As if smoking wasn’t bad enough

By Dr. John Ditraglia

By teaching them how to smoke tobacco the Native Americans exacted a terrible revenge on the invaders from the old world. The Indians were also smoking other things like kinnikinnick in Ohio. I haven’t googled it, but smoking seems to have been an Indian invention. I don’t think other humans were smoking until contact with North American natives. Today smoking tobacco kills more than 400,000 people a year in this country, more than 10 times the number who are dying each year from the opioid crisis, and smoking has spread over the whole world.

Smoking kills by causing heart disease and lung disease and lots of different kinds of cancer. As if that wasn’t bad enough it has also been shown to lead to obesity in the children of mothers who smoked during pregnancy. (1)

Other studies have shown this but because obesity and smoking are both associated with lower socioeconomic status this correlation between smoking during pregnancy and obesity could be confounded. To combat this possible residual confounding these investigators from Brazil used a comparison of the magnitude of the associations with maternal and paternal smoking is a strategy to increase the causal inference of pregnancy exposure.

This study report was based on data from two birth cohorts carried out in Pelotas, a southern Brazilian city. In 1982 and 1993, in a wider perinatal study, all maternity hospitals in the city were visited daily and the births identified. In addition to smoking by the mothers, they also collected information on partner smoking.

After correcting for smoking among fathers it was found in follow-up at 30 and 22 years that offspring of smoking mothers showed higher mean body mass index (BMI), fat mass index, waist circumference, and waist to height ratio whereas height was lower. Weight gain in the first 2 years captured most of the association of maternal smoking with BMI (96.2%), waist circumference (86.1%) and fat mass index (71.7%).

At birth babies of smoking mothers are smaller than average. Besides that smoking is terribly addicting, many people who smoke say they don’t quit because they don’t want to gain weight. But maybe this affect on the fetus of smoking means that people who never smoked would be thinner than smokers who manage to quit.

We’ve paid dearly enough for the atrocities against native Americans. Let’s all quit smoking now.

1. da Silva Magalhaes EI et al. Maternal smoking during pregnancy and offspring body composition in adulthood: Results from two birth cohort studies.

Epidemiology Research. BMJ Open 2019;9:e023852. doi: 10.1136/bmjopen-2018-023852

By Dr. John Ditraglia