Psychological Medicine

Original Articles

Is maternal smoking during pregnancy a causal environmental risk factor for adolescent antisocial behavior? Testing etiological theories and assumptions

B. M. D'Onofrioa1 c1, C. A. Van Hullea2, J. A. Goodnighta3, P. J. Rathouza2 and B. B. Laheya4

a1 Indiana University, Bloomington, IN, USA

a2 University of Wisconsin-Madison, Madison, WI, USA

a3 University of Dayton, Dayton, OH, USA

a4 University of Chicago, Chicago, IL, USA


Background Although many studies indicate that maternal smoking during pregnancy (SDP) is correlated with later offspring antisocial behavior (ASB), recent quasi-experimental studies suggest that background familial factors confound the association. The present study sought to test alternative etiological hypotheses using multiple indices of adolescent ASB, comparing differentially exposed siblings, and testing assumptions in the sibling-comparison design.

Method The study examined the association between maternal SDP and adolescent-reported ASB, criminal convictions and membership in a group of individuals with early-starting and chronic ASB among 6066 offspring of women from the National Longitudinal Survey of Youth, a representative sample of women in the USA. The analyses controlled for statistical covariates and examined associations while comparing differentially exposed siblings.

Results At the population level, each additional pack of cigarettes per day predicted greater mean adolescent-reported ASB symptoms [ratio of means 1.15, 95% confidence interval (CI) 1.08–1.22], odds of being in the top 10% of ASB [odds ratio (OR) 1.34, 95% CI 1.10–1.65], hazard of a criminal conviction [hazard ratio (HR) 1.51, 95% CI 1.34–1.68] and odds of chronic ASB (OR 1.57, 95% CI 1.25–1.99). SDP robustly predicted most assessments of ASB while controlling for measured covariates. When siblings exposed to differing levels of SDP were compared, however, all of the associations were attenuated and were not statistically significant: adolescent-reported mean ASB (ratio of means 0.86, 95% CI 0.74–1.01), high ASB (OR 0.67, 95% CI 0.41–1.12), criminal conviction (HR 0.98, 95% CI 0.66–1.44) and chronic ASB (OR 0.80, 95% CI 0.46–1.38).

Conclusions The results strongly suggest that familial factors account for the correlation between SDP and offspring adolescent ASB, rather than a putative causal environmental influence of SDP.

(Received May 31 2011)

(Revised September 22 2011)

(Accepted September 26 2011)

(Online publication November 16 2011)