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RESEARCH AND PRACTICE |
Lauren S. Wakschlag, Edwin Cook, and Bennett L. Leventhal are with the Department of Psychiatry, University of Chicago, Chicago, Ill. Kate E. Pickett is with the Departments of Health Studies and Obstetrics and Gynecology, University of Chicago, Chicago, Ill. Neal L. Benowitz is with the Division of Clinical Pharmacology and Experimental Therapeutics, Department of Medicine and Biopharmaceutical Sciences, University of California, San Francisco.
Correspondence: Requests for reprints should be sent to Lauren S. Wakschlag, PhD, University of Chicago, Department of Psychiatry, MC3077, 5841 S Maryland, Chicago, IL 60637 (e-mail: laurie{at}yoda.bsd.uchicago.edu).
Objectives. Recent research suggests that in utero exposure to maternal smoking is a risk factor for conduct disorder and delinquency. We review evidence of causality, a controversial but important public health question.
Methods. We analyzed studies of maternal prenatal smoking and offspring antisocial behavior within a causal framework.
Results. The association is (1) independent of confounders, (2) present across diverse contexts, and (3) consistent with basic science. Methodological limitations of existing studies preclude causal conclusions.
Conclusions. Existing evidence provides consistent support for, but not proof of, an etiologic role for prenatal smoking in the onset of antisocial behavior. The possibility of identifying a preventable prenatal risk factor for a serious mental disorder makes further research on this topic important for public health.
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