Maternal smoking during pregnancy and severe antisocial behavior in offspring: A review

Objectives. Recent research suggests that in utero exposure to maternal smoking is a risk factor for conduct disorder and delinquency. We review evidence of causality, a controversial but important public health question. Methods. We analyzed studies of maternal prenatal smoking and offspring antisocial behavior within a causal framework. Results. The association is (1) independent of confounders, (2) present across diverse contexts, and (3) consistent with basic science. Methodological limitations of existing studies preclude causal conclusions. Conclusions. Existing evidence provides consistent support for, but not proof of, an etiologic role for prenatal smoking in the onset of antisocial behavior. The possibility of identifying a preventable prenatal risk factor for a serious mental disorder makes further research on this topic important for public health.