.S. states. The data showed that 51 percent of pregnant women quit smoking in 1999, but half of them resumed smoking within six months of giving birth.

Those more likely to begin smoking again were teenagers and heavy smokers.

Based on the study's findings, author Dr. Gregory Colman of Pace University in New York recommended that doctors encourage women to stay away from cigarettes after their baby is born by emphasizing the dangers of secondhand smoke to infants.

The study is published in the January 2003 issue of the American Journal of Preventive Medicine.

Colman, G., & Joyce, T. (2003) Trends in smoking before, during, and after pregnancy in ten states. American Journal of Preventive Medicine, 24(1): 29-35.

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Recommend Message 43 of 90 in Discussion
From: Joel. Sent: 2/1/2003 10:37 AM
In lieu of the report I just posted above, I thought I would paste this post from back in October that toughed upon this issue:

You will see from the post above (#36 in this string), there are women who just seem to lose interest in smoking when pregnant. It is interesting because some of these women lose all desire for cigarettes before they actually even knew they were pregnant, as if their bodies just knew not to smoke. Unfortunately, if these same women do not work on establishing good reasons to stay off of smoking, they often relapse shortly after delivery. Back in the days when smoking was allowed in hospitals, some of these women relapsed almost instantly. I used to joke about it in clinics, to illustrate how strong the desire would be to these women I would say that they almost asked for a cigarette before they would ask what was the sex of the baby. Many women in my groups nodded and said they knew exactly what I was saying from their past experiences.

So as I said to Tulip up above, while pregnancy may be the impetus for some women starting a quit, more ammunition needs to be developed and worked on for these women to sustain their quits. Long-term abstinences is going to require that the ex-smoker is truly sustaining his or her quit for himself or herself. You are the primary benefactor of your quit and to keep the benefits is as simple as always remembering to never take another puff!
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Recommend Message 44 of 90 in Discussion
From: Joel. Sent: 2/6/2003 2:17 PM
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Recommend Message 45 of 90 in Discussion
From: Joel. Sent: 2/15/2003 5:12 AM
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Recommend Message 46 of 90 in Discussion
From: Joel Sent: 3/24/2003 7:24 AM
For Vickie:

The real "personal" benefit of quitting smoking when you are pregnant is that you have finally freed yourself smoking. That benefit is the same even if you quit when you are not pregnant. To keep your personal Freedom is as simple as always remembering to never take another puff!

Joel
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Joined: November 13th, 2008, 2:04 pm

January 30th, 2009, 4:57 pm #5

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Recommend Message 47 of 90 in Discussion
From: Joel Sent: 3/28/2003 6:48 AM
Study: Smoking During Pregnancy Impairs Fetal Development

British research finds that women who smoke during pregnancy risk having smaller babies with smaller brains, Reuters reported March 24.

According to researchers at University College London, smoking damages the placenta and reduces levels of a critical growth hormone.

"The profound effects of smoking on fetal development are irreversible and may cause impairment in the health and well-being of the offspring in later life," said Dr. Peter Hindmarsh, lead author of the study. "In particular, the reduced brain size that we saw in smokers' babies could lead to impaired cognitive ability of the child."

The study involved 1,650 expectant mothers, including 200 who smoked throughout their pregnancy. The researchers measured blood flow between the fetus and placenta and monitored levels of insulin-like growth factors (IGF), a group of hormones essential to fetal growth and organ development.

After birth, the researchers weighed the newborns and measured their head size to determine brain size.

The study found that blood flow in the artery joining the fetus to the placenta was lower in women who smoked. This resulted in damage to the placenta and restricted the delivery of essential nutrients.

In addition, there was a lower amount of IGF in umbilical-cord blood among women who smoked. The levels varied, based on how many cigarettes the mother smoked.

"What we're talking about are reductions of about 10 to 15 percent in IGF levels, producing rather similar reductions in overall birth size, birth length, and head growth," said Hindmarsh.

Hindmarsh presented the study's findings at the annual meeting of the British Endocrine Societies, held recently in Glasgow, Scotland.

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Recommend Message 48 of 90 in Discussion
From: Joel Sent: 5/27/2003 6:41 AM
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Recommend Message 49 of 90 in Discussion
From: Joel Sent: 6/29/2003 11:42 AM
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Recommend Message 50 of 90 in Discussion
From: Joel Sent: 10/14/2003 2:11 PM
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Recommend Message 51 of 90 in Discussion
From: Joel Sent: 12/1/2003 1:20 PM
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Recommend Message 52 of 90 in Discussion
From: Joel Sent: 12/17/2003 7:08 AM
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Recommend Message 53 of 90 in Discussion
From: Joel Sent: 4/19/2004 5:57 AM
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Recommend Message 54 of 90 in Discussion
From: John (Gold) Sent: 6/14/2004 5:54 AM

SIDS prevention--good progress,
but now we need to focus on avoiding nicotine.

Acta Paediatr. 2004 April;93(4):450-2.


Sundell HW.

Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee 37232-2585, USA. [url=mailto:hakan.sundell@vanderbilt.edu]hakan.sundell@vanderbilt.edu[/url]

Chong et al. examined risk factors for sudden infant death syndrome (SIDS) before and after the start of the Swedish campaign to reduce the risk of SIDS. They found that maternal smoking was the strongest risk factor for SIDS in the post-campaign compared to the pre-campaign period.


