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February 28, 1986

Maternal Cigarette Smoking and the Ghost of Yerushalmy—Will It Ever Rest?

Author Affiliations

University of Leeds Leeds, England

JAMA. 1986;255(8):1019. doi:10.1001/jama.1986.03370080041016

To the Editor.—  The results of two randomized controlled intervention trials of antismoking advice during pregnancy have now been reported.1,2 In the first, carried out by Donovan1 in 1972 and 1973 in London, the mean birth weight for singleton live births in the control group was 12 g higher than in the intervention group; the difference was not statistically significant.1 In the second trial, carried out in the United States and reported in 1984, the mean birth-weight difference (92 g) was in the opposite direction; it was statistically significant (P<.05) and corroborated the hypothesis that cigarette smoking during later stages of pregnancy causes a reduction in fetal growth.2There is no clear explanation2 for the divergent results between the two trials but Berman and colleagues3 suggest that if answers to three questions could be given "in the causal direction, we may then truly be