University of Oulu

Marian Sarala, Antti Mustonen, Anni-Emilia Alakokkare, Caroline Salom, Jouko Miettunen, Solja Niemelä, Parental smoking and young adult offspring psychosis, depression and anxiety disorders and substance use disorder, European Journal of Public Health, Volume 32, Issue 2, April 2022, Pages 254–260,

Parental smoking and young adult offspring psychosis, depression and anxiety disorders and substance use disorder

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Author: Sarala, Marian1; Mustonen, Antti1,2; Alakokkare, Anni-Emilia2,3;
Organizations: 1Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland
2Faculty of Medicine and Health Technology, University Consortium of Seinäjoki, Tampere University, Tampere, Finland
3Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finlan
4Institute for Social Science Research, University of Queensland, Queensland, Australia
5Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
6Center for Life Course Health Research, University of Oulu, Oulu, Finland
7Addiction Psychiatry Unit, Department of Psychiatry, Turku University Hospital, Turku, Finland
8Department of Psychiatry, University of Turku, Turku, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.2 MB)
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Language: English
Published: Oxford University Press, 2022
Publish Date: 2022-09-22


Background: To study the associations between maternal smoking during pregnancy and paternal smoking before pregnancy and adult offspring psychiatric disorders.

Methods: Prospective general population cohort study in Northern Finland, with people from the Northern Finland Birth Cohort 1986: 7259 subjects (77% of the original sample). Data on parental smoking were collected from parents during pregnancy using questionnaires. Outcomes were offspring’s register-based diagnoses: any psychiatric disorder, any non-organic psychosis, mood disorder, anxiety disorder and substance use disorder (SUD) until the age of 29–30 years. Maternal smoking during pregnancy and paternal smoking before pregnancy were pooled to three-class variables: (i) none; (ii) 1–9 and (iii) ≥10 cigarettes/day. Information regarding both parents’ alcohol use during pregnancy and at offspring age 15–16 years, maternal education level, family structure, parental psychiatric diagnoses and offspring gender, smoking, intoxication frequency and illicit substance use at the age of 15–16 years were investigated as covariates.

Results: In the multivariable analyses, maternal smoking during pregnancy did not associate with the studied outcomes after adjusting for offspring smoking and other substance use at offspring age 15–16 years and parental psychiatric disorders. However, paternal smoking ≥10 cigarettes/day before pregnancy [hazard ratio (HR) = 5.5, 95% confidence interval (CI) 2.7–11.2, P < 0.001] and paternal psychiatric disorders (HR = 1.7, 95% CI 1.1–2.8, P = 0.028) associated with offspring SUD after adjustments.

Conclusions: Information across the offspring life course is essential in exploring the association between parental smoking and offspring psychiatric disorders. Paternal smoking before pregnancy and paternal psychiatric disorders may act as modifiers in elevating the risk of substance-use-related problems among offspring.

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Series: European journal of public health
ISSN: 1101-1262
ISSN-E: 1464-360X
ISSN-L: 1101-1262
Volume: 32
Issue: 2
Pages: 254 - 260
DOI: 10.1093/eurpub/ckac004
Type of Publication: A1 Journal article – refereed
Field of Science: 3142 Public health care science, environmental and occupational health
Funding: This work was funded by European Union QLG1-CT-2000-01643 (EUROBLCS) (Grant no. E51560), USA/National Institute of Health 2000 G DF682 (Grant no. 50945), the Juho Vainio foundation and the Sohlberg foundation.
Copyright information: © The Author(s) 2022. Published by Oxford University Press on behalf of the European Public Health Association. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.