Tobacco Essay
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Tobacco is one of the leading preventable causes of death in the United States. Nicotine, which is an alkaloid derived from the tobacco plant, is a potent chemical that has powerful effects on the human body, especially when administered rapidly or at high doses. Prenatal exposure to nicotine is associated with adverse reproductive outcomes, including altered neural structure and functioning, cognitive deficits, and behavior problems in the offspring (9). At least 20% - 30% of pregnant women are estimated to smoke cigarettes, although smoking is associated with low birth weight, prematurity and infant mortality. In the United States, smoking accounts annually for estimated fetal deaths ranging from 19,000 to 141,000, for 1,900 to 4,800 deaths during or immediately after parturition, and for 1,200 to 2,200 death from Sudden Infant Death Syndrome (7).
Maternal smoking has been implicated in long term deficits in infant mental development and adverse behavioral problems in children such as attention disorder. Nicotine crosses the human placenta and has direct effects on the developing fetus. Pre-clinical studies suggest that maternal smoking during pregnancy produces changes on the offspring's neural functioning, including reductions in uptake of serotonin, alterations in dopaminergic systems, alterations in peripheral and central noradrenergic neurons, and changes in DNA and RNA synthesis in the brain (9). Children prenatally exposed to nicotine consistently score lower in the two subcategories of expressive language and conceptual comprehension.
Evidence from studies of human neonates suggests that maternal smoking during pregnancy is associated with increased rates of neurobehavioral difficulties. Several studies have linked maternal smoking during pregnancy with childhood inattention, impulsivity, and motor hyperactivity in offspring. Similarly, maternal smoking during pregnancy has been associated with parent-teacher ratings of conduct problems in children and a criminal record in young adults. A study by Yousef Tzabi suggested that cigarette smoking during pregnancy may be one of the causes of hyperactivity and learning deficits in children. In a laboratory study with Sprague-Dawley mice, it was shown that hyperactive male pups that were exposed to nicotine prenatally had significantly higher nicotinic receptor concentrations in the cortex than did the controlled pups (8). This study indicates that hyperactivity in male offspring induced by prenatal nicotine exposure is associated with an increase in neuronal nicotinic receptors in the cortex.
A similar study by Lauren S. Wakschlag, on maternal smoking during pregnancy and the risk of conduct disorder in boys, revealed that mothers who smoked more than half a pack of cigarettes daily during pregnancy were significantly more likely to have offspring who met DSM-III-R diagnostic criteria for Conduct Disorder during the preadolescent or adolescent years than women who did not smoke or smoked only occasionally during pregnancy. These findings support previous work showing that maternal smoking during pregnancy is associated with increased rates of preschool and school-age behavior problems and delinquency in the offspring.
The relationship between smoking and low birth weight, prematurity, and miscarriage has been well established. The effects of nicotine are seen in every trimester of pregnancy, from increased spontaneous abortions in the first trimester to increased premature delivery rates and decreased birth weights in the final trimester. In 1957, Simpson first noted in an observational study of 7,499 patients that the incidence of premature delivery, as defined by a birth weight less than 2,500g, was twice as great for the smoking mother as compared with the nonsmoking mother (5). A similar study by Walsh concluded that the smoking mother is at two-fold increased risk for delivering a low birth weight infant than her nonsmoking counterpart.
The birth weight of a baby is dependent on...
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