Children Of Non-smokers Research Articles

Parental bad habits breed bad behaviors in youth: Exposure to gestational smoke and child impulsivity

In utero exposure to cigarette smoke has been shown to have an adverse effect on healthy brain development in childhood. In the present study, we examine whether fetal exposure to mild and heavy smoking is associated with lower levels of impulsivity and cognitive control at age 10. Using a sample of 2120 children from the Québec Longitudinal Study of Child Development, we examine the association between gestational cigarette smoke exposure and fourth grade teacher reports of impulsivity and classroom engagement which represent behavioral indicators of executive functions. When compared to children of non-smokers, children of mothers who reported smoking heavily during pregnancy (10 or more cigarettes per day) were rated by their fourth grade teachers as displaying higher levels of impulsive behavior, scoring.112 standard deviation units higher than children of non-smokers. Children of mothers who smoked heavily were also less engaged in the classroom, scoring.057 standard deviation units lower than children of women who did not smoke. These analyses were adjusted for many potentially confounding child and family variables. Exposure to perinatal nicotine may compromise subsequent brain development. In particular, fetal nicotine may be associated with impairment in areas recruited for the effortful control of behavior in later childhood, a time when task-orientation and industriousness are imperative for academic success.

High dietary supplement intakes among Flemish preschoolers

The aim of this study was to determine the prevalence of dietary supplement use among Flemish preschoolers and to investigate associations between dietary supplement use and socio-economic variables of the parents. Parentally reported 3-day estimated dietary records ( n = 696) were used to calculate mean daily nutrient intakes, using Software for Intake Distribution Estimation (Cside). Socio-demographic information and frequency of dietary supplement use were collected via parental questionnaires, including a food frequency questionnaire (FFQ) ( n = 1847). The results from the FFQ revealed that more than 30% of the children used dietary supplements in the past month. Children of more highly educated parents and children of non-smokers were significantly more likely to use supplements than their counterparts. The types most frequently used were multi-vitamin/mineral supplements. Except for vitamin D, mean dietary intakes derived from foods alone was higher than the minimum recommendations for both supplement and non-supplement users. The youngest group of supplement users even exceeded the tolerable upper intake level for zinc (7 mg). However, for vitamin D, dietary supplements could help meet dietary recommendations for this micronutrient. In conclusion, the results indicated that dietary supplement use by healthy children who typically achieve their micronutrient requirements by foods alone could cause excessive intakes. Future studies should investigate potential harms and benefits of dietary supplementation use among preschoolers.

Smoke-free homes in England: prevalence, trends and validation by cotinine in children

Objective:To examine the prevalence of smoke-free homes in England between 1996 and 2007 and their impact on children’s exposure to second-hand smoke via a series of annual cross-sectional surveys: the...

Recovery of Potential Pathogens in the Nasopharynx of Healthy and Otitis Media—Prone Children and Their Smoking and Nonsmoking Parents

Exposure to smoking is associated with colonization with pathogenic bacteria. This study investigated the frequency of isolation of potential pathogens in the nasopharynx of healthy and otitis media-prone (OMP) children and their smoking or nonsmoking parents. Posterior nasopharynx cultures were taken from 40 healthy and 40 OMP children and one of their parents. Twenty parents in each group were smokers. Potential pathogenic organisms were identified. In the healthy children whose parents smoked, 15 potential pathogens were isolated from the parents and 13 were recovered from their children. Among the healthy children whose parents were nonsmokers, 3 potential pathogens were isolated from 2 parents (p < 0.005, compared to the parents and children in the smoking group) and 7 were recovered from their children. In the OMP children whose parents smoked, 16 potential pathogens were isolated from the parents and 19 were found in their children. Among the OMP children with nonsmoking parents, 3 potential pathogens were isolated from the parents (p < 0.001, compared to the parents and children in the OMP smoking group and the healthy children in the nonsmoking parents group) and 17 were recovered from their children. Parents who smoke are more often colonized with pathogens than those who do not smoke. The nasopharynx of healthy children of smokers harbors a high number of pathogens that are similar to the flora found in their parents and OMP children. Pathogenic organisms were found more often in OMP children of both smoking and nonsmoking parents, as compared to healthy children whose parents were nonsmokers. Concordance with pathogens in the parent was high among the OMP children of smoking parents, but this was not observed in the OMP children of nonsmokers.

