Journal Mobile Options
Table of Contents
Vol. 9, No. 3, 2003
Issue release date: July 2003
Eur Addict Res 2003;9:120–130

Maternal Smoking and Smoking in Adolescents: A Prospective Community Study of Adolescents and Their Mothers

Lieb R. · Schreier A. · Pfister H. · Wittchen H.-U.
aClinical Psychology and Epidemiology Unit, Max Planck Institute of Psychiatry, Munich, and bInstitute of Clinical Psychology and Psychotherapy, Technical University of Dresden, Dresden, Germany

Individual Users: Register with Karger Login Information

Please create your User ID & Password

Contact Information

I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in


The associations between maternal smoking and nicotine dependence and patterns of smoking and nicotine dependence in offspring were examined in a large community-based sample of adolescents. Data were derived from baseline and 4-year follow-up assessments of 938 respondents aged 14–17 years at the outset of the Early Developmental Stages of Psychopathology (EDSP) study, a prospective-longitudinal community study of adolescents and young adults and their parents respectively. Smoking and nicotine dependence in respondents were assessed using the Munich Composite International Diagnostic Interview (DSM-IV algorithms). Diagnostic information about smoking behavior in mothers was collected by independent direct diagnostic interviews with the mothers. In comparison to children of non- or occasionally smoking mothers, children of regularly smoking and nicotine-dependent mothers had higher probabilities of using tobacco as well as of developing nicotine dependence. For all ages under consideration, survival analyses revealed a higher cumulative lifetime risk of regular smoking and nicotine dependence among these children. Maternal smoking during pregnancy seems to represent an additional risk for these outcomes in children, specifically with regard to the risk of developing nicotine dependence. Associations were comparable for sons and daughters. Our findings show that maternal smoking predicts escalation of smoking, development of nicotine dependence, and stability of smoking behavior in children. Implications for specific intervention and prevention efforts are discussed.

Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.


  1. Sieber M, Angst J: Drogen-, Alkohol- und Tabakkonsum. Ein Beitrag zur Epidemiologie und Ätiologie bei jungen Erwachsenen. Bern, Huber, 1981.
  2. Russell M, Cooper ML, Frone MR: The influence of sociodemographic characteristics on familial alcohol problems: Data from a community sample. Alcohol Clin Exp Res 1990;14:221–226.
  3. Sher KJ, Walitzer KS, Wood PK, Brent EE: Characteristics of children of alcoholics: Putative risk factors, substance use and abuser, and psychopathology. J Abnorm Psychol 1991;100:427–448.
  4. Mathew RJ, Wilson WH, Blazer DG, George LK: Psychiatric disorders in adult children of alcoholics: Data from the Epidemiologic Catchment Area Project. Am J Psychiatry 1993;150:793–800.
  5. Bidaut-Russell M, Bradford SE, Smith EM: Prevalence of mental illness in adult offspring of alcoholic mothers. Drug Alcohol Depend 1994;35:81–90.
  6. Dierker LC, Merikangas KR, Szatmari P: Influence of parental concordance for psychiatric disorders on psychopathology in offspring. J Am Acad Child Adolesc Psychiatry 1999;38:280–288.
  7. Hill SY, Yuan H: Familial density of alcoholism and onset of adolescent drinking. J Stud Alcohol 1999;60:7–17.
  8. Lieb R, Merikangas K, Höfler M, Pfister H, Isensee B, Wittchen H-U: Parental alcohol use disorders and alcohol use and disorders in offspring: A community study. Psychol Med 2002;32:63–78.
  9. Reich W, Earls F, Frankel O, Shayka JJ: Psychopathology in children of alcoholics. J Am Acad Child Adolesc Psychiatry 1993;32:995–1002.
  10. Sher KJ, Gothman HJ, Erickson DJ, Wood PK: A prospective, high risk-study of the relationship between tobacco dependence and alcohol use disorders. Alcohol Clin Exp Res 1996;20:485–492.
  11. Windle M: Mate similarity, heavy substance use and family history of problem drinking among young adult women. J Stud Alcohol 1997;58:573–580.
  12. Lieb R, Isensee B, Höfler M, Pfister H, Wittchen H-U: Elterliche Alkoholbelastung und die Entwicklung von Suchtproblemen bei ihren Kindern – Ergebnisse der prospektiv-longitudinalen EDSP-Studie. Suchttherapie 2001;2:125–136.
  13. Biederman J, Faraone SV, Monuteaux MC, Feighner JA: Patterns of alcohol and drug use in adolescents can be predicted by parental substance use disorders. Pediatrics 2000;106:792–797.
  14. Anthony JC, Warner LA, Kessler RC: Comparative epidemiology of dependence on tobacco, alcohol, controlled substances, and inhalants: Basic findings from the National Comorbidity Survey. Exp Clin Psychopharmacol 1994;2:244–268.

