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August 15, 1986

Fetal Tobacco Syndrome

Author Affiliations

Health Advocacy Center Palo Alto, Calif

JAMA. 1986;256(7):862-863. doi:10.1001/jama.1986.03380070068011

To the Editor.—  The American Medical Association's recent report on tobacco-products liability1 omitted an important source of probable future liability for tobacco companies: cigarette-induced diseases of pregnancy.Tobacco smoke contains many toxic substances, including nicotine, carbon monoxide, and radioactive polonium, which are transplacentally transmitted to the developing fetus. According to one authority, 13 700 perinatal deaths are caused each year as a result of smoking by pregnant women.2 The 1983 cost of providing neonatal intensive care for cigarette-related low-birth-weight infants is estimated to have been $180 million.3The association between tobacco use by pregnant women and infant disease and death is not a recent revelation. A 1957 study reviewed animal and human studies linking pregnant women's tobacco exposure with elevated infant death rates and reported a strong relationship between maternal cigarette smoking and premature delivery.4 In subsequent years, medical research linked maternal smoking with a growing