Delay discounting by the children of smokers and nonsmokers

This research compared delay discounting in mothers and their children (12 or 13 years of age). Half of the mothers (n=15) were current smokers, and the other half (n=15) reported never smoking. Considerable research has shown that adult smokers discount more by delay than nonsmokers, and that parent smoking is a risk factor for adolescent smoking. Thus, it was hypothesized that the mothers who smoked would discount more by delay than the mothers who had never smoked. Also, it was expected that children at increased risk for smoking (i.e., mother is smoker) would discount more by delay than children at lower risk for smoking (i.e., mother is nonsmoker). The results confirmed these hypotheses: mothers who smoked discounted significantly more than nonsmoking mothers; and, in a parallel fashion, children with mothers who smoked discounted significantly more than children of nonsmokers. These findings indicate that delay discounting may be a behavioral risk factor for adolescent cigarette smoking that predates any substantial use of nicotine.

The moderating role of parental smoking on their children's attitudes toward smoking among a predominantly minority sample: a cross-sectional analysis

BackgroundIn general having a parent who smokes or smoked is a strong and consistent predictor of smoking initiation among their children while authoritative parenting style, open communication that demonstrates mutual respect between child and parent, and parental expectations not to smoke are protective. It has been hypothesized that parental smoking affects their children's smoking initiation through both imitation of the behavior and effects on attitudes toward smoking. The goals of the current analysis were to examine these two potential mechanisms.MethodsIn 2003, 1,417 high school students in Houston, Texas, completed a cross-sectional survey as part of the evaluation of an interactive smoking prevention and cessation program delivered via CD-ROM. To assess the relationship between number of parents who currently smoke and children's smoking status, we completed an unconditional logistic regression. To determine whether the attitudes that children of smokers hold toward smoking are significantly more positive than the attitudes of children of non-smokers we examined whether the parents smoking status moderated the relationship between children's attitudes toward smoking and their ever smoking using unconditional logistic regressions.ResultsCompared to participants whose parents did not currently smoke, participants who reported one or both parents currently smoke, had increased odds of ever smoking (OR = 1.31; 95% CI: 1.03–1.68; Wald χ2 = 4.78 (df = 1) p = 0.03 and OR = 2.16; 95% CI: 1.51–3.10; Wald χ2 = 17.80 (df = 1) p < 0.001, respectively). In addition, the relationship between attitudes and ever smoking was stronger among participants when at least one parent currently smokes (OR = 2.50; 95% CI: 1.96–3.19; Wald χ2 = 54.71 (df = 1) p < 0.001) than among participants whose parents did not smoke (OR = 1.72; 95% CI: 1.40–2.12; Wald χ2 = 26.45 (df = 1) p < 0.001).ConclusionChildren of smokers were more likely to smoke and reported more favorable attitudes toward smoking compared to children of non-smokers. One interpretation of our findings is that parental smoking not only directly influences behavior; it also moderates their children's attitudes towards smoking and thereby impacts their children's behavior. Our results demonstrate a continued need for primary prevention smoking interventions to be sensitive to the family context. They also underscore the importance of discussing parental smoking as a risk factor for smoking initiation, regardless of ethnicity, and of tailoring prevention messages to account for the influence that parental smoking status may have on the smoking attitudes and the associated normative beliefs.

Maternal smoking cessation in early pregnancy and offspring weight status at four years of age. A prospective birth cohort study

Background: Maternal smoking during pregnancy is associated with fetal growth restriction, but also with increased risk for overweight in childhood. If the mother stops smoking in early pregnancy fetal growth is not restricted, but whether the risk for later overweight persists is unclear. Aim: To study if four year old children of mothers who stopped smoking in early pregnancy have higher mean body mass index (BMI) and/or increased odds of being overweight compared with children of non-smokers. Study Design: Prospective population based study on Norwegian mothers and children. Subjects: Among 711 children available for analysis, 540 were children of never smoking mothers, 114 of mothers who stopped smoking in early pregnancy, and 57 of mothers who continued to smoke throughout pregnancy. Outcome Measures: BMI and overweight defined by international criteria at age four. Results: Compared with children of never smoking mothers, children of smoking mothers had higher mean BMI (mean difference: 0.47; 95% CI: 0.10, 0.84 kg/m 2), whereas mean BMI was not higher among children of mothers who stopped smoking (mean difference: 0.02; 95% CI: -- 0.24, 0.28 kg/m 2. Similarly, children of smoking mothers had increased odds for overweight (adjusted OR: 2.83; 95% CI: 1.13, 7.10), whereas children of mothers who stopped smoking did not have increased odds (adjusted OR: 1.29; 95% CI: 0.62, 2.68) compared with children of never smoking mothers. Conclusions: In this study, the association between smoking exposure and childhood overweight did not persist in children of mothers who stopped smoking early in pregnancy.

