Pre-and postnatal maternal smoking and offspring smoking trajectories: Evidence from a 20-year birth cohort.

Abstract

Maternal smoking is associated with increased risk of smoking in the offspring. However, it remains unclear whether this association depends on the timing of exposure to maternal smoking. We investigated the association between prenatal and/or postnatal maternal smoking and offspring smoking during adolescence. Participants (N\u202f=\u202f1661) were from the Québec Longitudinal Study of Child Development cohort. We identified longitudinal trajectories of maternal smoking from before pregnancy to child age 12\u202fyears using group-based trajectory modeling (GBTM). Adolescent (12-19\u202fyears) smoking trajectories were also identified using GBTM. Associations between maternal smoking and offspring smoking trajectories were estimated using multinomial logistic regressions. We used propensity score inverse probability weighting (IPW) to account for the differential distribution of maternal and familial characteristics across exposure groups. We identified four distinct groups for maternal smoking: no (66.1%), decreasing (5.6%), increasing (9.5%) and persistent (18.8%) smoking, and three adolescent smoking trajectories: abstinent, early-onset (before age 15) and late-onset (after age 15). In IPW-adjusted models, youth with mothers with decreasing, increasing and persistent smoking had higher risk of being early-onset smokers compared with youth with mothers in the non-smoking group. We also found that only youth whose mothers were persistent smokers had an increased risk of late-onset smoking. Regardless of timing, offspring exposure to maternal smoking is associated with increased risk of smoking during adolescence. More research is needed on how to create effective smoking cessation campaigns that span preconception, prenatal, and postnatal periods to help prevent intergenerational transmission of smoking behaviors.