CONCLUSION: After successful results of the SIDS campaigns to prevent prone sleeping, strong efforts need to be undertaken to eliminate maternal smoking during pregnancy altogether without replacing cigarette smoking with other nicotine delivery devices such as snuff, gum or patches.

Publication Types:
PMID: 15188968 [PubMed - in process]


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Recommend (1 recommendation so far) Message 55 of 90 in Discussion
From: John (Gold) Sent: 6/14/2004 6:23 AM
Other discussions, studies and articles in this thread include ...
  • Message 2 & Message 3 Quitting during pregnancy sometimes seeming absurdly easy (Joel)
  • Message 7 Postpartum return to smoking among usual smokers who quit during pregnancy (2001 study)
  • Message 8, Message 11 NRT during pregnancy (Joel)
  • Message 13 Smoking, Sex and Reproduction (ASH Fact Sheet)
  • Message 17 Mothers who smoke may be hearing from colicky babies (2001 news article)
  • Message 18 Prenatal Nicotine Exposure Evokes Alterations of Cell Structure in Hippocampus and Somatosensory Cortex (2002 study)
  • Message 24 Nicotinic receptor expression following nicotine exposure via maternal milk (2002 study)
  • Message 25 Fetal Nicotine Exposure Tied to Breathing Problems (2002 news article)
  • Message 26 Altered Breathing Pattern after Prenatal Nicotine Exposure in the Young Lamb (2002 study)
  • Message 27 Smoking Moms Boost Unborn Babies' Autism Risk (2002 news article)
  • Message 28 When Moms Smoke, Certain Kids Are More Vulnerable to Respiratory Disease; Children With Key Common Genetic Variation Are More Susceptible to Asthma and Other Breathing Problems If Exposed to Tobacco in Womb (2002 news article)
  • Message 30 Study Suggests Why Cigarette Smoke a SIDS Risk (2002 news article)
  • Message 36 Joel discussing how quitting for the fetus or baby is not quitting for you.
  • Message 37 Joel discussing post-partum relapse
  • Message 38 Dangers of smoking while pregnant need to be emphasized by health care providers (2002 article)
  • Message 39 A reexamination of smoking before, during, and after pregnacy (2002 study)
  • Message 42 Many Women Return to Smoking After Pregnancy (2003 article)
  • Message 47 Study: Smoking During Pregnancy Impairs Fetal Development (2003 article)
  • Message 54 SIDS prevention--good progress, but now we need to focus on avoiding nicotine (2004 study)
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Recommend Message 56 of 90 in Discussion
From: Joel Sent: 9/28/2004 1:21 PM
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Recommend Message 57 of 90 in Discussion
From: gold_osomashi Sent: 9/28/2004 1:24 PM
Thanks very much!!
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Recommend Message 58 of 90 in Discussion
From: Rhiannonsky Sent: 9/28/2004 9:13 PM
Thank you for this string. This has been so appropriate in my life. For my first two pregnancies, I quit smoking easily. However, I did it for my child- not for me. I immediately relapsed right after both children were born. I am currently pregnant again. However, this time I quit and joined this site months before becoming pregnant. I quit this time for me. Thanks!

Jen

I have been quit for 5 Months, 3 Weeks, 1 Day, 23 hours, 15 minutes and 44 seconds (175 days). I have saved $874.55 by not smoking 4,927 cigarettes. I have saved 2 Weeks, 3 Days, 2 hours and 35 minutes of my life. My Quit Date: 4/5/2004
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Recommend Message 59 of 90 in Discussion
From: Joel Sent: 3/4/2005 4:12 PM
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Recommend Message 60 of 90 in Discussion
From: Joel Sent: 3/4/2005 4:27 PM
From above:
FACT SHEET NO. 7 July 2001

SMOKING, SEX & REPRODUCTION

Introduction

Cigarette smoking can affect women's fertility; men's fertility; sexual function in men; pregnant women's health; the health of an unborn child; and the health of young children.

Fertility

Women who smoke may have reduced fertility. One study found that 38% of non-smokers conceived in their first cycle compared with 28% of smokers. Smokers were 3.4 times more likely than non-smokers to have taken more than one year to conceive. It was estimated that the fertility of smoking women was 72% that of non-smokers.[1] A recent British study found that both active and passive smoking was associated with delayed conception.[2] Cigarette smoking may also affect male fertility: spermatozoa from smokers has been found to be decreased in density and motility compared with that of non-smokers.[3]

Male sexual impotence

Impotence, or penile erectile dysfuntion, is the repeated inability to have or maintain an erection. One US study of men between the ages of 31 and 49 showed a 50% increase in the risk of impotence among smokers compared with men who had never smoked.[4] Another US study, of patients attending an impotence clinic, found that the number of current and ex-smokers (81%) was significantly higher than would be expected in the general population (58%).[5]

Overall smoking increases the risk of impotence by around 50% for men in their 30s and 40s. ASH and the British Medical Association have calculated that around 120,000 UK men in this age group are needlessly impotent as a result of smoking.[6]

Smoking and oral contraceptives

For younger women, smoking and the use of oral contraceptives increases the risk of a heart attack, stroke or other cardiovascular disease by tenfold. This effect is even more marked in women over 45.[7] It is therefore important that all women who take the contraceptive pill be advised not to smoke.

