Prenatal cigarette smoking: Long-term effects on young adult behavior problems and smoking behavior.

We examined the long-term effects of prenatal cigarette smoke exposure (PCSE) on the behavior problems and smoking behavior of 22-year-old offspring. The mothers of these offspring were interviewed about their tobacco and other drug use during pregnancy at the fourth and seventh gestational months, and at delivery. Data on the offspring are from interviews at age 22 (n=608). Behavior problems were measured by the Adult Self-Report (ASR) with the following outcome scales: total behavior problems, externalizing, internalizing, attention, anxiety/depression, withdrawn, thought, intrusive, aggression, somatic and rule breaking behavioral problems. Young adult smoking behavior was measured using self-reported average daily cigarettes, and was validated with urine cotinine. Nicotine dependence was measured with the Fagerström Tobacco and Nicotine Dependence (FTND) scale. Regression analyses tested the relations between trimester-specific PCSE and young adult's behavioral problems and smoking behavior, adjusting for demographic and maternal psychological characteristics, and other prenatal substance exposures. Exposed young adults had significantly higher scores on the externalizing, internalizing, aggression, and somatic scales of the ASR. These young adults were also more likely to have a history of arrests. Young adults with PCSE also had a higher rate of smoking and nicotine dependence. Our previous findings of the relations between PCSE and aggressive behavior in early childhood and PCSE and smoking behavior in early adolescence extend into young adulthood.