Cigarette Smoking of Pregnant Women
Date: 08 Mar 1982
Length: 3 pages
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Length: 3 pages
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- Vandenberg, B.J.
- REPT, OTHER REPORT
- LEGAL DEPT FILE ROOM
- Named Organization
- Kaiser Foundation Health Plan
- Named Person
- Yerushalmy, J.
- Date Loaded
- 07 Jan 1999
- Master ID
- 03607523-8364 Comprehensive Smoking Prevention Education Act of 810000 Hearing Before the Committee on Labor and Human Resources United States Senate Ninety-Seventh Congress Second Session on S. 1929
- 03607531-7540 97th Congress 1st Session S. 1929 to Amend the Public Health Service Act and the Federal Cigarette Labeling and Advertising Act to Increase the Availability to the American Public of Information on the Health Consequences of Smoking and Thereby Improve Informed Choice, and for Other Purposes.
- 03607587-7594 National Institute on Drug Abuse Technical Review on Cigarette Smoking As An Addiction
- 03607618-7620 Coaliion on Smoking or Health Seeks to Influence Legislators
- 03607621-7623 Coalition on Smoking or Health .. A Public Policy Project with the National Interagency Council on Smoking and Health
- 03607624-7626 Former Ftc Counsel to Staff Coalition on Smoking or Health
- 03607627-7629 Statement of the American Lung Association to the House Subcommittee on Health and the Environment on H.R. 5653, the Comprehensive Smoking Prevention Education Act
- 03607630-7636 the Importance of the Federal Government in the Prevention of Smoking Related Diseases Testimony in Support of H.R. 5653, A Revised Version of H.R. 4957 the Comprehensive Smoking Prevention Education Act by the American Lung Association
- 03607681-7692 Lung Cancer, Coronary Heart Disease and Smoking
- 03607717-7724 Statement on S. 1929 'comprehensive Smoking Prevention Education Act of 810000' of Dan G. Mcnamara, M.D., F.A.C.C. President to Honorable Orrin G. Hatch Chairman Committee on Labor and Human Resources
- 03607725-7726 File No. 792-3204
- 03607727-7730 Statement of the American Medical Association to the Labor and Human Resources Committee U.S. Senate Re: S. 1929 Comprehensive Smoking Prevention Education Act
- 03607731-7734 Statement on S. 1929 the Comprehensive Smoking Prevention Education Act of 810000 by John R. Walton, Rrt President
- 03607735-7740 Statement of the American College of Physicians on S. 1929, the 'comprehensive Smoking Prevention Education Act of 810000'
- 03607741-7749 Testimony of the American College of Chest Physicians Submitted by Thomas L Petty, M.D., F.C.C.P. President Regarding S. 1929 'the Comprehensive Smoking Prevention Education Act of 820000'
- 03607750-7751 Testimony of Action on Smoking and Health (Ash), by Its Executive Director and Chief Counsel, John F, Banzhaf III, Before the Senate Committee on Labor and Human Resources, Chaired by the Honorable Orrin G. Hatch, on the Comprehfnsive Smoking Prevention Education Act (S. 1929) Submitted 820402
- 03607752-7763 Federal Trade Commission Staff Report on the Cigarette Advertising Investigation
- 03607764-7770 Statement of the Bakery, Confectionery & Tobacco Workers International Union to the Senate Committee on Labor and Human Resources Re: S. 1929 'the Comprehensive Smoking Prevention Education Act of 820000
- 03607771-7790 Comments on H.R. 4957 - - Proposed 'comprehensive Smoking Prevention Education Act of 810000'
- 03607794-7809 Peter L. Berger
- 03607810-7813 Gilgamesh on the Washington Shuttle
- 03607814-7848 Statement Rodger L. Bick, M.D.
- 03607849-7854 Statement of Theodore H. Blau Ph.D. Presented Before Subcommittee on Health and the Environment House of Representatives
- 03607855-7858 Statement of Walter M. Booker, Ph.D.
- 03607859-7864 Statment Smoking and Fetal Growth
- 03607865-7873 Curriculum Vitae Oliver Gilbert Brooke
- 03607874-7884 Statement of Barbara B. Brown, Ph.D.
- 03607885-7892 Statement of Dr. Victor Buhler
- 03607893-7896 Statement of Jack Matthews Farris, M.D.
- 03607897-7909 Statement of Sherwin J. Feinhandler, Ph.D.
- 03607910-7936 Statement of Edwin R. Fisher, M.D.
- 03607937-7945 Statement of H. Russell Fisher, M.D.
- 03607946-7979 Statement of Jean D. Gibbons
- 03607980-7983 Statement of Katherine Mcdermott Herrold, M.D.