Smoking and pregnancy

Approximately one-quarter of pregnant women in the UK smoke. Women who smoke in pregnancy are more likely to be younger, single, of lower educational achievement and in unskilled occupations. The male partner is more likely to smoke. Only one in four women who smoke succeed in stopping at some time during pregnancy. Almost two-thirds of women who succeed in stopping smoking in pregnancy restart again after the birth of their baby.[8] In December 1998, the Government set a target to reduce the percentage of women who smoked during pregnancy from 23% to 15% by the year 2010, with a fall to 18% by 2005.[9] This will mean approximately 55,000 fewer women in England who smoke during pregnancy.

Foetal growth and birth weight

Babies born to women who smoke are on average 200 grams (8 ozs) lighter than babies born to comparable non-smoking mothers. Furthermore, the more cigarettes a woman smokes during pregnancy, the greater the probable reduction in birth weight. Low birth weight is associated with higher risks of death and disease in infancy and early childhood. The adverse effects of smoking in pregnancy are due mainly to smoking in the second and third trimesters. Therefore, if a woman stops smoking within the first three months of pregnancy, her risk of having a low‑weight baby will be similar to that of a non-smoker. 8

Spontaneous abortion

The rate of spontaneous abortion (miscarriage) is substantially higher in women who smoke. This is the case even when other factors have been taken into account.8

Other complications of pregnancy

On average, smokers have more complications of pregnancy and labour which can include bleeding during pregnancy, premature detachment of the placenta and premature rupture of the membranes.[10] Some studies have also revealed a link between smoking and ectopic pregnancy 10 and congenital defects in the offspring of smokers.[11]

Perinatal mortality

Perinatal mortality (defined as still‑birth or death of an infant within the first week of life) is increased by about one-third in babies of smokers. This is equivalent to approximately 420 deaths per year in England and Wales. The increased perinatal mortality in smoking mothers occurs particularly among manual socio-economic groups and in groups that are already at high risk of perinatal death, such as older mothers or those who have had a previous perinatal death. More than one-quarter of the risk of death due to Sudden Infant Death Syndrome (cot death) is attributable to maternal smoking (equivalent to 365 deaths per year in England and Wales).8

Passive smoking and pregnancy

Exposure by the mother to passive smoking has also been associated with lower birth weight, a higher risk of perinatal mortality and spontaneous abortion.[12]

Breast feeding

Research has shown that smoking cigarettes may contribute to inadequate breast milk production. In one study, fat concentrations were found to be lower in the milk from mothers who smoked and milk volumes were lower.[13]

Health and long‑term growth

Infants of parents who smoke are twice as likely to suffer from serious respiratory infection than the children of non-smokers. (See also Fact Sheet No. 8, Passive Smoking.) Smoking in pregnancy may also have implications for the long term physical growth and intellectual development of the child. It has been associated with a reduced height of children of smoking mothers as compared with non-smoking mothers, with lower attainments in reading and mathematics up to age 16 and even with the highest qualification achieved by the age of 23.[14] One study has demonstrated a link between maternal smoking during pregnancy and adult male crime.[15] There is also evidence that smoking interferes with women's hormonal balance during pregnancy and that this may have long-term consequences on the reproductive organs of her children.[16]

Smoking and cervical cancer

Epidemiological studies have found that women who smoke have up to four times higher risk of developing cervical cancer than non-smokers and that the risk increases with duration of smoking. Studies have demonstrated biochemical evidence that smoking is a causal factor in cervical cancer.[17][18]



Smoking and the menopause

The natural menopause occurs up to two years earlier in smokers. The likelihood of an earlier menopause is related to the number of cigarettes smoked, with those smoking more than ten cigarettes a day having an increased risk of an early menopause.[19] New research suggests that polycyclic aromatic hydrocarbons found in tobacco smoke can trigger premature egg cell death which may in turn lead to earlier menopause. [20]


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Joined: November 13th, 2008, 2:04 pm

January 30th, 2009, 4:59 pm #6

From: Joel Sent: 11/10/2005 6:56 AM
The idea of just quitting to get pregnant or having a baby can pose a risk after the baby is delivered. You can figure now that the risks are now gone, you quit for the important time period. But still keep in mind that even though you did your baby a favor by quitting, you really did yourself the bigger favor.
For not only did you reduce the risk to your baby, you reduced your risk of being sicker throughout your life and eventually dying prematurely--you increased your ability to be active with your baby, throughout his or her life, even when your baby becomes an adult. You increased the odds that you will be around to see your baby eventually have children of his or her own, and even then you can be an active participant in yet another generation, as opposed to an elderly person on oxygen who watches family events from the sidelines, if you can even go to see them at all.

Quitting for pregnancy is a reason to start your quit. Staying off though is more comprehensive than this. There are many other benefits that go along with staying an ex-smoker that will stick with you throughout your entire life. To keep these benefits, always remember that the best way to improve "your" overall health and quality of life is to never take another puff!

Joel
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Recommend Message 65 of 90 in Discussion
From: GrumpyOMrsS (Gold) Sent: 12/25/2005 9:30 AM
The idea of just quitting to get pregnant or having a baby can pose a risk after the baby is delivered. You can figure now that the risks are now gone, you quit for the important time period. But still keep in mind that even though you did your baby a favor by quitting, you really did yourself the bigger favor.
For not only did you reduce the risk to your baby, you reduced your risk of being sicker throughout your life and eventually dying prematurely--you increased your ability to be active with your baby, throughout his or her life, even when your baby becomes an adult. You increased the odds that you will be around to see your baby eventually have children of his or her own, and even then you can be an active participant in yet another generation, as opposed to an elderly person on oxygen who watches family events from the sidelines, if you can even go to see them at all.

