University of Oulu

Rissanen, I., Paananen, M., Harju, T., Miettunen, J., & Oura, P. (2021). Maternal smoking trajectory during pregnancy predicts offspring’s smoking and substance use – The Northern Finland birth cohort 1966 study. In Preventive Medicine Reports (Vol. 23, p. 101467). Elsevier BV.

Maternal smoking trajectory during pregnancy predicts offspring’s smoking and substance use : the Northern Finland birth cohort 1966 study

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Author: Rissanen, Ina1,2,3; Paananen, Markus2,3; Harju, Terttu3,4;
Organizations: 1Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands
2Center for Life Course Health Research, University of Oulu, Oulu, Finland
3Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
4Research Unit of Internal Medicine, University of Oulu, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.4 MB)
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Language: English
Published: Elsevier, 2021
Publish Date: 2021-10-19


The aim was to characterize the association of maternal smoking trajectory during pregnancy with offspring’s smoking, alcohol and substance use behavior. We used the prospective Northern Finland Birth Cohort 1966 study including 11,653 mothers and their offspring followed up from mothers’ mid-pregnancy to age of 46 years. Main exposure was number of smoked cigarettes per day at each month of pregnancy. Outcome measures were offspring’s smoking, alcohol and drug use at age 14, starting age of smoking, ever-smoking, and smoked pack-years until age 46. Four maternal smoking trajectories during pregnancy were identified with latent class trajectory modelling, namely “non-smokers” (86.0% of mothers), “early quitters” (2.0%), “late quitters” (2.1%), and “consistent smokers” (9.9%). In comparison to non-smokers, all maternal smoking was associated with offspring’s increased odds of lifetime smoking adjusted for sex of the child, father’s smoking, occupational status and place of residence of family, marital status and mood of mother, and desirability of pregnancy. The consistent smoker’s class was associated with offspring’s number of smoked pack years by midlife (median [interquartile range]: 8.3 [1.4–17.4] vs. 4.8 [0.0–13.0], p = 0.028), and alcohol use in young age (odds ratio 1.23 [95% confidence interval 1.05–1.43]). Overall, to prevent parent-offspring transmission of smoking, the cessation support should target women planning pregnancy. Negative effects of maternal continuous smoking during pregnancy include all substance use and reach up to offspring’s middle age.

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Series: Preventive medicine reports
ISSN: 2211-3355
ISSN-E: 2211-3355
ISSN-L: 2211-3355
Volume: 23
Article number: 101467
DOI: 10.1016/j.pmedr.2021.101467
Type of Publication: A1 Journal article – refereed
Field of Science: 3141 Health care science
3142 Public health care science, environmental and occupational health
3123 Gynaecology and paediatrics
Funding: NFBC1966 received financial support from University of Oulu Grant no. 65354, Oulu University Hospital Grant no. 2/97, 8/97, Ministry of Health and Social Affairs Grant no. 23/251/97, 160/97, 190/97, National Institute for Health and Welfare, Helsinki Grant no. 54121, Regional Institute of Occupational Health, Oulu, Finland Grant no. 50621, 54231, University of Oulu Grant no. 24000692, Oulu University Hospital Grant no. 24301140, ERDF European Regional Development Fund Grant no. 539/2010 A31592.
Copyright information: © 2021 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (