Rogers JM, Abbott BD. 2003. Screening for developmental toxicity of tobacco smoke constituents. Toxicol Sci 75:227–228.
Cigarette smoking is unrivaled among developmental toxicants in terms of total adverse impact on the human population. According to the American Lung Association, smoking during pregnancy is estimated to account for 20–30% of low-weight babies, up to 14% of preterm deliveries, and about 10% of all infant deaths (http://www.lungusa.org/tobacco/pregnancy_factsheet99.html). Both active (Stillman et al., 1986) and passive smokers (Martin and Bracken, 1986) have babies with lower than normal birthweights. The long-term consequences associated with low birthweight are just beginning to come to light, and they are many. Risks of childhood and adult morbidity, including—but not limited to—diabetes, cardiovascular disease, obesity, and cancer, are inversely related to birthweight (for review, see Godfrey and Barker, 2001; Slikker and Schwetz, 2003). It has been estimated that 12–24% of pregnant women smoke, with the lower figure coming from surveys based on self-reporting. Smoking is the single largest preventable risk factor for pregnancy-related morbidity and mortality in the US (Dempsey and Benowitz, 2001), and the Surgeon General’s Report (USDHHS, 2001) states that the known adverse women’s health effects of smoking “compels the Nation to make reducing and preventing smoking one of the highest contemporary priorities for women’s health.”