Quitting for pregnancy is a reason to start your quit. Staying off though is more comprehensive than this. There are many other benefits that go along with staying an ex-smoker that will stick with you throughout your entire life. To keep these benefits, always remember that the best way to improve "your" overall health and quality of life is to never take another puff!

Joel

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Recommend Message 66 of 90 in Discussion
From: John (Gold) Sent: 1/30/2006 8:48 PM
Mode of action: disruption of brain cell replication, second messenger, and neurotransmitter systems during development leading to cognitive dysfunction--developmental neurotoxicity of nicotine.
Critical Reviews in Toxicology 2005 Oct-Nov;35(8-9):703-11.


Slikker W Jr, Xu Z, Levin ED, Slotkin TA.

Division of Neurotoxicology, NCTR/FDA, Jefferson, Arkansas 72079, USA. [url=mailto:wslikker@nctr.fda.gov]wslikker@nctr.fda.gov[/url]

Developmental exposure to nicotine in rats results in neurobehavioral effects such as reduced locomotor and cognitive function. Key events in the animal mode of action (MOA) include binding to the nicotinic cholinergic receptor during prenatal and/or early postnatal development. This leads to premature onset of cell differentiation at the expense of cell replication, which leads to brain cell death or structural alterations in regional brain areas.
Other events include an initial increase followed by a decrease in adenyl cyclase activity, as well as effects on the noradrenergic, dopaminergic, and serotonergic neurotransmitter systems. Because the nicotine receptor is also present in the developing human brain and the underlying biology for DNA synthesis and cell signaling is comparable, this MOA is likely to be relevant for humans.
Although the effects of nicotine exposure in developing humans is not well documented, nicotine exposure as a result of cigarette smoking during pregnancy is associated with several physiological and behavioral outcomes that are reminiscent of the effects of nicotine alone in animal models. As data become available with the advent of the use of the nicotine patch in pregnant humans, the question as to the relative importance of smoking per se versus nicotine alone may be determined.

PMID: 16417037 [PubMed - in process]
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Recommend Message 67 of 90 in Discussion
From: John (Gold) Sent: 1/30/2006 8:58 PM
If you are pregnant and reading this message Dr. Slotkin of Duke Medical University, who is referenced in the above study, has a few words he wants to read and think about. Please keep in mind that Dr. Slotkin is one of the world's lead toxicologists studying nicotine's path of destruction during fetal animal development.

From: Theodore Slotkin [url=mailto:t.slotkin@duke.edu]t.slotkin@duke.edu[/url]
To: John R. Polito
[url=mailto:john@whyquit.com]john@whyquit.com[/url]
Sent: Monday, January 09, 2006 11:33 AM
Subject: Re: NRT pregnancy use


I certainly have no objections to your sharing my comments - I'm on record for this information in a number of reviews and primary research papers, and I think it's important to get that information out to practitioners and to smokers.


One of my main concerns is that, although NRT is fine for smoking cessation in nonpregnant smokers, the assumption that it is safe in pregnancy leads people away from thinking about more effective (albeit more costly) ways of addressing the issue. It's easy to dispense drugs (even if they don't work and cause damage to the fetus, and damage to the developing brain doesn't show up as an obvious "birth defect") and although it's harder to go one-on-one with a pregnant smoker to try to get the desired results, it's probably more effective. Also, the patch is the "easiest" NRT approach, and it turns out that this is the absolute worst form of nicotine administration for the fetus.

Essentially, achieving a continuous steady-state plasma level of nicotine in the mother removes the protective effect of the placenta (delay of entry to fetus, partial catabolism of nicotine) because all water spaces become saturated with nicotine. A recent paper from Walter Lichtensteiger's group showed that the brains of fetal mice wound up with 3x the nicotine concentration found in maternal plasma when a continuous administration paradigm was used.

So NRT might be OK, but not on a continuous basis - at the very least, removing the patch at night would allow for some "wash-out" from the fetus (but probably not much, since fetal clearance of nicotine is lower than in mom). Beyond that, there is still the nagging problem that the only two controlled studies on quit rate in pregnant smokers found no help from NRT. So promoting NRT in pregnancy still needs someone to show that the benefits outweigh the risks.

Regards,


Ted Slotkin
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Recommend Message 68 of 90 in Discussion
From: Sal-GOLD Sent: 3/30/2006 5:04 PM
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Recommend Message 69 of 90 in Discussion
From: Sal-GOLD Sent: 7/6/2006 1:47 PM
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Recommend Message 70 of 90 in Discussion
From: Sal-GOLD Sent: 7/25/2006 8:08 PM
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Recommend Message 71 of 90 in Discussion
From: Joel Sent: 8/1/2006 7:21 AM
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Recommend Message 72 of 90 in Discussion
From: Sal-GOLD Sent: 8/31/2006 8:41 PM
Smoking: A baby's view

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Recommend Message 73 of 90 in Discussion
From: Joel Sent: 9/4/2006 8:50 AM
It is important for women who are in the stage of their lives of family planning take their smoking into consideration. The idea of just quitting to get pregnant or having a baby can pose a risk after the baby is delivered. You can figure now that the risks are now gone, you quit for the important time period. But still keep in mind that even though you did your baby a favor by quitting, you really did yourself the bigger favor.

