Smoking during pregnancy associated with offspring behavior problems, study suggests

Smoking during pregnancy appears to be a prenatal risk factor associated with conduct problems in children, according to a study published by JAMA Psychiatry.
Conduct disorder represents an issue of significant social, clinical, and practice concern, with evidence highlighting increasing rates of child conduct problems internationally. Maternal smoking during pregnancy is known to be a risk factor for offspring psychological problems, including attention deficits and conduct problems, the authors write in the study background.

Professor Gordon Harold and Dr. Darya Gaysina, of the University of Leicester, with colleagues in the United States and New Zealand, examined the relationship between maternal smoking during pregnancy and offspring conduct problems among children raised by genetically related mothers and genetically unrelated mothers.

"Our findings suggest an association between pregnancy smoking and child conduct problems that is unlikely to be fully explained by postnatal environmental factors (i.e., parenting practices) even when the postnatal passive genotype-environment correlation has been removed." The authors conclude, "The causal explanation for the association between smoking in pregnancy and offspring conduct problems is not known but may include genetic factors and other prenatal environmental hazards, including smoking itself."

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One third of world's population benefits from effective tobacco control measure

At 2.3 billion, the number of people worldwide covered by at least one life-saving measure to limit tobacco use has more than doubled in the last five years, according to the WHO Report on the Global Tobacco Epidemic 2013. The number of people covered by bans on tobacco advertising, promotion and sponsorship, the focus of this year’s report, increased by almost 400 million people residing mainly in low- and middle-income countries.

Furthermore, the Report shows that 3 billion people are now covered by national anti-tobacco campaigns. As a result, hundreds of millions of nonsmokers are less likely to start.
However, the Report notes, to achieve the globally agreed target of a 30% reduction of tobacco use by 2025, more countries have to implement comprehensive tobacco control programmes.

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Re-enforce bans on tobacco advertising, promotion and sponsorship worldwide

Bans on tobacco advertising, promotion and sponsorship are one of the most powerful measures to control tobacco use. As of today, 24 countries with 694 million people have introduced complete bans and 100 more countries are close to a complete ban. However, 67 countries currently do not ban any tobacco advertising, promotion and sponsorship activities or have a ban that excludes advertising in national broadcast and print media.
“If we do not close ranks and ban tobacco advertising, promotion and sponsorship, adolescents and young adults will continue to be lured into tobacco consumption by an ever-more aggressive tobacco industry,” says WHO Director-General Dr Margaret Chan. “Every country has the responsibility to protect its population from tobacco-related illness, disability and death.”

Tobacco is the leading global cause of preventable death and kills 6 million people every year. It can cause cancer, cardiovascular disease, diabetes and chronic respiratory diseases. If current trends continue, the number of deaths attributed to tobacco smoking is projected to rise to 8 million a year by 2030. In defiance of the deleterious effects of smoking, tobacco companies are spending tens of billions of dollars each year on advertising, promotion and sponsorship.


“We know that only complete bans on tobacco advertising, promotion and sponsorship are effective," stresses Dr Douglas Bettcher, the Director of WHO’s Prevention of Noncommunicable Diseases department. “Countries that introduced complete bans together with other tobacco control measures have been able to cut tobacco use significantly within only a few years.“
Other measures to cut tobacco use

Other key findings of the report include:

• Effective health warning labels on tobacco packaging continue to be established by more countries. In the past five years, a total of 20 countries with 657 million people put strong warning label requirements in place, with 11 countries (with 265 million people) doing so since 2010.
• More than half a billion people in nine countries have gained access to appropriate cessation services in the past five years. However, there has been little progress since 2010, as only four additional countries with a combined population of 85 million were newly provided access to cost-covered services including a toll-free national quit line.
• Creation of smoke-free public places and workplaces continues to be the most commonly established measure at the highest level of achievement. There are 32 countries that passed complete smoking bans covering all work places, public places and public transportation means between 2007 and 2012, protecting nearly 900 million additional people. Since 2010, 12 countries and one territory, with 350 million people, passed strong smoke-free laws at a national level.

