3.8 Infant health and smoking

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3.0 Background

3.1 Tobacco—a leading preventable cause of death and disease

3.2 Cardiovascular diseases

3.3 Lung cancer

3.4 Respiratory diseases

3.5 Other cancers caused by or associated with smoking

3.6 Reproductive health and smoking

3.7 Pregnancy and smoking

3.8 Infant health and smoking

3.9 Increased susceptibility to infection in smokers

3.10 Eye diseases

3.11 Dental diseases

3.12 Gastrointestinal diseases

3.13 Bone density and risk of fractures

3.14 Effects of smoking on the skin

3.15 Smoking and complications in medical treatment

3.16 Smoking and diabetes

3.17 Poorer levels of general health

3.18 Smoking, motor vehicle crashes and other injuries

3.19 Burns and fires caused by tobacco use

3.20 Tobacco poisoning

3.21 Health effects for younger smokers

3.22 Genetic influences on tobacco-caused disease

3.23 Smoking, dementia and cognitive decline

3.24 Lung disease, smoking and occupational exposures

3.25 Air pollution, cigarette smoking and ill health

3.26 Health effects of smoking brands that claim to deliver lower levels of tar, nicotine and carbon monoxide

3.27 Health effects of smoking tobacco in other forms

3.28 Health 'benefits' of smoking?

3.29 Morbidity (ill health) attributable to tobacco-caused disease

3.30 Deaths attributable to tobacco by disease category

3.31 Morbidity and mortality due to tobacco-caused disease and socioeconomic disadvantage

3.32 Health effects of smoking other substances

3.33 Health effects of chewing tobacco, and of other smokeless tobacco products

3.34 Public perceptions of tobacco as a drug, and knowledge and beliefs about the health consequences of smoking

3.35 Health benefits of cessation

3.36 The global tobacco pandemic

Acknowledgments

References

Infant health is affected by exposure to tobacco smoke before birth, by maternal smoking and exposure to secondhand smoke, and following birth, through maternal smoking and by exposure to secondhand tobacco smoke in the home, car and other places. Nicotine is found in the breast milk of mothers who smoke, and cotinine, one of the main metabolites of nicotine, is found in the urine of breastfed infants of smokers, as well as in the urine of infants who are exposed to secondhand smoke.50

3.8.1 Respiratory health

Infants of smokers are at increased risk of having reduced lung function, which may persist into adulthood.5 Recent Australian research suggests that infants born to women who have smoked during pregnancy have weakened innate immune defences, and develop their acquired immune system more slowly than infants of non-smoking mothers. This may explain why infants of smokers are more prone to be asthmatic and to develop respiratory infections.51 In Australia in 2004?05, it is estimated that about 13% of all deaths due to lower respiratory tract infections in babies less than one year of age were attributable to exposure to maternal tobacco smoking.7

Infants living with smokers are also more likely to experience a range of respiratory symptoms and chest illnesses.52 These findings are discussed in greater detail in Chapter 4, Section 4.7.

3.8.2 Sudden infant death syndrome

Sudden infant death syndrome (SIDS) is the sudden, unexplained, unexpected death of a child before one year of age.5 Smoking has been established as a cause of SIDS, whether the baby has been exposed to smoking before birth or in the home following birth.5 The biological pathway remains uncertain, but may be due to neurotoxic effects of tobacco smoke on the central nervous system.5 Almost one in five deaths from SIDS in Australia (18%) is thought to be caused by maternal tobacco use.7

3.8.3 Long-term effects

Studies into the long-term effects on the health of children born to smokers have not provided conclusive evidence about possible effects of smoking on subsequent physical and cognitive development, behavioural outcomes and educational achievements.5 Although recent research points to several possible long-term outcomes for children born to women who smoked during pregnancy,53 such as disruptive behaviour54 and increased risk for childhood obesity,55 mechanisms underlying these associations remain unclear and further investigation is needed.

Evidence is also emerging which suggests that exposure to nicotine in utero predisposes an individual to a greater likelihood of nicotine dependence later in life, independent of socioeconomic and other factors that influence uptake of smoking.56 It is possible that this may occur by nicotine having a direct effect on the developing foetal brain, causing permanent abnormalities in neurotransmitter regulation.56, 57 Other research, while confirming that offspring of women who smoked during pregnancy are more likely to become smokers in early adolescence, suggests that proximal influences on smoking uptake such as mother's current smoking status and peer group behaviour are stronger predictors.58 This is an area requiring further study.