Smokers in addiction treatment see their risk of tobacco-related disease as lower than that of an average smoker

Abstract

This chapter describes the major observations and principal controversies related to the effects of cigarette smoking and the constituents of tobacco on the female and male reproduction and the development of offspring. Maternal exposure is assessed relative to specific tobacco-related chemicals and the impact of mutagenic products on reproductive targets. Maternal smoking during pregnancy is associated with adverse pregnancy outcomes, including low birth weight, premature delivery, spontaneous abortion, placental abruption, and perinatal mortality. Important new information is being learned from clinical in vitro fertilization and assisted reproduction technologies that have allowed for a more thorough analysis of the negative consequences of smoking on pregnancy cycles. In men, the effects of smoking have been reported as reductions in sperm density, motility, and function. Additional evidence links cigarette smoke exposure in utero with the development of disease pathologies in older offspring, including childhood cancers, respiratory disorders, diabetes, obesity, and developmental and behavioral consequences. Lastly, increased emphasis is placed on smoking cessation during pregnancy using pharmacological intervention with nicotine replacement.