    External Resources

  15. Simon R, Tauscher M, Pfeiffer T: Suchtbericht Deutschland 1999. Hohengehren, Schneider, 1999.
  16. Breslau N, Johnson EO, Hiripi E, Kessler R: Nicotine dependence in the United States – Prevalence, trends, and smoking persistence. Arch Gen Psychiatry 2001;58:810–816.
  17. Weitzman M, Gortmaker S, Sobol A: Maternal smoking and behavior problems of children. Pediatrics 1992;90:342–349.
  18. Fergusson DM, Horwood LJ, Lynskey MT: Maternal smoking before and after pregnancy: Effects on behavioral outcomes in middle childhood. Pediatrics 1993;92:815–822.
  19. Orlebeke J, Knol DL, Verhulst FC: Increase in child behavior problems resulting from maternal smoking during pregnancy. Arch Environ Health 1997;52:317–321.
  20. Wakschlag LS, Lahey BB, Loeher R, Green SM, Gordon RA, Leventhal BL: Maternal smoking during pregnancy and the risk of conduct disorder in boys. Arch Gen Psychiatry 1997;54:670–676.
  21. Fergusson DM, Woodward LJ, Horwood LJ: Maternal smoking during pregnancy and psychiatric adjustment in late adolescence. Arch Gen Psychiatry 1998;55:721–727.
  22. Weissman MM, Warner V, Wickramaratne PJ, Kandel DB: Maternal smoking during pregnancy and psychopathology in offspring followed to adulthood. J Am Acad Child Adolesc Psychiatry 1999;38:892–899.
  23. Brook JS, Brook DW, Whiteman M: The influence of maternal smoking during pregnancy on the toddler’s negativity. Arch Pediatr Adol Med 2000;154:381–385.
  24. Hill SY, Lowers L, Locke-Wellman J, Shen S: Maternal smoking and drinking during pregnancy and the risk for child and adolescent psychiatric disorders. J Stud Alcohol 2000;61:661–668.
  25. Wasserman GA, Liu X, Pine DS, Graziano JH: Contributions of maternal smoking during pregnancy and lead exposure to early child behavior problems. Neurotox Teratol 2001;23:13–21.
  26. Fox NL, Sexton M, Hebel JR: Prenatal exposure to tobacco. I. Effects on physical growth at age three. Intern J Epidemiol 1990;19:66–71.
  27. Gilliland FD, Li Y-F, Peters M: Effects of maternal smoking during pregnancy and environmental tobacco smoke on asthma and wheezing in children. Am J Resp Crit Care Med 2001;163:429–436.
  28. Tong S, McMichael AJ: Maternal smoking and neuropsychological development in childhood – A review of the evidence. Dev Med Child Neurol 1992;34:191–197.
  29. MacArthur CM, Knox EG, Lancashire RJ: Effects at age nine of maternal smoking in pregnancy: Experimental and observational findings. Br J Obstet Gynaecol 2001;108:67–73.