- 03607984-7997 Statement of Arthur Furst, Ph.D.
- 03607998-8015 Statement of Richard J, Hickey, Ph.D.
- 03608016-8021 Statement of Duncan Hutcheon, M.D., D.Phil. Departments of Pharmacology and Medicine 820312
- 03608022-8053 Statement of Leon O. Jacobson
- 03608054-8065 State Ment of Lawrence L, Kupper, Ph.D.
- 03608066-8085 Statement of Hiram Thomas Langston M.D. Clinical Professor of Surgery (Emeritus) Northwestern University Medical School
- 03608086-8091 the Alleged Cost of Cigarette Smoke
- 03608092-8121 Statement of Eleanor J. Macdonald Professor Emeritus of Epidemiology Department of Cancer Prevention University of Texas System Cancer Center M.D. Anderson Hospital and Tumor Institute, Houston, Texas
- 03608122-8129 Statement of John E. O'toole, Chairman, Foote, Cone & Belding Communications, Inc.
- 03608130-8166 Statement by L.G.S. Rao, Ph.D. Bellshill Maternity Hospital Bellshill, Scotland, U.K. Regarding H.R. 4957 S. 1929
- 03608170-8173 Statement of Henry Rothschild, M.D., Ph.D.
- 03608177-8190 Statement of Bernice C. Sachs, M.D., Seattle, Washington
- 03608191-8195 Concerning the 'comprehensive Smoking Prevention Act of 820000'
- 03608205-8236 Statement of Sheldon C. Sommers, M.D.
- 03608237-8246 Statement Professor T.D. Sterling
- 03608247-8275 Statement of Professor Yoram J. Wind for Submission to the Subcommittee on Health and the Environment
- 03608276-8277 for Use at 10 A.M. Tuesday, 820316
- 03608278-8287 Statement of Robert Casad Hockett
- 03608288-8317 Relationships Between Family Smoking Habits, Individual Differences in Personality, and the Smoking Behavior of College Students
- 03608318-8337 Personality and Smoking Behavior
- 03608338-8364 on the Relation Between Family Smoking Habits and the Smoking Behavior of College Students
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268 March 8, 1982 Cigarette Smoking of Pregnant Women A note regarding the "Comprehensive Smoking Prevention Education Act of 1982" HR 5653 S. 1929 My name is Bea J. van den Berg. Currently I am director of the Child Health and Development Studies, a research unit of the School of Public Health of the University of California at Berkeley. I received my medical doctor's degree in the Netherlands and in 1965 I joined the research staff of the Child Health and Development Studies that were designed and directed by the later Dr. J. Yerushalmy, professor of Biostatistics at the University of California at Berkeley. My CV is enclosed with the copy of my statement. I am here to express my concern about the statements made in the proposed 'Smoking Prevention Education Act of 1982" regarding an increased risk of spontaneous abortion, stillbirth, premature birth, child weight deficiencies and birth defects in pregnant women who smoke. For many years I have been involved in research regarding pregnancy and pregnancy outcome, and research results do not support these statements. Our studies were among the very first to identify the lower birth weight of babies born to smoking mothers as compared with that of non- smoking mothers. However, our studies did not indicate an increased risk of abortion and still births among smoking pregnant women nor are our studies supportive of the stated increased risk of birth defects. For almost two decades, at the Child Health and Development Studies, we have studied the pregnancy outcome of women who smoked cigarettes during pregnancy, in comparison with women who never smoked or who stopped smoking before or early in their pregnancy. These studies were based on interviews, early in their pregnancies, of scme 15,000 women who were members of Kaiser Foundation Health Plan, and who enrolled in the Child Health and Development Studies. Extensive information was obtained from the medical records of the mothers during their pregnancy and delivery and from the medical records of the children from birth to at least age five. Our studies are prospective and observational; prospective because the smoking data were assembled before the outcome of the pregnancy was known. This approach avoids a possible recall bias that might occur when the mothers are interviewed after the termination of the pregnancy. An unfavorable pregnancy outcome might affect the mothers' recall of any event that occurred during her pregnancy, including smoking habits. Our studies 269 -2- are observational and not experimentalj t'. researcher, but the women themselves decic cigarettes. The women in these separate r only in their smoking habits, but also in charactenistics. This methodological pro! as the problem of self-selection, has to : compare the pregnancy outcome of women whc outcome of women who do not smoke. I would like to summarize the resulte relate to the statements concerning preqnc On birth weight. As early as in 196: increased proportion of low birth weight : smoking pregnant women as compared with tt pregnant women. The observed association relationship but it may also be influencec and non-smokers in characteristics other t indeed showed that a variety of other matc socioeconomic status, maternal age and et` association between smoking during pregna: Controlling for a number of these variabl, the birthweight of the offspring of both Yerushalmy'a later work on maternal : methodologies and designing studies to te: the alternative