For not only did you reduce the risk to your baby, you reduced your risk of being sicker throughout your life and eventually dying prematurely--you increased your ability to be active with your baby, throughout his or her life, even when your baby becomes an adult. You increased the odds that you will be around to see your baby eventually have children of his or her own, and even then you can be an active participant in yet another generation, as opposed to an elderly person on oxygen who watches family events from the sidelines, if you can even go to see them at all.

Quitting for pregnancy is a reason to start your quit. Staying off though is more comprehensive than this. There are many other benefits that go along with staying an ex-smoker that will stick with you throughout your entire life. To keep these benefits, always remember that the best way to improve "your" overall health and quality of life is to never take another puff!

Joel
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Recommend Message 74 of 90 in Discussion
From: Blue1451 Sent: 9/6/2006 1:11 AM
I quit when I got pregnant with my son....i think i smoked another week after learning i was pregnant and just couldn't anymore...i didn't want to hurt my unborn child. He was born healthy and happy March.1/ 05...I breast fed him for 8 months...the day i switched to formula is the day i started smoking again!!!!!

I am pregnant again...with a sibling for my sweet baby....this time...i was smoke free for over 2 months BEFORE I got pregnant. The difference this time...i had quit for myself..for my body!!! I will never smoke again....i am an addict and will stay in recovery!
NTAP!!!!!
Gosh...don't smoke while pregnant...don't smoke while bf...don't smoke around your children...it is not only harmful to them but as they watch you..your teaching them to be addicts!!!!!

I have been quit for 5 Months, 1 Week, 4 Days, 6 minutes and 55 seconds (164 days). I have saved $770.81 by not smoking 1,312 cigarettes. I have saved 4 Days, 13 hours and 20 minutes of my life.
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Recommend Message 75 of 90 in Discussion
From: Sal-GOLD Sent: 9/23/2006 2:12 PM
From: John (Gold) Sent: 1/30/2006 8:58 PM
If you are pregnant and reading this message Dr. Slotkin of Duke Medical University, who is referenced in the above study, has a few words he wants to read and think about. Please keep in mind that Dr. Slotkin is one of the world's lead toxicologists studying nicotine's path of destruction during fetal animal development.

From: Theodore Slotkin [url=mailto:t.slotkin@duke.edu]t.slotkin@duke.edu[/url]
To: John R. Polito
[url=mailto:john@whyquit.com]john@whyquit.com[/url]
Sent: Monday, January 09, 2006 11:33 AM
Subject: Re: NRT pregnancy use


I certainly have no objections to your sharing my comments - I'm on record for this information in a number of reviews and primary research papers, and I think it's important to get that information out to practitioners and to smokers.


One of my main concerns is that, although NRT is fine for smoking cessation in nonpregnant smokers, the assumption that it is safe in pregnancy leads people away from thinking about more effective (albeit more costly) ways of addressing the issue. It's easy to dispense drugs (even if they don't work and cause damage to the fetus, and damage to the developing brain doesn't show up as an obvious "birth defect") and although it's harder to go one-on-one with a pregnant smoker to try to get the desired results, it's probably more effective. Also, the patch is the "easiest" NRT approach, and it turns out that this is the absolute worst form of nicotine administration for the fetus.

Essentially, achieving a continuous steady-state plasma level of nicotine in the mother removes the protective effect of the placenta (delay of entry to fetus, partial catabolism of nicotine) because all water spaces become saturated with nicotine. A recent paper from Walter Lichtensteiger's group showed that the brains of fetal mice wound up with 3x the nicotine concentration found in maternal plasma when a continuous administration paradigm was used.

So NRT might be OK, but not on a continuous basis - at the very least, removing the patch at night would allow for some "wash-out" from the fetus (but probably not much, since fetal clearance of nicotine is lower than in mom). Beyond that, there is still the nagging problem that the only two controlled studies on quit rate in pregnant smokers found no help from NRT. So promoting NRT in pregnancy still needs someone to show that the benefits outweigh the risks.

Regards,


Ted Slotkin
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Joined: November 13th, 2008, 2:04 pm

January 30th, 2009, 4:59 pm #7

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Recommend Message 79 of 90 in Discussion
From: John (Gold) Sent: 2/14/2007 10:56 AM
Critical Review"
Nicotine for the Fetus,
the Infant and the Adolescent?