    External Resources

  30. Chassin L, Presson CC, Sherman SJ: Cigarette smoking and adolescent psychosocial development. Basic Appl Soc Psych 1984;5:295–315.
  31. Chassin L, Presson CC, Sherman SJ, Montello D, McGrew J: Changes in peer and parent influence during adolescence: Longitudinal versus cross-sectional perspectives on smoking initiation. Dev Psychol 1986;22:327–334.

    External Resources

  32. Foshee V, Bauman KE: Parental and peer characteristics as modifiers of the bond-behavior relationship: An elaboration of control theory. J Health Soc Behav 1992;33:66–76.
  33. Flay BR, Hu FB, Richardson J: Psychosocial predictors of different stages of cigarette smoking among high school students. Prevent Med 1998;27:A9-A18.
  34. Flay BR, Hu FB, Siddiqui O, Day LE, Hedeker D, Petraitis J, Richardson J, Sussman S: Differential influence of parental smoking and friends’ smoking on adolescent initiation and escalation of smoking. J Health Soc Behav 1994;35:248–265.
  35. Kandel DB, Wu P, Davies M: Maternal smoking during pregnancy and smoking by adolescent daughters. Am J Publ Health 1994;84:1407–1413.
  36. Kandel DB, Udry JR: Prenatal effects of maternal smoking on daughters’ smoking: Nicotine or testosterone exposure? Am J Publ Health 1999;89:1377–1383.
  37. Kandel DB, Wu P: The contributions of mothers and fathers to the intergenerational transmission of cigarette smoking in adolescence. J Res Adolescence 1995;5:225–252.
  38. Pederson LL, Koval JJ, O’Connor K: Are psychosocial factors related to smoking in grade-6 students? Addict Behav 1997;22:169–181.
  39. Jackson C, Henriksen L: Do as I say: Parent smoking, antismoking socialization, and smoking onset among children. Addict Behav 1997;22:107–114.
  40. Griesler PC, Kandel DB, Davies M: Maternal smoking in pregnancy, child behavior problems, and adolescent smoking. J Res Adolesc 1998;8:159–185.
  41. Cornelius MD, Leech SL, Goldschmidt L, Day NL: Prenatal tobacco exposure: Is it a risk factor for early tobacco experimentation? Nicotine Tobacco Res 2000;2:45–52.
  42. Eckhardt L, Woodruff SI, Elder JP: A longitudinal analysis of adolescent smoking and its correlates. J School Health 1994;64:67–72.
  43. Rowe DC, Chassin L, Presson C, Sherman SJ: Parental smoking and the ‘epidemic’ spread of cigarette smoking. J Appl Soc Psychol 1996;26:437–454.
  44. Zhu S-H, Sun J, Billings SC, Choi WS, Malarcher A: Predictors of smoking cessation in US adolescents. Am J Prevent Med 1999;16:202–207.
  45. Ary DV, Biglan A: Longitudinal changes in adolescent cigarette smoking behavior: Onset and cessation. J Behav Med 1988;11:361–382.
  46. Harrel JS, Bangdiwala SI, Deng SB, Webb JP, Bradley C: Smoking initiation in youth – The role of gender, race, socioeconomics, and developmental status. J Adolesc Health 1998;23:271–279.

