In the UK in 2005, 32% of women smoked cigarettes in the year before they became pregnant and, although most pregnant smokers would like to quit, 17% of women continue to smoke throughout pregnancy – exposing around 120,000 infants each year. Interventions to promote smoking cessation in pregnant women are only moderately successful, a meta-analysis of 48 trials suggests that 6 more women may quit, for every 100 assigned to an intervention, and relapse rates are high.
Smoking during pregnancy is well known to have a number of adverse effects, including increased risk of miscarriage, low birth weight, preterm delivery, stillbirth and Sudden Infant Death Syndrome. More recently, studies have suggested that smoking in pregnancy has long-term effects on offspring, including a higher risk of disruptive behaviour problems and cognitive deficits.
I am part of a collaborative research programme focused on determining whether or not in utero exposure is causally related to such outcomes or whether smoking in pregnancy is a marker for intergenerational processes associated with both the tendency to smoke and to have offspring with behavioural and cognitive problems. As the timing, intensity and duration of exposure may be critical in such studies, we also focus on enhancing the quality of measurement of smoking in pregnancy. Our team brings several different disciplinary approaches (epidemiology, biostatistics, developmental psychopathology, pharmacology, and health psychology) and cross-national datasets (data from US and UK national surveys, and small samples with intensive multi-method assessment) to bear on these issues.