Maternal tobacco smoking, nicotine replacement and neurobehavioural development

Acta Paediatr. 2008 Oct;97(10):1331-7. doi: 10.1111/j.1651-2227.2008.00852.x. Epub 2008 Jun 12.


Abstract The adverse effects of prenatal cigarette smoke exposure on human reproductive outcomes are a major scientific and public health concern. In the United States, approximately 25% of women of childbearing age currently smoke cigarettes, and only a small percentage of these individuals quit after learning of their pregnancy. Women interested in smoking cessation during pregnancy have a number of options, including behavioural and pharmacological aids, but nicotine replacement therapy (NRT) is by far the most common approach. While NRT avoids exposure to the myriad compounds present in tobacco smoke, nicotine itself causes damage to the developing nervous system. The purpose of this article is to review the detrimental effects of developmental tobacco smoke exposure on short- and long-term outcomes with particular emphasis on neurobehavioural consequences. In conclusion based on the clear, adverse effects of nicotine on brain development observed in human and animal studies, we suggest that safer alternatives for smoking cessation in pregnancy are badly needed.

Publication types

  • Review

MeSH terms

  • Attention Deficit Disorder with Hyperactivity / etiology
  • Brain / drug effects
  • Brain / growth & development
  • Female
  • Ganglionic Stimulants / administration & dosage
  • Ganglionic Stimulants / adverse effects*
  • Humans
  • Infant, Newborn
  • Mothers
  • Nicotine / administration & dosage
  • Nicotine / adverse effects*
  • Perinatal Care*
  • Pregnancy
  • Pregnancy Complications / therapy*
  • Prenatal Exposure Delayed Effects / etiology*
  • Risk Factors
  • Smoking / adverse effects*
  • Smoking / therapy
  • Smoking Cessation / methods*
  • Sudden Infant Death / etiology
  • Time Factors


  • Ganglionic Stimulants
  • Nicotine