Smoking during pregnancy and hyperactivity-inattention in the offspring--comparing results from three Nordic cohorts

Prenatal exposure to smoking has been associated with Attention Deficit Hyperactivity Disorder (ADHD) in a number of epidemiological studies. However, mothers with the ADHD phenotype may 'treat' their problem by smoking and therefore be more likely to smoke even in a society where smoking is not acceptable. This will cause genetic confounding if ADHD has a heritable component, especially in populations with low prevalence rates of smoking since this reason for smoking is expected to be proportionally more frequent in a population with few 'normal' smokers. We compared the association in cohorts with different smoking frequencies. A total of 20 936 women with singleton pregnancies were identified within three population-based pregnancy cohorts in Northern Finland (1985-1986) and in Denmark (1984-1987 and 1989-1991). We collected self-reported data on their pre-pregnancy and pregnancy smoking habits and followed the children to school age where teachers and parents rated hyperactivity and inattention symptoms. Children, whose mothers smoked during pregnancy, had an increased prevalence of a high hyperactivity-inattention score compared with children of nonsmokers in each of the cohorts after adjustment for confounders but we found no statistical significant difference between the associations across the cohorts. The estimated association was not strongest in the population with the fewest smokers which does not support the hypothesis that the association is entirely due to genetic confounding.

Secondhand Smoke Exposure in Homes Through Serum Samples From Children Younger Than 5 Years Old

ISEE-845 Objective: To evaluate the secondhand smoke in homes through serum levels of cotinine and trans-3′-hydroxycotinine in children younger than 5 years of age, who were participants of the National Survey of Health 2000, Mexico. Materials and Methods: Serum samples from adult-child matched by homes who participated in the National Survey of Health 2000 were random selected. The study population was stratified according to adult smoking status (smokers vs. nonsmokers). Serum samples were analyzed by liquid chromatography—atmospheric pressure chemical ionization tandem mass spectrometry (LC-MS/MS), modified for the simultaneous determination of cotinine and trans-3′-hydroxycotinine. The descriptive analysis and multiple regression linear models were carried out to evaluate the difference among the children of smoking homes versus nonsmokers, adjusted by anthropometric characteristic, demographic, health and serum levels of cotinine and trans-3′-hydroxycotinine in adults. Results: Population study was of 159 adult-child binomials; 76 were with adult nonsmokers, and 83 with smoking adults. The mean age of children was 39.32 months (EE = 1.6) in nonsmokers group and 40.11 months (EE = 1.28) in the smokers group. The mean serum levels of cotinine and trans-3′-hydroxycotinine in children nonsmokers group was 0.19 ng/dL (EE = 0.01) and 0.06 ng/dL (EE = 0.008), respectively; and in the smokers group was of 0.60 ng/dL (EE = 0.04) and 0.19 ng/dL (EE = 0.01) ng/dL, respectively, being statistically significant (P < 0.001). The linear regression models show, on average, that the cotinine concentrations among children of the group of smokers is 2.284 ng/dL higher than that among the group of nonsmokers (P < 0.05); for trans-3′-hydroxycotinine the difference is 3.08 ng/dL (P < 0.05); R2 adjusted was 47.7% for the cotinine model and 49.3% for trans-3′-hydroxycotinine model. Conclusions: The present work shows the feasibility to identify and to quantify the secondhand smoke exposure in home in children aged less than 5 years through serum samples obtained from national surveys.

Perinatal Risk Factors for Hospitalization for Pneumococcal Disease in Childhood: A Population-Based Cohort Study