Journal of Health Psychology
Vol. 12, No. 2, 215-224, March 2007
K. H. Ginzel, Westhampton, Massachusetts, USA, [url=mailto:khginzel@yahoo.com]khginzel@yahoo.com[/url], Gert S. Maritz, University of the Western Cape, South Africa, David F. Marks, City University, London, UK, Manfred Neuberger, Medical University of Vienna, Austria, Jim. R. Pauly, University of Kentucky, Lexington, USA, John R. Polito
Mount Pleasant, South Carolina, USA, Rolf Schulte-Hermann, Medical University of Vienna, Austria, Theodore A. Slotkin, Duke University Medical Center, Durham, North Carolina, USA
The recent expansion of Nicotine Replacement Therapy to pregnant women and children ignores the fact that nicotine impairs, disrupts, duplicates and/or interacts with essential physiological functions and is involved in tobacco-related carcinogenesis. The main concerns in the present context are its fetotoxicity and neuroteratogenicity that can cause cognitive, affective and behavioral disorders in children born to mothers exposed to nicotine during pregnancy, and the detrimental effects of nicotine on the growing organism. Hence, the use of nicotine, whose efficacy in treating nicotine addiction is controversial even in adults, must be strictly avoided in pregnancy, breastfeeding, childhood and adolescence.
If any member would like to read a full-text PDF reprint copy of this review please let me know. Please mention "Nicotine for the Fetus" [url=mailto:john@whyquit.com]john@whyquit.com[/url]
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Recommend Message 80 of 90 in Discussion
From: John (Gold) Sent: 3/23/2007 8:16 AM
Study: Nicotine reduces attention capacity
NEW HAVEN, Conn., March 22 (UPI) --U.S. scientists have determined exposure to nicotine might diminish a person's attention capacity.
Yale University researchers led by Leslie Jacobsen found teenage smokers who were also exposed to nicotine before birth showed a dramatic reduction in attention capacities related to vision and hearing. The scientists also demonstrated male and female attention capacities are affected by the exposure in different ways.


Jacobsen's team determined girls who smoke and were subject to nicotine exposure in the womb performed most poorly in both visual and auditory attention tasks. In boys, nicotine exposure had a greater effect on auditory attention, suggesting brain regions involved in auditory attention might be more vulnerable to nicotine in males.


The researchers believe the gender-specific effects may result from differences in hormonal control of nicotine's actions.


The study appears in the journal Neuropsychopharmacology.

Source link:

http://www.upi.com/NewsTr...ce/20070322-082351-1235r/
© Copyright 2007 United Press International, Inc. All Rights Reserved.
----------------------------

Gender-Specific Effects of Prenatal and Adolescent Exposure to Tobacco Smoke on Auditory and Visual Attention.
Neuropsychopharmacology. 2007 March Volume 21
Jacobsen LK, Slotkin TA, Mencl WE, Frost SJ, Pugh KR.
[1] 1Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA [2] 2Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA [3] 3Haskins Laboratories, New Haven, CT, USA.
Prenatal exposure to active maternal tobacco smoking elevates risk of cognitive and auditory processing deficits, and of smoking in offspring. Recent preclinical work has demonstrated a sex-specific pattern of reduction in cortical cholinergic markers following prenatal, adolescent, or combined prenatal and adolescent exposure to nicotine, the primary psychoactive component of tobacco smoke.
Given the importance of cortical cholinergic neurotransmission to attentional function, we examined auditory and visual selective and divided attention in 181 male and female adolescent smokers and nonsmokers with and without prenatal exposure to maternal smoking. Groups did not differ in age, educational attainment, symptoms of inattention, or years of parent education. A subset of 63 subjects also underwent functional magnetic resonance imaging while performing an auditory and visual selective and divided attention task.
Among females, exposure to tobacco smoke during prenatal or adolescent development was associated with reductions in auditory and visual attention performance accuracy that were greatest in female smokers with prenatal exposure (combined exposure). Among males, combined exposure was associated with marked deficits in auditory attention, suggesting greater vulnerability of neurocircuitry supporting auditory attention to insult stemming from developmental exposure to tobacco smoke in males. Activation of brain regions that support auditory attention was greater in adolescents with prenatal or adolescent exposure to tobacco smoke relative to adolescents with neither prenatal nor adolescent exposure to tobacco smoke.
These findings extend earlier preclinical work and suggest that, in humans, prenatal and adolescent exposure to nicotine exerts gender-specific deleterious effects on auditory and visual attention, with concomitant alterations in the efficiency of neurocircuitry supporting auditory attention.
Neuropsychopharmacology advance online publication, 21 March 2007; doi:10.1038/sj.npp.1301398.
PMID: 17375135 [PubMed - as supplied by publisher]
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Recommend Message 81 of 90 in Discussion
From: debbie51975 Sent: 4/21/2007 8:35 PM
I feel a need to respond to this. Through my own shame about smoking around young kids. While I literally couldn't smoke while pregant, due to being in the hospital on bedrest for MONTHS! (Boy did that wreak havoc on my nerves!), I ALWAYS lit up on walking out the door after ny babys birth. As soon as that baby came out I'd wheel myself outside and puff away. (gestational diabetes and all)


Anyway, just to run home for any lurkers just thinking about quitting right now, but maybe they're not ready, I'm going to confess to you and to myself, my childrens problems due to my smoking. (Like in the car with the windows down, thinking that will be plenty of ventilation!)

My oldest is 14, with mild asthma, but when she was born, I wasn't even a smoker yet, but it should have given me a clue, that it was in the gene pool! I have smoked for 12 years. He asthama developed at 3 years. Do the math.

My 7 year old has moderate to severe asthma.

My 2 year old has been close to losing his life on several occassions. He's Severe. They actaully thought Cystic Fibrosis. The fluid in his lungs would not go away. It built up for year. He had a sweat test, but when that was negative, they did a test to check the DNA for any CF markers. That was neg. Let me tell about his life and mine. We wake up every morning to a pill (not supposed to put names of meds on here I think), then a tsp of liquid, followed by a mask connected to a nebulizer, two, one a steroid (that takes 15 minutes), the other a bronchial dialater (another 15 minutes). He does those treatments every for hours, 24/7. If I skip, there are days when his fingertips, tint a bluish color. Last year, he contracted RSV (a virus that severly effects babies lungs and can be fatal). The night he went into the hospital, he didn't even have the strength to open his eyes. When they flew him to Cleveland, they rushed to connect him to all this equipment. We had to sign a form saying we gave permission for intubation if it became neccessary. There was big bed, no cribs. The nurse said that the toddlers in this ward didn't need cribs, because they were all so ill, they couldn't roll off the bed. They couldn't move! At around 10:30 pm I asked the nurse why my son was making that horrible grunting cry and that maybe he was hurting. She said he wasn't hurting, he was gasping for air. My beautiful Thomas couldn't breath. Alot of people came into the room. They were giving him so many drugs and then more drugs to counteract the side effects of the drugs they had just given him.

