Children who are exposed to tobacco smoke during their early development can develop abnormal behavioral symptoms by the age of ten years. This association was discovered using data from the GINI-plus study by scientists of Helmholtz Zentrum München in collaboration with colleagues of Ludwig-Maximilians-Universität Munich, Technische Universität München and Marienhospital Wesel. The scientists observed that the impact of tobacco smoke was especially detrimental during gestation. The results of the study have been published in the current online issue of the renowned journal Environmental Health Perspectives.

“We were able to show that children who are exposed to tobacco smoke prenatally and during the first years of life have a higher risk of developing abnormal behavioral symptoms when they are of school age,” said Dr. Joachim Heinrich of the Institute of Epidemiology at Helmholtz Zentrum München. “Moreover, it makes a difference whether the child was exposed to tobacco smoke first after birth or was already confronted with it during prenatal development.”

According to the study, children who were only exposed to tobacco smoke prenatally have a 1.9 times higher risk of developing abnormal behavioral symptoms in comparison to children without any exposure (change this if it is the wrong comparison).

The risk for children first exposed to tobacco smoke after birth is 1.3 times higher. Furthermore, children who were exposed to tobacco smoke both while in the womb and while growing up doubled the risk of developing abnormal behavioral symptoms. Such symptoms include hyperactivity, attention deficits or problems in their relationships with peers. The results of the study were independent of affects from the social environment in which the children were growing up.

In the framework of the GINI-plus study, data of a large birth cohort comprising 5991 children and their parents was analyzed. Extensive studies will follow up on this study. “The value of our study is based not only on our prospective, investigative approach, but also on the comprehensiveness of our survey as to possible pollution levels for the unborn, infants and children at different times,” Joachim Heinrich explained. “This makes it possible to determine the effects of prenatal and postnatal tobacco smoke exposure and to differentiate between them.”

To ensure the validity of their results from the questionnaires, the scientists carried out carefully controlled tests to exclude possible bias due to social factors. Simon Ru"ckinger, lead author of the study, stated - “The relationship we found between tobacco exposure during fetal development and early childhood and behavioral problems at school age was not biased by other factors of the social environment.”

The findings make clear that tobacco smoke exposure has a significant impact on the behavioral development of children. The negative influence is greater on the unborn child during the pregnancy of the mother than it is after this sensitive developmental phase.

Further information

Original publication: Rückinger S, Rzehak P, Chen C-M, Sausenthaler S, Koletzko S, Bauer C-P, Hoffmann U, Kramer U, Berdel D, von Berg A, Bayer O, Wichmann H.-E., von Kries R, Heinrich J: Prenatal and Postnatal Tobacco Exposure and Behavioural Problems in 10 Year Old Children: Results from the GINI-plus Prospective Birth Cohort Study, Environmental Health Perspectives doi:10.1289/ehp.0901209 [Online 07 October 2009].

GINI: The GINI study, which began in 1995, and its follow-up study, GINI plus (German Infant Study on the influence of Nutrition Intervention PLUS environmental and genetic influences on allergy development), investigate the health of children in Germany. The objective of the prospective birth cohort study is to investigate the influence of nutrition, environmental factors and genetic predisposition on the health of children. Approximately 6000 children aged one to ten years are included in the study. Besides Helmholtz Zentrum München, Ludwig-Maximilians-Universität Munich, Technische Universität München, Marienhospital Wesel and the Institute of Environmental Research of the University of Düsseldorf participated in the large-scale study. Further information…

Helmholtz Zentrum München is the German Research Center for Environmental Health. As leading center oriented toward Environmental Health, it focuses on chronic and complex diseases which develop from the interaction of environmental factors and individual genetic disposition. Helmholtz Zentrum München has around 1680 staff members. The head office of the center is located in Neuherberg to the north of Munich on a 50-hectare research campus. Helmholtz Zentrum München belongs to the Helmholtz Association, Germany’s largest research organization, a community of 16 scientific-technical and medical-biological research centers with a total of 26,500 staff members.

Research in the Institute of Epidemiology at Helmholtz Zentrum München focuses on methodological problems related to the quantification of small risks, the impact of particles and airborne pollutants on the lung and the cardiovascular system, and the regional distribution and development of diseases of the respiratory tract and allergies. A new focus of the Institute is the molecular analysis of complex diseases (e.g. asthma, type 2 diabetes, cardiac infarction). The main aim is to investigate the role of environmental factors and genetic disposition in human health using epidemiological methods.

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