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Maternal tobacco smoking, nicotine replacement and neurobehavioural development


  • James R Pauly,

    1. Department of Pharmaceutical Sciences, Spinal Cord and Brain Injury Research Center, College of Pharmacy, University of Kentucky, Lexington, Massachusetts, USA
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  • Theodore A Slotkin

    1. Department of Pharmacology and Cancer Biology, Duke University Medical Center, Durham, North Carolina, USA
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This article is corrected by:

  1. Errata: CORRIGENDUM Volume 98, Issue 1, 208, Article first published online: 9 December 2008

James R Pauly, Department of Pharmaceutical Sciences, College of Pharmacy, University of Kentucky, Lexington Kentucky, Massachusetts 40536-0082, USA. Tel: +859-323-8164 | Fax: +859-257-7564 | Email:


The adverse effects of prenatal cigarette smoke exposure on human reproductive outcomes are a major scientific and public health concern. In the United States, approximately 25% of women of childbearing age currently smoke cigarettes, and only a small percentage of these individuals quit after learning of their pregnancy. Women interested in smoking cessation during pregnancy have a number of options, including behavioural and pharmacological aids, but nicotine replacement therapy (NRT) is by far the most common approach. While NRT avoids exposure to the myriad compounds present in tobacco smoke, nicotine itself causes damage to the developing nervous system. The purpose of this article is to review the detrimental effects of developmental tobacco smoke exposure on short- and long-term outcomes with particular emphasis on neurobehavioural consequences. In conclusion based on the clear, adverse effects of nicotine on brain development observed in human and animal studies, we suggest that safer alternatives for smoking cessation in pregnancy are badly needed.