More Reasons Not to Smoke.

* Attention deficit hyperactivity disorder (ADHD) is a chronic disorder marked by decreased attention and impulse control and increased motor activity with onset in early childhood. There is evidence for both genetic and environmental factors. Studies in rodents have found an association between chronic in utero exposure to nicotine and hyperactivity. In humans smoking causes fetal hypoxia, and nicotine is found in higher concentrations in the fetus than in the smoking mother.

This study compared the maternal smoking histories of 140 boys diagnosed with ADHD with those of 120 boys without the disorder. The two groups differed significantly: 22% of the ADHD children's mothers reported having smoked during the index pregnancy, versus only 8% of the normal children's mothers. This difference remained even after adjustment for socioeconomic status, parental IQ, and parental ADHD status. The children of nonsmoking mothers also had IQs that averaged about 10 points above the others'.

-- American Journal of Psychiatry, September 1996

* Many children are exposed to smoking by adults in their households. Studies have linked environmental tobacco smoke (ETS) with otitis media, asthma and other conditions.

In this recent study, researchers attempted to estimate the number of children adversely affected by involuntary smoking. Studies published after 1965 were meta-analyzed to compute a pooled risk ratio for pediatric disorders caused by smoking. Based on the most conservative assumptions, ETS produces:

2 to 13% of the cases of otitis media (middle ear infections) 1 to 26% of the need for tympanostomy (ear) tubes 16 to 24% of tonsillectomy and adenoidectomy cases 8 to 13% of asthma cases 10 to 16% of children's coughs 12 to 20% of lower respiratory tract infections 15 to 23% of hospitalizations and deaths caused by respiratory tract illnesses in children under age 5.

Some 284 to 360 children die each year because of illnesses and fire-related injuries attributable to others' smoking. "The use of tobacco products by adults has an enormous adverse impact on the health of children," the researchers conclude. They suggest that children should be excluded from designated smoking areas, and organizations that cater to children should guarantee them smoke-free environments. The researchers would go farther: potential exposure to ETS should be one of many factors considered in custody cases, they say, and continued exposure to household ETS for asthmatic children should constitute neglect or abuse.

-- Pediatrics, April 1996

* Doctors have known for some time that smoking during pregnancy has several negative effects on fetal and infant development. Among them are a reduction in birth weight and an increased risk of sudden infant death syndrome (SIDS). Now researchers have also discovered a link between maternal smoking during pregnancy and mental retardation in the baby.

The study, published in the journal Pediatrics, looked at 221 mentally retarded children and 400 normal children. The children's mothers answered questions about whether -- and how much -- they had smoked during pregnancy. Smoking was defined as having at least five cigarettes per week.

The researchers found a 50 percent greater incidence of mental retardation among the children of mothers who smoked during pregnancy, and they found that the more a woman smoked when she was expecting, the greater the chance of retardation in her baby. The study didn't prove a causal relationship between maternal smoking and retardation. (It's possible that postnatal exposure to smoke, or some other factor, is responsible for the association.)

--American Baby, September 1996