The objective of this study was to examine the relation of factors that are present at birth to subsequent hospitalization for childhood pneumococcal disease. We conducted a cohort study of all singletons born in 3 counties in western Denmark from 1980 through 2001, using population-based registries to obtain data on pregnancy- and birth-related variables and hospitalizations through age 12. We calculated incidence rates of pneumococcal disease hospitalization overall and within strata of study variables and used Poisson regression to estimate rate ratios for pneumococcal disease hospitalization while accounting for other birth characteristics. Among 338,504 eligible births, 1052 children were later hospitalized for pneumococcal disease. Pneumonia accounted for most hospitalizations (81.9%). The pneumococcal disease hospitalization rate was highest among 7- to 24-month-olds, followed by 0- to 6-month-olds and 25- to 60-month-olds. The highest rates, typically over 200 hospitalizations per 100,000 person-years, were in 0- to 6- and 7- to 24-month-old children who were born preterm or with low birth weight, a low 5-minute Apgar score, or birth defects. The hospitalization rate was lower for first-born children at 0 to 6 months but not at older ages. At older ages, hospitalization rates were not substantially different for children whose mothers smoked during pregnancy, but at 0 to 6 months, the rate was higher for children of multiparous nonsmokers than for others. Adjusted rate ratios were elevated across all age categories for several variables, including low birth weight, presence of birth defects, and low 5-minute Apgar. For several others, including preterm birth, maternal multiparity, age < or = 20 years, and non-Danish/European Union citizenship, adjusted rate ratios were elevated only for 0- to 6-month-olds. This large cohort study of hospitalization for childhood pneumococcal disease clarifies the roles of some gestation and birth factors while raising new questions about how these factors work.

Cigarette smoking during pregnancy and hyperactive-distractible preschooler's: A follow-up study

To study the association between intrauterine exposure to tobacco smoke and behavioural disorders in preschool children, primarily symptoms of inattention, hyperactivity and impulsivity but also hostile-aggressive and anxious-fearful symptoms. We conducted a follow-up study in 1355 singletons born to Danish-speaking mothers. Information on smoking habits during pregnancy and other lifestyle factors was obtained from self-administered questionnaires filled in during second and third trimester. Approximately 3.5 years later, the parents provided information on their child's behaviour using the self-administered Preschool Behaviour Questionnaire. The children were categorized into three not mutually exclusive behaviour groups: hyperactive - distractible (13.6%), hostile-aggressive (4.6%), and anxious-fearful (6.4%) children. Compared with children of non-smokers, children born to women who smoked 10 or more cigarettes per day had a 60% increased risk of hyperactivity and distractibility perceived by the parents (OR 1.6; 95% CI 1.0-2.3; P < 0.05). The results were adjusted for maternal lifestyle factors and socioeconomic characteristics. Additional adjustment for perinatal factors and parental psychiatric hospitalization did not change the results substantially (OR 1.7; 95% CI 1.1-2.6). We found no statistically significant association between maternal smoking in pregnancy and hostile-aggressive and anxious-fearful behaviour in the offspring. Exposure to tobacco smoke in utero was associated with hyperactive-distractible behaviour in preschool children.

Smoking When Pregnant Linked To Sons' Behavioral Problems

Smoking When Pregnant Linked To Sons' Behavioral Problems

Smoking in Pregnancy

Zanardo et al. (2005) raise an interesting issue in their article, namely, the influence of smoking on immunologic parameters and especially on the composition of human breast milk. The findings deserve notice and further investigation. Because of the importance of the findings, the errors and inconsistencies in the article (Zanardo et al. 2005) should be corrected. The first inconsistency is related to the number of participants: In the “Materials and Methods,” Zanardo et al. (2005) gave two different numbers: Of the 1,217 eligible participants, 25 of 26 self-identified as smokers (≥ 5 cigarettes per day through pregnancy until last trimester) were recruited for study participation. One was excluded from the final analysis because of maternal fever. Control participants included consecutive women without history of smoking and matched a smoking participant on the basis of overall inclusion criteria. We grouped human milk samples into third postpartum day smoker and nonsmoker mother groups, with 42 and 40 samples per group, respectively, and into 10th postpartum day smoker and nonsmoker mother groups, with 42 and 40 samples per group, respectively. The latter numbers (42 and 40) are also repeated in the first sentence of “Results” and in Table 1. Also in Table 1 the average number of cigarettes smoked per day by the 42 smokers is given as 3.2 ± 0.7 (mean ± SD). This is inconsistent with their selection criterion of “≥ 5 cigarettes per day.” Table 1 also provides information on birth weight, gestational age, and APGAR score. As expected from numerous previous studies, the children of the smokers scored lower in all these respects. Under “statistical analysis” the authors write that they “used the Student t-test for the analysis of [these] data.” To apply the Student t-test for the birth weight data seems a sensible choice. When doing this using the figures provided in Table 1, the difference of the birth weight between the children of smokers and nonsmokers is clearly highly significant (t = 9.45). In the “Results,” Zanardo et al. (2005) stated erroneously that “the birth weight of the newborn infants of smoker mothers was not significantly lower.”