    External Resources

  47. Dierker LC, Avenevoli S, Merikangas KR, Flaherty BP, Stolar M: Association between psychiatric disorders and the progression of tobacco use behaviors. J Am Acad Child Adolesc Psychiatry 2001;40:1159–1167.
  48. Wittchen H-U, Perkonigg A, Lachner G, Nelson CB: Early developmental stages of psychopathology study (EDSP): Objectives and design. Eur Addict Res 1998;4:18–27.
  49. Lieb R, Isensee B, Sydow K von, Wittchen H-U: The Early Developmental Stages of Psychopathology Study (EDSP): A methodological update. Eur Addict Res 2000;6:170–182.
  50. Wittchen H-U, Pfister H (eds): DIA-X-Interviews: Manual für Screening-Verfahren und Interview. Interviewheft Längsschnittuntersuchung (DIA-X-Lifetime); Ergänzungsheft (DIA-X-Lifetime); Interviewheft Querschnittuntersuchung (DIA-X-12 Monate); Ergänzungsheft (DIA-X-12 Monate); PC-Programm zur Durchführung des Interviews (Längs- und Querschnittuntersuchung); Auswertungsprogramm. Frankfurt, Swets & Zeitlinger, 1997.
  51. Lachner G, Wittchen H-U, Perkonigg A, Holly A, Schuster P, Wunderlich U, Türk D, Garczynski E, Pfister H: Structure, content and reliability of the Munich-Composite International Diagnostic Interview (M-CIDI). Substance use sections. Eur Addict Res 1998;4:28–41.
  52. Reed V, Gander F, Pfister H, Steiger A, Sonntag H, Trenkwalder C, Hundt W, Wittchen H-U: To what degree the Composite International Diagnostic Interview (CIDI) correctly identifies DSM-IV disorders? Testing validity issues in a clinical sample. Int J Meth Psychiatr Res 1998;7:142–155.
  53. Wittchen H-U, Lachner G, Wunderlich U, Pfister H, 1998: Test-retest reliability of the computerized DSM-IV version of the Munich-Composite International Diagnostic Interview (M-CIDI). Soc Psychiatry Psychiatr Epidemiol 1998;33:568–578.
  54. Höfler M, Lieb R, Perkonigg A, Schuster P, Sonntag H, Wittchen H-U: Covariates of cannabis use progression in a representative population sample of adolescents: A prospective examination of vulnerability and risk factors. Addiction 1999;94:1679–1694.
  55. Wittchen H-U, Lieb R, Schuster P, Oldehinkel T: When is onset? Investigations into early developmental stages of anxiety and depressive disorders; in Rapoport JL (ed): Childhood Onset of ‘Adult’ Psychopathology: Clinical and Research Advances. Washington, American Psychiatric Press, 1999, pp 259–302.
  56. Nelson CB, Wittchen H-U: DSM-IV alcohol disorders in a general population sample of adolescents and young adults. Addiction 1998;93:1065–1077.
  57. Sonntag H, Wittchen H-U, Höfler M, Kessler RC, Stein MB: Are social fears and DSM-IV social anxiety disorder associated with smoking and nicotine dependence in adolescents and young adults. Eur Psychiatry 2000;15:67–74.
  58. StataCorp: Stata Statistical Software: Release 7.0. College Station, Stata, 2001.
  59. Royall RM: Model Robust Confidence Intervals using Maximum Likelihood Estimators. Int Statist Rev 1986;54:221–226.
  60. McCullagh P, Nelder JA: Generalized Linear Models, ed 2. London, Chapman & Hall, 1989.
  61. Fahrmeir A, Tutz G: Multivariate Statistical Modelling Based on Generalized Linear Models. Berlin, Springer, 1994.
  62. Andersen PK, Keiding N: Survival analysis; in Armitage P, David HA (eds): Advances in Biometry – 50 Years of the International Biometric Society. New York, Wiley, 1996, pp 177–200.
  63. Cox DR: Regression models and life tables (with discussion). J R Stat Soc 1972;34:187–220.
  64. Chassin L, Presson CC, Bensenberg M, Corty E, Olshavsky RW, Sherman SJ: Predicting adolescents’ intentions to smoke cigarettes. J Health Soc Behav 1981;22:445–455.
  65. Bauman KE, Botvin EM, Baker E: Normative expectations and the behavior of significant others: An integration of traditions in research on adolescents’ cigarette smoking. Psychol Rep 1992;71:568–570.
  66. Swan AV, Creeser R, Murray M: When and why children first start to smoke. Int J Epidemiol 1990;19:323–330.
  67. Sullivan PF, Kendler KS: The genetic epidemiology of smoking. Nicotine Tobacco Res 1999;1(suppl 2):S51–S57.
  68. Mayhew KP, Flay BR, Mott JA: Stages in the development of adolescent smoking. Drug Alcohol Depend 2000;59(suppl 1):S61–S81.

Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50