Our lowest point...and I'll never forget this (heck, I'm crying now, just remembering), "Mike and Debbie, we've reached the point were your son is not progressing and we may need to start thinking about what might make him more comfortable at this point."

Of course stupid me "I don't know what you mean, what are saying"

My husbands in the corner of the room, balled up and sobbing.

At that point I asked the doctor to please leave the room, I couldn't talk right now. Please leave me alone with my son.


We held Thomas all through the night. He was hugging my chest. I prayed like I have NEVER prayed in my life. I bargained and begged. A couple hours later, all of those miracle drugs finally started to do their job.

Don't for a minute pity or tell me this wasn't my fault. I KNOW more then I know anything in this world, that my smoking and my husbands smoking contibuted to the illness that my son will live with for the rest of his life.

With every thing those small creatures do, through every smile and tear, with every breath they take....EVERYTHING we do effects THEM!

I am BEGGING anyone who is thinking about quitting and wants to know if their smoking REALLY effects their child, please know, YES it DOES!


Thomas is ok now. Never perfect...the treatments and weekly doctor visits, the weekened immune system from all of the steroids, smaller height due to a stunted growth from lack of oxygen and sooooooo many different meds. It will be years before I know all of the effects that so many drugs have done to him. Learning disabilities, behavior problems etc. For almost a full year, the highest his pulse ox got on his BEST day, was 93. It often dropped into the low 80's and during his RSV and his critical days last year once it got into the 78's, the nurse turned the bleeping box thing away from us. To give you an idea, if you're in the low 80's, you're usually showing purplish or bluish coloration in your lips. (For those who don't know, your pulse ox is the amount of oxygen in your blood stream, normal folks are usually 99~100.) I very much dread the day, when he asks me why he is like this.

Some people think what I thought. Asthma is no big deal....just carry around an inhaler and take a puff as needed. They're wrong. Kids still die from asthma. And two big factors are genetics and smoking.

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Recommend Message 82 of 90 in Discussion
From: John (Gold) Sent: 6/5/2007 8:44 PM

Nicotine alters lung branching morphogenesis through the {alpha}7 nicotinic acetylcholine receptor

Journal: American journal of physiology. Lung cellular and molecular physiology, June 1, 2007

Authors: Wongtrakool C, Roser-Page S, Rivera HN, Roman J.

Pulmonary, Emory University School of Medicine, Atlanta, Georgia, United States.


There is abundant epidemiologic data linking prenatal environmental tobacco smoke with childhood asthma and wheezing, but the underlying molecular and physiologic mechanisms that occur in utero to explain this link remain unelucidated. Several studies suggest that nicotine, which traverses the placenta, is a causative agent. Therefore, we studied the effects of nicotine on lung branching morphogenesis using embryonic murine lung explants.

We found that the expression of alpha7 nicotinic acetylcholine receptors, which mediate many of the biological effects of nicotine, is highest in pseudoglandular stage lungs when compared to later stages. We then studied the effects of nicotine in the explant model and found that nicotine stimulated lung branching in a dose-dependent fashion. alpha-bungarotoxin, an antagonist of alpha7 nicotinic acetylcholine receptors, blocked the stimulatory effect of nicotine, whereas GTS-21, a specific agonist, stimulated branching thereby mimicking the effects of nicotine. Explants deficient in alpha7 nicotinic acetylcholine receptors did not respond to nicotine. Nicotine also stimulated the growth of the explant.

Altogether, these studies suggest that nicotine stimulates lung branching morphogenesis through alpha7 nicotinic acetylcholine receptors and may contribute to dysanaptic lung growth which, in turn, may predispose the host to airways disease in the postnatal period.

Key words: nicotine, branching morphogenesis, lung growth, nicotinic receptors.
PMID: 17545491 [PubMed - as supplied by publisher]

Source link: http://www.ncbi.nlm.nih.g...amp;TermToSearch=17545491
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Recommend Message 83 of 90 in Discussion
From: Joel Sent: 8/2/2007 5:41 PM
It is important for women who are in the stage of their lives of family planning take their smoking into consideration. The idea of just quitting to get pregnant or having a baby can pose a risk after the baby is delivered. You can figure now that the risks are now gone, you quit for the important time period. But still keep in mind that even though you did your baby a favor by quitting, you really did yourself the bigger favor.

For not only did you reduce the risk to your baby, you reduced your risk of being sicker throughout your life and eventually dying prematurely--you increased your ability to be active with your baby, throughout his or her life, even when your baby becomes an adult. You increased the odds that you will be around to see your baby eventually have children of his or her own, and even then you can be an active participant in yet another generation, as opposed to an elderly person on oxygen who watches family events from the sidelines, if you can even go to see them at all.

