The conclusions of this body of quasi-experimental approaches to this research question should not be over-interpreted so as to suggest that maternal cigarette smoking during pregnancy is a benign influence. Substantial evidence exists to suggest prenatal cigarette smoke exposure is associated with numerous adverse outcomes related to birth and infancy, such as birth weight (Cnattingius, 2004; D’Onofrio, Singh, Iliadou, Lambe, Hultman, Grann, et al., 2010; D’Onofrio, Singh, Iliadou, Lambe, Hultman, Neiderhiser, et al., 2010; D’Onofrio et al., 2003; Gilman, Gardener, & Buka, 2008; Johansson, Dickman, Kramer, & Cnattingius, 2009; Rice, et al., 2009; Sexton & Hebel, 1984). Thus, there is a need for continued smoking cessation efforts in pregnant mothers. However, given that smoking during pregnancy is correlated with a host of other behaviors (Agrawal, et al., 2008; D’Onofrio, Singh, Iliadou, Lambe, Hultman, Neiderhiser, et al., 2010; Knopik, 2009; Knopik, et al., 2006; Knopik, et al., 2005), this suggests that treatment and prevention efforts might need to also consider other factors, such as maternal alcohol dependence, maternal nicotine dependence, and maternal ADHD, among other things.
