Maternal smoking during pregnancy and severe antisocial behavior in offspring: a review

Am J Public Health. 2002 Jun;92(6):966-74. doi: 10.2105/ajph.92.6.966.


Objectives: Recent research suggests that in utero exposure to maternal smoking is a risk factor for conduct disorder and delinquency. We review evidence of causality, a controversial but important public health question.

Methods: We analyzed studies of maternal prenatal smoking and offspring antisocial behavior within a causal framework.

Results: The association is (1) independent of confounders, (2) present across diverse contexts, and (3) consistent with basic science. Methodological limitations of existing studies preclude causal conclusions.

Conclusions: Existing evidence provides consistent support for, but not proof of, an etiologic role for prenatal smoking in the onset of antisocial behavior. The possibility of identifying a preventable prenatal risk factor for a serious mental disorder makes further research on this topic important for public health.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Antisocial Personality Disorder / epidemiology
  • Antisocial Personality Disorder / etiology*
  • Causality
  • Child
  • Conduct Disorder / epidemiology
  • Conduct Disorder / etiology*
  • Female
  • Humans
  • Juvenile Delinquency / statistics & numerical data*
  • Male
  • Maternal Exposure / adverse effects*
  • Pregnancy
  • Prenatal Exposure Delayed Effects*
  • Risk Factors
  • Smoking / adverse effects*
  • Smoking / epidemiology
  • United States / epidemiology