Bibliography on studies - The untold evidence
The 1989 Surgeon General report (Reducing the Health Consequences of
Smoking. 25 Years of Progress DHHS Pub No [CDC] 89-8411, 1989) insinuated that maternal
smoking causes birth defects by mentioning only two small studies by Lelsey and
Himmelberger that showed a risk.
In the graphic at the bottom of this page is
indicated the amount of excess risk established by each of the studies listed below.
Please remember that anything smaller than 2.5 to 3.0 excess risk factor is considered insignificant
by the scientific world, thus unworthy of consideration. Even in the highest risk case
(Seidman, first on the left) the risk factor is smaller than 2.0. These studies cover a
vast amount of cases, thus the base for their conclusions is a broad one.
The studies covering less than 1,000 cases are not shown in the graph.
Of particular interest is that, when the study
considers the actual number of cigarettes smoked each day, there is NO CONSISTENT
DOSE-RESPONSE relationship. For example, in the AD McDonald, et al. study, the
non-existant "risk" actually became LESS as the number of cigarettes smoked
INCREASED.
There are several immutable "rules of the
road" in the science of risk assessment -- one of them is that a clear and repeatable
dose-response (the dose makes the poison) curve be displayed. In the case of
maternal smoking and birth defects, there is simply no association. This is clear,
unequivocal fact. No spin, no hype. Using scare tactics based on
misinterpretations of scientific research to change human behavior is reprehensible,
irresponsible and does tremendous damage to the reputations of the vast majority of
scientists who conduct careful and meticulous research.
 Seidman DS,
Ever-Hadani P, Gale R Effects of maternal smoking and age on congenital anomalies.
Obstet Gynecol Dec. 1990;76:1046-1050. Israel, 1921 major defects, smokers 0.94
(0.62-1.43); minor 1,06 (0.90-1.25).
Kelsey JL, Dwyler
T, Halford TR, Bracken MB Maternal smoking and congenital malformations: An
epidemiological study. J Epidemiol Commun Health 1978:32:102-107. Retrospective
case-control, random control at "several hospital in Connecticut," 1369 cases.
1-10 cigarettes 1.0, 11-20 1.1, 21-30c 1.4, >/= 31c 1.9; all smokers 1.10 (0.97-1.26).
Evans DR,
Newcombe RG, Campbell H. Maternal smoking habits and congenital malformations: a
population study. BMJ 1979 Jul 21;2:171-173. Cardiff, Wales Noted association with low
class. Rates for all 1864 cases: 0 cigarettes 2.8%, 1-9 2.5%, 10-19 2.8%, >/= 20 3.0%
[calculated relative risk for smokers 0.89, 1.0, 1.07].
MacDonald AD,
Armstrong BG, Sloan M. Cigarette, alcohol, and coffee consumption and congenital
defects. AJPH Jan 1992;82(1) : 91-93. 1928 total. 1-9 cigarettes 1.14 (1.0-1.4), 10-19
1.08 (0.9-1.2), 20+ 1.02 (0.9-1.2).
Christianson RE. The
relationship between maternal smoking and the incidence of congenital anomalies. Am. J
of Epidemiol 1980;112(5):684-695. Kaiser Foundation. "There was no significant
differences in the incidence of congenital anomalies" overall. 2077 total
cases. RRs white light smokers, male child 1.03, female 0.91; heavy smoker m 1.22, f 1.05;
black ls m 0.92, f 0.95; hs m 1.18, f 1.11.
Heinonen OP,
Slone D, Shapiro S, eds. Birth defects and drugs in pregnancy. Littleton, MA:
Publishing Sciences Group, 1977. Collaborative Perinatal Project prospective. 2277 cases.
All malformations, 1050 white 14 cigarettes 0.9, 15-29 1.0, >/= 30 0.9; 1097 black 1.0
1.0 1.0.
Van Den Eeden SK,
Karagas MR, Daling JR, Vaughan TL. A case-control study of maternal smoking and
congenital malformations. Paediatr Perinatal Epidemiol 1990;4:147- 155. 3048
malformations, smokers 1.0 (0.9-1.1).
Shiono, PH,
Klebanoff MA, Berendes HW. Congenital malformations and maternal smoking during
pregnancy. Teratol 1986;34:65-71. Kaiser-Premanente prospective. 5624 total cases: 592
major, smokers 1.0 (0.8-1.2); 4032 minor, smokers 0.9 (0.8-0.9).
Malloy MH,
Kleinman JC, Blakewell JM, Schramm WF, Land GH. Maternal smoking during pregnancy: No
association with congenital malformations in Missouri. AJPH 1989 Sep:79 (9):1243-1246.
Total 10,223, smokers 0.98 (0.94-1.03).
LESS THAN 1,000 CASES, NOT SHOWN ON GRAPH:
Andrews J,
McGarry JM. A community study of smoking in pregnancy. J Obstet Gynaecol Br Commonw
1972 Dec;79 (12):1057-1073. Cardiff, Wales. 509 cases. Non-smokers 2.37%, smokers 2.73%
abnormal infants.
Himmelberger
DU, Brown BW, Cohen EN. Cigarette smoking during pregnancy and the risk of spontaneous
abortion and congenital anomaly. Am J Epidemiol 1978;108 (6) : 470- 479. Trace
Anesthetic Study, retrospective mail survey of health professionals, 935 cases, All
smokers from 0.90 to 2.34, depending on parity and age.
Courtesy of Carol Thompson
08/23/93
Smokers' Rights Action Group
P.O. Box 259575
Madison, WI 53725-9575
Phone: 608-249-4568 |