Association of maternal smoking with overweight at age 3 y in American Indian children

Prevalence rates of overweight are higher among American Indian children than among any other ethnic group, but little research has explored contributing influences. The objective was to determine the prevalence and predictors of body mass index (BMI; in kg/m2) > or = 85th percentile in American Indian children in Wisconsin. A retrospective analysis was conducted with linked pediatric and pregnancy nutrition surveillance systems and birth records from 1997 through 2001. Participants were American Indian mothers and children (aged 0-3 y) who were participating in the Special Supplemental Nutrition Program for Women, Infants, and Children in Wisconsin. Outcome measurements included indicators of BMI > or = 85th percentile identified by using binary logistic regression. Of the 3-y-olds, 22.2% were overweight and 18.7% were at risk of overweight. Of their mothers, 42.5% had smoked during pregnancy. Smoking at the initial prenatal visit significantly predicted overweight and risk of overweight in children at age 3 y (odds ratio: 2.16; 95% CI: 1.05, 4.47). Despite being smaller at birth, the children of smoking mothers had a significantly (P < 0.05) greater increase in weight-for-length z score between birth and age 3 y than did children of nonsmokers. This greater increase was due to a significantly (P < 0.02) greater increase in weight in children of smokers than in those of nonsmokers and not to a relatively slower increase in height. Our findings suggest the early influence of maternal smoking on the prevalence of overweight at age 3 y in a high-risk American Indian population and provide evidence that interventions to reduce smoking in pregnant women may be warranted.

Children's Hedonic Judgments of Cigarette Smoke Odor: Effects of Parental Smoking and Maternal Mood.

Age-appropriate tasks were used to assess 3- to 8-year-old children's liking, identification, and preference for a variety of odors, including that of exhaled cigarette smoke. Children whose parents smoke took longer to decide whether they liked the cigarette odor and were significantly more likely to prefer the odor of cigarette to the neutral and unfamiliar odor of green tea compared with children of nonsmokers. Among children of smokers, relative preferences for the cigarette odor were related to maternal mood disturbance and depression scores. These findings suggest that some early learning about cigarette smoke odor is based on sensory experiences at home and anchors it to the emotional context in which their mothers smoke.

Efecto del tabaquismo durante el embarazo sobre la antropometría al nacimiento

To assess the effect of tobacco consumption during pregnancy on height and birth weight of newborns. Two cohort studies on lead exposure conducted in Mexico City between 1993 and 2000 were analyzed. Data were analyzed to assess the differences in height and birth weight between children of women who smoked during pregnancy and those who did not, adjusting for other important factors. Statistical analysis consisted of multiple linear regression models. The proportion of women who smoked during pregnancy was 4.7%. The birth weight of children of mothers who smoked during pregnancy was 154 grams less on average (95% confidence interval [CI] -284.7, -24.7) and their height was 0.79 cm less (95% CI -1.5, -0.1) than the children of non-smokers during pregnancy. These findings evidence the deleterious effect of tobacco consumption on children.

Active and passive tobacco smoke exposure: A comparison of maternal and child hair cotinine levels

The objective of this study was to compare tobacco smoke exposure in mothers and their healthy children less than 3 years old using hair cotinine (HC) levels as an objective long-term measure of exposure. Hair samples were obtained from mother/child pairs recruited from the Columbus Children's Hospital Primary Care Center, and were analyzed by radioimmunoassay to compare HC levels. Mothers were both self-reported smokers and nonsmokers. Contributing and confounding variables were assessed based on questionnaires completed by participants. Exclusion criteria for children were prematurity and presence of chronic cardiopulmonary disease. Hair samples and questionnaires were obtained from 104 mother/child pairs. Child and maternal HC levels were correlated for both self-reported maternal smokers (R2 = .13, p < .013) and self-reported maternal nonsmokers (R2 = .54, p < 001). Child HC levels were higher than maternal HC levels (1.18 ng/mg vs. .78 ng/mg, p < .001). Children of nonsmokers had higher HC levels than their mothers (.77 ng/mg vs. .35 ng/mg, p < .001), while HC levels of smokers and their children were no different (1.91 ng/mg vs. 1.92 ng/mg, p = .978). The relationship between child and maternal HC did not differ by child age, gender, or race. In conclusion, environmental tobacco smoke exposure in young children as reflected by HC is higher than expected based on prior studies of biomarkers and passive tobacco smoke exposure in adult nonsmokers.

