News Release

In utero tobacco exposure can lead to executive function issues in adolescents

Peer-Reviewed Publication

Boston University School of Medicine

Boston - Prenatal tobacco exposure is known to have negative short-term impacts including preterm birth, low birth weight and subsequent behavioral issues. However, a new study found that the negative impacts can last well into the child's future. The results showed that exposure to as few as 10 cigarettes was associated with negative impacts on the executive function of adolescents who were exposed prenatally. Published online in Drug and Alcohol Dependence, the study is the first to look at the long-term impact on students in a high school setting and demonstrates the importance of providing more evidence-based smoking cessation programs to women of childbearing age and pregnant women.

According to a report issued by the Centers for Disease Control and Prevention, smoking during pregnancy is common across the US, with as many as 8 percent of women having smoked at some point during pregnancy. Executive functioning includes a higher level of cognitive organization and management processes that are important for success both in school and in daily life. These skills are learned throughout childhood and include how to self-manage behavior and how best to organize and act on information.

The study included teachers filling out a Behavior Rating Inventory of Executive Functioning - Teacher Form (BRIEF-TF) once a year for the sample of students involved in the study. The teachers were not aware of the study aims, but were knowledgeable about the students. The students involved were 51 percent male and 89 percent African American and went to school in an urban community. Teachers filled out at least one BRIEF-TF for 131 adolescents, and the study controlled for demographics, substance exposures other than tobacco, early childhood exposure to lead and exposure to violence.

The findings show that only tobacco was associated with less optimal executive functioning in the classroom for the students, particularly impacting their ability to regulate their behavior.

"Because tobacco is one of the most common substances used during pregnancy - and it's legal for adults to use - these results indicate the tremendous importance of bolstering efforts to ensure that women of child-bearing age and pregnant women have increased access to evidence-based tobacco smoking cessation programs," said Ruth Rose-Jacobs, ScD, MS, from Boston Medical Center and Boston University School of Medicine who served as the study's first author. "Given that as few as ten cigarettes can have a negative impact, it is imperative that we act on this and provide as much access and education as we can to help prevent these negative outcomes."


This study was supported in part by the National Institutes on Drug Abuse (grant number DA006532) and by the National Institutes of Health (grant numbers MO1 RR00533 and RR025771).

About Boston Medical Center

Boston Medical Center is a private, not-for-profit, 487-bed, academic medical center that is the primary teaching affiliate of Boston University School of Medicine. It is the largest and busiest provider of trauma and emergency services in New England. It offers specialized care for complex health problems and is a leading research institution, receiving more than $117 million in sponsored research funding in fiscal year 2016. It is the 13th largest recipient of funding in the U.S. from the National Institutes of Health among independent hospitals. In 1997, BMC founded Boston Medical Center Health Plan, Inc., now one of the top ranked Medicaid MCOs in the country, as a non-profit managed care organization. Boston Medical Center and Boston University School of Medicine are partners in the Boston HealthNet - 14 community health centers focused on providing exceptional health care to residents of Boston. For more information, please visit

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.