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Effects of Postnatal Parental Smoking on Parent and Teacher Ratings of ADHD and Oppositional Symptoms

Kollins, Scott H. PhD*; Garrett, Melanie E. MS; McClernon, F Joseph PhD*; Lachiewicz, Ave M. MD; Morrissey-Kane, Erin PhD§; FitzGerald, David PhD*; Collins, Ann L. PhD; Anastopoulos, Arthur D. PhD§; Ashley-Koch, Allison E. PhD

The Journal of Nervous and Mental Disease: June 2009 - Volume 197 - Issue 6 - p 442-449
doi: 10.1097/NMD.0b013e3181a61d9e
Original Article

To assess the effects of postnatal parental smoking on subsequent parent and teacher ratings of DSM-IV attention deficit hyperactivity disorder (ADHD) symptoms and oppositional behaviors in children diagnosed with ADHD and their siblings. Children between 5 and 12 years of age with ADHD and their siblings were included. DSM-IV ADHD symptom subscales (Inattentive and hyperactive-impulsive), and oppositionality subscale scores from Conners’ Rating Scales were predicted on the basis of parental smoking status in the first 7 years after birth using Generalized Estimating Equations controlling for a range of relevant covariates. Postnatal parental smoking was associated with both parent and teacher ratings of ADHD symptoms and oppositional behavior. After controlling for a number of covariates, several of these relationships were still significant. The risk of maternal smoking for the development of ADHD symptoms does not end during pregnancy. Research on the mechanisms underlying the observed associations is needed.

*Department of Psychiatry, †Center for Human Genetics, and ‡Department of Pediatrics, Duke University Medical Center, Durham, North Carolina; and §Department of Psychology, University of North Carolina Greensboro, Greensboro, North Carolina.

Supported by grants 1R01NS049067, 1K24DA023464, and ES011961-01A1 from National Institutes of Health (NIH). The research conducted in this study complies with current US laws.

Dr. Kollins has received research support or honoraria from the following sources: Shire Pharmaceuticals, Eli Lilly, Comentis, Psychogenics, Pfizer, Cephalon, New River Pharmaceuticals, NIDA, NIMH, NINDS, NIEHS, and EPA. Dr. McClernon has received honoraria from Eli Lilly and research support from NIDA. Dr. Anastopoulos has received honoraria from Shire Pharmaceuticals. Ms. Garrett and Drs. Lachiewicz, Morrissey-Kane, Fitzgerald, Collins, and Ashley-Koch have no disclosures to report.

Send reprint requests to Scott H. Kollins, PhD, Duke ADHD Program, 718 Rutherford St, Durham, NC 27705. E-mail:

© 2009 Lippincott Williams & Wilkins, Inc.