Prenatal cigarette smoke exposure and early initiation of multiple substance use

Nicotine Tob Res. 2012 Jun;14(6):694-702. doi: 10.1093/ntr/ntr280. Epub 2011 Dec 16.


Introduction: Earlier studies have shown a relation between prenatal cigarette smoke exposure (PCSE) and offspring initiation of tobacco use. No prior study has examined the association between PCSE and early initiation of multiple substances (EIMS) including marijuana and alcohol in addition to tobacco. We investigated the association between PCSE and multiple substance use during adolescence.

Methods: Pregnant women attending an urban prenatal clinic were selected to participate in the prospective longitudinal study based on their substance use. This study is based on the 16-year follow-up phase and consists of 579 mother-offspring dyads. The women were of lower socioeconomic status, 54% were Black, and 53% reported smoking cigarettes. 52% of the offspring were female. EIMS is a measure of the number of substances initiated prior to age 16 by the adolescents; it ranged from 0 (no initiation, N = 166) to 3 (all, N = 162).

Results: Adolescents exposed to tobacco during first trimester of gestation were 1.4 times more likely to initiate multiple substances by age 16 than the nonexposed group. PCSE was a significant predictor of EIMS after controlling for other prenatal exposures, home environment, and demographic characteristics, using ordinal polytomous logistic regression. Other risk factors of EIMS were maternal and adolescent depression, less strict and less involved parenting, offspring attention problems, and lack of participation in a youth club.

Conclusions: There is a significant relation between PCSE and adolescent's EIMS.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adolescent Behavior / drug effects*
  • Adolescent Behavior / psychology
  • European Continental Ancestry Group / psychology
  • European Continental Ancestry Group / statistics & numerical data
  • Female
  • Humans
  • Intellectual Disability / chemically induced
  • Logistic Models
  • Longitudinal Studies
  • Male
  • Pregnancy
  • Pregnancy Trimester, First
  • Prenatal Exposure Delayed Effects / psychology*
  • Prevalence
  • Risk Factors
  • Smoking / adverse effects*
  • Smoking / psychology
  • Social Class
  • Substance-Related Disorders / diagnosis
  • Substance-Related Disorders / psychology
  • Tobacco Smoke Pollution / adverse effects*
  • Young Adult


  • Tobacco Smoke Pollution