Relationship of pet exposure and atopic dermatitis (AD) in the childhood allergy study (CAS)

Rationale We have reported that early-life pet ownership is protective for positive serum specific IgE and skin tests to inhalant allergens at age 6. We investigated whether the presence of household cats or dogs affects childhood AD incidence. Methods We analyzed data from 474 participants in CAS, a prospective birth cohort who completed a study exam at age 6. AD was based on parental response to the question “Did a physician ever tell you your child had atopic dermatitis or eczema?” Pet exposure was categorized as no household cats or dogs, 1 pet and 2 or more pets. Using logistic regression, we assessed confounding and interaction for gender, parental history, birth order, parental smoking, dust mite exposure, fever and antibiotic use. Results 47% of the households had no pets, 36.5% had one and 16.5% had ≥2 cats or dogs. AD was reported in 59 (12.4%). Unadjusted analyses failed to show associations between pet ownership and physician diagnosed AD. The association between pet ownership and AD differed by parental smoking behavior. For children of smokers (n=142), the adjusted odds ratio (OR) between 1 pet and AD was 0.15 (95% confidence interval (CI) 0.02-1.35, p=0.17), and for ≥2 pets the OR=0.59 (CI 0.06-5.8, p=.73). For children of non-smokers (n=329), the OR for one pet and AD was 1.64 (CI 0.75-3.59, p=0.85) and for ≥2 pets 3.08 (CI 1.22-7.73, p=0.04). Conclusions Pet ownership in the first year of life may increase risk of AD among children of non-smokers, emphasizing the need to consider multiple risk factors.

Epstein-Barr virus infection is not associated with development of allergy in children.

Differences in concentrations of antibodies to Epstein-Barr virus (EBV) in atopic and nonatopic children have been observed, suggesting that EBV infection may play a role in allergic diseases. AIM To assess the association between EBV infection and atopy in Swedish children at 4 years of age. Were studied 2561 children born in 1994 through 1996 in Stockholm, Sweden. The children were enrolled in a prospective birth cohort study focusing on the relation of exposure to various environmental and life style factors during early childhood and development of atopy. Blood samples were obtained when the children were approximately 4 years old, and immunoglobulin G to EBV was determined by indirect immunofluorescence. The relationship between the seroprevalence to EBV and various allergic disorders was assessed, withthe use of logistic regression analysis to account for other risk factors. Totally 1347 of 2561 (52%) children were EBV-seropositive. Associations between EBV seropositivity and the occurrence of asthma [adjusted odds ratio (OR(adj)), 1.10; 95% confidence interval (95% CI) 0.81 to 1.49] or suspected allergic rhinitis (OR(adj) 0.97; 95% CI 0.76 to 1.25) were not apparent. In children whose mothers were up to 25 years old, a higher EBV seroprevalence was observed than in children of older mothers (OR(adj) 1.34; 95% CI 1.04 to 1.71). Also in children whose mothers smoked, the seroprevalence was higher than in children of nonsmokers (OR(adj) 1.29; 95% CI 1.02 to 1.63). The study does not support the hypothesis that EBV infection in early childhood plays an important role in the pathogenesis of allergic diseases in children.

The effect of maternal smoking status, educational level and age on food and nutrient intakes in preschool children: results from the Avon Longitudinal Study of Parents and Children.

Studies in adults have demonstrated that smoking status is associated with dietary quality, with smokers tending to have diets that conform less closely to guidelines on healthy eating than nonsmokers. However, there is very little information on the relation between children's dietary quality and parental smoking status. The objective of this study was to investigate the relation between maternal smoking status and nutrient intake in preschool children, allowing for the possible confounding effects of maternal educational level and age at delivery. In total, 993 children aged 18 months participating in the Avon Longitudinal Study of Parents and Children. Diet was assessed by a 3-day food record. Maternal smoking status and educational level and age at delivery were assessed by questionnaire. In multivariate analysis, the children of smokers had significantly higher intakes of monounsaturated fatty acids and starch, and lower intakes of nonstarch polysaccharides (NSP). They were also less likely to have eaten poultry, buns, cakes and puddings, wholemeal bread and fruit, and more likely to have drunk sugar-sweetened soft drinks. Intakes of NSP and most vitamins and minerals increased significantly with increasing maternal education. Children of more highly educated mothers were less likely to have eaten chocolate, crisps and white bread, and more likely to have consumed wholemeal bread, fruit and fruit juice. The children of nonsmokers and more highly educated mothers consumed a diet that conformed more closely to current guidelines on healthy eating. These dietary differences may contribute to the excess of ill-health observed in the children of smokers and of less-educated mothers.