Longitudinal Study of the Effects of Maternal Smoking on Pulmonary Function in Children

We investigated the effects of maternal cigarette smoking on pulmonary function in a cohort of children and adolescents observed prospectively for seven years. A multivariate analysis revealed that after correction for previous forced expiratory volume in one second (FEV₁), age, height, change in height, and cigarette smoking in the child or adolescent, maternal cigarette smoking significantly lowered the expected average annual increase in FEV₁ (P = 0.015). On the basis of this analysis, it is estimated that if two children have the same initial FEV₁, age, height, increase in height, and personal cigarette-smoking history, but the mother of one has smoked throughout the child's life whereas the mother of the other has not, the difference in the change in FEV₁ over time in the exposed child, as compared with that in the unexposed child, will be approximately 28, 51, and 101 ml after one, two, and five years, respectively, or a reduction of 10.7,9.5, and 7.0 per cent, respectively, in the expected increase. These results suggest that passive exposure to maternal cigarette smoke may have important effects on the development of pulmonary function in children. (N Engl J Med 1983; 309:699–703.).