1. Carrie Dawson PAS 646 Spring 2007 Advisor: Eileen Van Dyke Negative Effects of Prenatal Smoking on School Aged Children

2. Background Information on Pregnancy and Smoking 2001 CDC Report on Women and Smoking 2001 CDC Report on Women and Smoking –About 22% of women in US smoke –About 28% of women in KY smoke –12-22% of women admit to smoking during pregnancy

3. Negative Effects that Prenatal Smoking is Causing in School Aged Kids Physiologic Health Problems Physiologic Health Problems asthma, allergies, ear disease Behavior and Psychiatric Disorders Behavior and Psychiatric Disorders ADD, ADHD Obesity Obesity

4. Asthma and Respiratory Health In-utero exposure found to be greatest predictor of asthma diagnosis (Gilliand) In-utero exposure found to be greatest predictor of asthma diagnosis (Gilliand) Prenatal smoking combined with low birth weight increased risk of asthma diagnosis at age 7 by 83% Prenatal smoking combined with low birth weight increased risk of asthma diagnosis at age 7 by 83% Prenatal smoking and preterm delivery increased risk of asthma diagnosis at age 7 by 64% Prenatal smoking and preterm delivery increased risk of asthma diagnosis at age 7 by 64%

5. Middle Ear Disease 5 year olds were examined and were found to have more acute ear infections if prenatal smoking at any level had occurred 5 year olds were examined and were found to have more acute ear infections if prenatal smoking at any level had occurred Increased risk of ear surgery if in-utero exposure was 20+ cigarettes a day Increased risk of ear surgery if in-utero exposure was 20+ cigarettes a day

6. Behavior and Psychiatric Problems Hyperkinetic disorders like ADHD three times more likely with maternal prenatal smoking Hyperkinetic disorders like ADHD three times more likely with maternal prenatal smoking Severe behavior problems were 25% of the time attributable to prenatal changes of gene expression and nature/function of nicotinic receptors due to nicotine exposure Severe behavior problems were 25% of the time attributable to prenatal changes of gene expression and nature/function of nicotinic receptors due to nicotine exposure

7. Obesity Prenatal smoking was found to have same relationship to weight as “frequently” watching TV or playing video games Prenatal smoking was found to have same relationship to weight as “frequently” watching TV or playing video games BMI and prevalence of being overweight in kids whose mothers stopped smoking during pregnancy found to be about the same as those whose mothers had never smoked BMI and prevalence of being overweight in kids whose mothers stopped smoking during pregnancy found to be about the same as those whose mothers had never smoked

8. What does all this mean to us? Increased cost to parents who have to deal with the health problems of these children Increased cost to parents who have to deal with the health problems of these children Increased cost to everyone because of increased health care costs to deal with these health problems Increased cost to everyone because of increased health care costs to deal with these health problems

9. What can we do? Patient Education – one study showed that one counseling session with a trained professional doubles the cessation rate among pregnant smokers Patient Education – one study showed that one counseling session with a trained professional doubles the cessation rate among pregnant smokers Teachable Moments – another study suggests pregnancy is one of the four most “teachable moments” in a patients life Teachable Moments – another study suggests pregnancy is one of the four most “teachable moments” in a patients life

10. Putting it Simply! As we were told last semester, getting one person to stop smoking in our career will be a great accomplishment, imagine how sweet it would be if our one patient is a pregnant mom who can save her child a lifetime of health problems. As we were told last semester, getting one person to stop smoking in our career will be a great accomplishment, imagine how sweet it would be if our one patient is a pregnant mom who can save her child a lifetime of health problems.

11. Bibliography Benowitz et al. The use of Pharmacotherapy for Smoking Cessation During Pregnancy. Tobacco Control. 2000:9:iii91-iii94 Benowitz et al. The use of Pharmacotherapy for Smoking Cessation During Pregnancy. Tobacco Control. 2000:9:iii91-iii94 Chen et al. Maternal Smoking During Pregnancy in Relation to Child Overweight: Follow-up to Age 8 Years. International Journal of Epidemiology. 2006:35:121-130 Chen et al. Maternal Smoking During Pregnancy in Relation to Child Overweight: Follow-up to Age 8 Years. International Journal of Epidemiology. 2006:35:121-130 Eskenazi and Castorina. Association of Prenatal Maternal or Postnatal Child Environmental Tobacco Smoke Exposure and Neurodevelopmental and Behavioral Problems in Children. Environmental Health Perspectives. December 1999:107:991-1000 Eskenazi and Castorina. Association of Prenatal Maternal or Postnatal Child Environmental Tobacco Smoke Exposure and Neurodevelopmental and Behavioral Problems in Children. Environmental Health Perspectives. December 1999:107:991-1000 Fergusson, Horwood and Lynskey. Maternal Smoking Before and After Pregnancy: Effect on Behavioral Outcomes in Middle Childhood. Pediatrics. 1993;92:815-822 Fergusson, Horwood and Lynskey. Maternal Smoking Before and After Pregnancy: Effect on Behavioral Outcomes in Middle Childhood. Pediatrics. 1993;92:815-822 Gilliand, Li and Peters. Effects of Maternal Smoking During Pregnancy and Evironmental Tobacco Smoke on Asthma and Wheezing in Children. American Journal of Respiratory and Critical Care Medicine. February 2001;163:429-436 Gilliand, Li and Peters. Effects of Maternal Smoking During Pregnancy and Evironmental Tobacco Smoke on Asthma and Wheezing in Children. American Journal of Respiratory and Critical Care Medicine. February 2001;163:429-436 Jaakkola and Gissler. Maternal Smoking in Pregnancy, Fetal Development, and Childhood Asthma. American Journal of Public Health. 2004:94(1):136-141 Jaakkola and Gissler. 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