Quitting for pregnancy is a reason to start your quit. Staying off though is more comprehensive than this. There are many other benefits that go along with staying an ex-smoker that will stick with you throughout your entire life. To keep these benefits, always remember that the best way to improve "your" overall health and quality of life is to never take another puff!

Joel
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Recommend Message 84 of 90 in Discussion
From: Joel Sent: 9/19/2007 1:21 PM
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Recommend Message 85 of 90 in Discussion
From: Joel Sent: 1/7/2008 8:29 AM
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Recommend Message 86 of 90 in Discussion
From: Joel Sent: 1/8/2008 8:23 AM
It is important for women who are in the stage of their lives of family planning take their smoking into consideration. The idea of just quitting to get pregnant or having a baby can pose a risk after the baby is delivered. You can figure now that the risks are now gone, you quit for the important time period. But still keep in mind that even though you did your baby a favor by quitting, you really did yourself the bigger favor.

For not only did you reduce the risk to your baby, you reduced your risk of being sicker throughout your life and eventually dying prematurely--you increased your ability to be active with your baby, throughout his or her life, even when your baby becomes an adult. You increased the odds that you will be around to see your baby eventually have children of his or her own, and even then you can be an active participant in yet another generation, as opposed to an elderly person on oxygen who watches family events from the sidelines, if you can even go to see them at all.

Quitting for pregnancy is a reason to start your quit. Staying off though is more comprehensive than this. There are many other benefits that go along with staying an ex-smoker that will stick with you throughout your entire life. To keep these benefits, always remember that the best way to improve "your" overall health and quality of life is to never take another puff!

Joel
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Recommend Message 87 of 90 in Discussion
From: GoldenMareBear Sent: 4/23/2008 2:46 PM
I'm bumping this up for "ForeverOptimist" from another forum outside MSN, in the hopes that she took my offer to help for what it was--one addict hoping to help another.

One day at a time, one minute at a time if you have to. Do it for your baby, but it's important to do it for yourself too! Best of luck~

YQS~
MareBear
(cl-mhm127 elsewhere)

Almost 6 years free! If I can do it, you can too!
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Recommend Message 88 of 90 in Discussion
From: Joel Sent: 5/10/2008 3:41 PM
It is important for women who are in the stage of their lives of family planning take their smoking into consideration. The idea of just quitting to get pregnant or having a baby can pose a risk after the baby is delivered. You can figure now that the risks are now gone, you quit for the important time period. But still keep in mind that even though you did your baby a favor by quitting, you really did yourself the bigger favor.

For not only did you reduce the risk to your baby, you reduced your risk of being sicker throughout your life and eventually dying prematurely--you increased your ability to be active with your baby, throughout his or her life, even when your baby becomes an adult. You increased the odds that you will be around to see your baby eventually have children of his or her own, and even then you can be an active participant in yet another generation, as opposed to an elderly person on oxygen who watches family events from the sidelines, if you can even go to see them at all.

Quitting for pregnancy is a reason to start your quit. Staying off though is more comprehensive than this. There are many other benefits that go along with staying an ex-smoker that will stick with you throughout your entire life. To keep these benefits, always remember that the best way to improve "your" overall health and quality of life is to never take another puff!

Joel
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Recommend Message 89 of 90 in Discussion
From: Joel Sent: 7/8/2008 1:42 PM
It is important for women who are in the stage of their lives of family planning take their smoking into consideration. The idea of just quitting to get pregnant or having a baby can pose a risk after the baby is delivered. You can figure now that the risks are now gone, you quit for the important time period. But still keep in mind that even though you did your baby a favor by quitting, you really did yourself the bigger favor.

For not only did you reduce the risk to your baby, you reduced your risk of being sicker throughout your life and eventually dying prematurely--you increased your ability to be active with your baby, throughout his or her life, even when your baby becomes an adult. You increased the odds that you will be around to see your baby eventually have children of his or her own, and even then you can be an active participant in yet another generation, as opposed to an elderly person on oxygen who watches family events from the sidelines, if you can even go to see them at all.

Quitting for pregnancy is a reason to start your quit. Staying off though is more comprehensive than this. There are many other benefits that go along with staying an ex-smoker that will stick with you throughout your entire life. To keep these benefits, always remember that the best way to improve "your" overall health and quality of life is to never take another puff!

Joel
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Recommend Message 90 of 90 in Discussion
From: Joel Sent: 9/3/2008 10:11 PM
It is important for women who are in the stage of their lives of family planning take their smoking into consideration. The idea of just quitting to get pregnant or having a baby can pose a risk after the baby is delivered. You can figure now that the risks are now gone, you quit for the important time period. But still keep in mind that even though you did your baby a favor by quitting, you really did yourself the bigger favor.

For not only did you reduce the risk to your baby, you reduced your risk of being sicker throughout your life and eventually dying prematurely--you increased your ability to be active with your baby, throughout his or her life, even when your baby becomes an adult. You increased the odds that you will be around to see your baby eventually have children of his or her own, and even then you can be an active participant in yet another generation, as opposed to an elderly person on oxygen who watches family events from the sidelines, if you can even go to see them at all.

Quitting for pregnancy is a reason to start your quit. Staying off though is more comprehensive than this. There are many other benefits that go along with staying an ex-smoker that will stick with you throughout your entire life. To keep these benefits, always remember that the best way to improve "your" overall health and quality of life is to never take another puff!

Joel
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