In 2008, WHO identified six evidence-based tobacco control measures that are the most effective in reducing tobacco use. Known as “MPOWER”, these measures correspond to one or more of the demand reduction provisions included in the WHO Framework Convention on Tobacco Control (WHO FCTC): Monitor tobacco use and prevention policies, Protect people from tobacco smoke, Offer help to quit tobacco use, Warn people about the dangers of tobacco, Enforce bans on tobacco advertising, promotion and sponsorship, and Raise taxes on tobacco.

This year’s report is the fourth in the series of WHO reports on the status of the MPOWER measures. These measures provide countries with practical assistance to reduce demand for tobacco in line with the WHO FCTC, thereby reducing related illness, disability and death.

The WHO FCTC entered into force in 2005 and, with 177 Parties today, is a powerful tool to combat the deadly tobacco epidemic. 

Non-smoking hotel rooms still expose occupants to tobacco smoke

Non-smoking rooms in hotels operating a partial smoking ban don’t protect their occupants from tobacco smoke, reveals research published online in journal Tobacco Control.

Non-smokers should give hotels that allow smoking in certain rooms a wide berth, say the authors, and instead choose completely smoke free hotels.

The researchers analyzed the surfaces and air quality of rooms for evidence of tobacco smoke pollution (nicotine and 3EP), known as third hand smoke, in a random sample of budget to mid-range hotels in San Diego, California.

Ten hotels in the sample operated complete bans and 30 operated partial smoking bans, providing designated non-smoking rooms.

Non-smokers who spent the night at any of the hotels, provided urine and finger wipe samples to assess their exposure to nicotine and a cancer causing agent found specifically in tobacco smoke - known as NKK - as measured by their metabolites cotinine and NNAL.

The findings showed that smoking in hotels left a legacy of tobacco pollution in both smoking and non-smoking rooms. A partial smoking ban did not protect the occupants of non-smoking rooms from exposure to tobacco pollution.

Compared with hotels operating total smoking bans, surface nicotine and air 3EP levels were higher in both non-smoking and smoking rooms of hotels operating partial bans.

Surface nicotine levels were more than twice as high in non-smoking rooms of hotels operating partial bans as those of hotels operating total smoking bans (3.7 µg/m2 compared with 1.4 µg/m2), while air levels of 3EP were more than 7 times as high.

Surface and air nicotine levels in rooms where previous guests had smoked were 35 and 22 times higher than those of rooms in hotels operating a total smoking ban.

Air nicotine levels in smoking rooms were significantly higher than in non-smoking rooms; and they were also higher 40% higher in non-smoking rooms of hotels operating partial smoking bans than in those operating total bans.

Similarly, hallway surfaces outside smoking rooms also showed higher nicotine levels than those outside non-smoking rooms.

Non-smokers who stayed in hotels with partial smoking bans also had higher levels of finger nicotine and urinary cotinine than those staying in hotels operating total bans. Urinary NNAL was also significantly higher in those staying in the 10 rooms containing the highest levels of tobacco pollutants.

“Our findings demonstrate that some non-smoking guest rooms in smoking hotels are as polluted with [third hand smoke] as are some smoking rooms,” write the authors. They go on to say: “Moreover, non-smoking guests staying in smoking rooms may be exposed to tobacco smoke pollutants at levels found among non-smokers exposed to second hand smoke.”

Few countries have adopted a smoking ban that includes hotels, say the authors, but their findings “suggest that it is time to abandon smoke-free exemptions for hotels,” they write.

New hotels should operate total smoking bans to protect not only their guests, but also their employees, say the authors. In the meantime, they advise: “Guests who wish to protect themselves from exposure to tobacco smoke should avoid hotels that permit smoking and instead stay in completely smoke-free hotels.”
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