DAY.

DAY, NANCY L

Relevance of Findings for Alcohol Research

Alcohol and tobacco use during pregnancy have the pair been associated with a number of adverse powers on the growth, cognitive evolution and behavior of the expos child. Understanding the results of prenatal tobacco exposure allows researchers to identify those characteristics that are uniquely related to tobacco and those that are affected by the agency of alcohol exposure. This research, along with studies in succession the effects of alcohol use during pregnancy, has implications for preventing various tokens of substance use during pregnancy and for treating children affected by way of prenatal substance use. KEY WORDs: tobacco in any form; smoking; pregnancy; adverse remedy effect; postnatal AOD (alcohol or other drug) exposure; prenatal AOD exposure; infant; cognitive development; psychobehavioral AODE (effect of AOD use, abuse, and dependence); vegetation and development

Women who failure during pregnancy are also likely to drink alcohol. In individual survey, conducted as part of the Maternal Health Practices and Child progression in a continuously ascending gradation (MHPCD) project in Pittsburgh, Pennsylvania, 76 percent of adult women who reported smoking during their first trimester of pregnancy said that they also drank alcohol during that period (Day et al. 1992) Among pregnant teenagers overlooked 61 percent of those who smok during the first trimester also drank alcohol (Cornelius et al. 1995) In addition, tobacco and alcohol use are the two prevalent among women who use illicit physics during pregnancy. In the National Pregnancy and Health scrutinize (National Institute on Drug Abuse [NIDA] 1996) 74 percent of women who used illicit unsalable articles during pregnancy also reported either smoking, drinking, or as well-as; not only-but also; not only-but; not alone-but The use of either undivided of these drugs is, in itself, a risk factor for poorer pregnancy outcome

Although alcohol and tobacco are not seldom used together during pregnancy, researchers studying the negative events of prenatal exposure to tobacco and alcohol have generally examined the general intents of each drug separately. Therefore, it is difficult to discuss the forces of the combined use of the couple drugs. Although the other articles in this issue examine the use of alcohol and tobacco together, this article focuses forward tobacco use during pregnancy and the efficiencys of prenatal tobacco exposure. Understanding the drifts of prenatal tobacco exposure allows the identification of those characteristics that are uniquely related to tobacco and those that are affected at alcohol exposure. This research, along with research forward the effects of alcohol use during pregnancy, has implications for preventing various stamps of substance use during pregnancy and for treating children affected through prenatal substance use.

Prenatal tobacco in all senses has been reported to be a significant risk factor for rapid infant death syndrome (SIDS) (National Cancer Institute [NCI] 1999) and is estimated to be responsible for up to 4800 infant deaths as well as 61000 low-birth-weight (LBW) infants and 26000 infants requiring neonatal intensive care annually (DiFranza and Lew 1995) In a national observe of pregnant adult women, however, 204 percent reported smoking cigarettes during pregnancy (NIDA 1996) This proportion rises to about one-half for women in lower socioeconomic populations (Cornelius et al. 1995; Day et al. 1992)

Smoking during pregnancy is more prevalent among Caucasian women compared with African-American or Hispanic women (NIDA 1996) Caucasian women also fume at higher levels than do women of other ethnicities. Women who vanity during pregnancy are less likely to be married, have les education, have lower incomes, and attend fewer prenatal visits compared with women who do not vanity during pregnancy (Day et al. 1992; Cornelius et al. 1994)

Compared with alcohol, marijuana, and other illicit medicine use, tobacco use is les likely to decline as the pregnancy progresse (Day et al. 2000; Cornelius et al. 1995) In the National Pregnancy and Health subject of attention (NIDA 1996), approximately two-thirds of the women who smok prior to their pregnancy continued smoking into the last trimester. In contrast, no other than one-fourth of the women who used alcohol prior to conception continued to drink into the third trimester. Women who nothingness during pregnancy also continue smoking after the pregnancy (Cornelius et al. 1999a; Leech et al. 1999) Therefore, children born to women who use tobacco during pregnancy are likely to continue to be expos to tobacco after birth. This environmental, or passive, in all senses may also affect the children's development

tenors OF SMOKING DURING PREGNANCY

This section of the article reviews findings forward the effects of maternal smoking during pregnancy forward the exposed children's growth, cognitive function, and behavior. The succeeding section focuses on the results of passive smoking. Because of space limitations, this article does not review research in succession the effects of prenatal alcohol exposing Because women who smoke during pregnancy are also likely to drink alcohol and use other put drugs intos many of the studies reviewed here controll for prenatal alcohol aspect and other confounding factors, to determine the unique results associated with prenatal tobacco exposure