hypothesis that increased due to the differences between smoking anc such study evaluated the frequency of low of mothers who began smoking after the bi: that women who subsequently became smoker: low birth weight babies during the period finding cannot be explained by the causal need for a larger study to confirm or ref. On abortion and stillbirth. Our sta- week of gestation the risk of fetal death pregnant women, failed to find a differen, results, based on the pregnancy outcome o provide evidence that smoking during preg: abortion and stillbirth. On birth defects. We recently publi. of the incidence of congenital anomalies children born to women who never smoked, to women who smoked during pregnancy. Th enrolled in the Child Health and Developm. show a difference in the incidence of sev children of smoking women and children of : I to
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269 -2- an ss.rntioeal ard not .>re='-aental: this signifies that not the 90.sra.r, but th. Mom.n -~e:ves decide whether or not to smoke .#&qaat... SA. ,ros.n Ln :: cs. separate groups might be different, not M;f La t.`uir saoking haL.iv, t7ut also in various other known or unknown pArs..^tsyatica. This a. ~Odclogical problem, coined by Dr. J. Yerushalmy M p,%* procl.m of s.lf-se:ac~_i-n, has to be taken into consideration if we smwear. Use pr.gnancy out_-aoe cf women who do smoke with the pregnancy Kteo.e of voo.n who do not sxke. I would like to r^-a:z.e the results of our studies to date that p/ate to the statements -+++ce^ing pregnancy in the proposed Bill. Cn birth weight. As ear_y as in 1962 Dr. Yerushalmy reported an lecz.as.d proportion of :.,^r `:;..h weight infants among the offspring of saaxinq pregnant women as ==-a red with the offspring of non-smoking pr.y-iant women. The obse_~d association may indicate a cause-and-effect r.lationship but it may a:.so be influenced by differences between smokers ar.: -ten-smoKers in chara=e=s-.ics other than smoking. A later study lyd.ad showed that a var-=ety of other maternal characteristics, such as socioeconomic status, ma=er_a.i age and ethnic background, influence the association between szti;ci..^g during pregnancy and birthweight of offspring. Cantrollir.g for a number =f -_"nese variables reduces the crude difference in the birthweight of the ofsr-i.ng of both groups of women. Terushalmy's later work on maternal smoking was aimed at developing rtlvdologies and desigm_i-mg studies to test the causal hypothesis against the alternative hypothesis that inceased incidence of low birth weight is due to the differences :De:+ee.n smoking and non-smoking pregnant women. One .uch study evaluated the f--e:,uency of low birth weight among the offspring of mothers who began smo<<-g after the birth of the infants. It was found that women who subsequently became smokers also had a high incidence of low birth weight babies durirg the period before they started to smoke. This finding cannot be explained by the causal hypothesis and underscores the need for a larger study to confirm or refute this finding. On abortion and stillbi--,.h. Our statistical study, comparing for each week of gestation the risk of fetal death for smoking and non-smoking pregnant women, failed to find a difference between the two groups. These results, based on the pregnancy outcome of 15,000 pregnant women, do not provide evidence that smokinq during pregnancy raises the risk of spontaneous abortion and stillbirth. On birth defects. We recently published the results of our evaluation of the incidence of congenital anomalies (or birth defects) among the 14,735 children born to women who never smoked, to women who were past smokers or to women who smoked during pregnancy. The children were offspring of mothers enrolled in the Child Sealth and Development Studies. Our data did not show a difference in the incidence of severe congenital anomalies among children of smoking women and children of women who never smoked. We also T
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270 -3- ]qoked at the incidents of non-severe congenital anomalies. We found that, while the incidence of these non-severe birth defects among children of h.avy smokers (more than 20 cigarettes per day) was slightly more than among children of non-smokexs, the incidence among children our light smokers (less than 20 cigarettes per day) was equal to that of the children of non-smokers. These observations, again, do not support the statement in the proposed Bill that cigarette smoking by pregnant women may result in birth defects. In conclusion, our data do not support the statements in the proposed Bill. 'tc 27 PETER L. 4 Worthinc Brookline, M Tel. (617) I am a sociologist, cur Boston University. The following does not necessarily represent tYh which I am affiliated. (A brief My attention was first by an article in the New York T subsequently obtained the texts o my opinion, constitute a further for some time now, interested me me as a citizen; that is, the anti-smoking movement and its a smoking activity. I have no comaetence questions at issue. However, I c to the broader social and culture and it seems to me that it rai: questions about the scope and pu- on which any citizen has the righ What first interested aggressiveness with which anti-s their campaign. It annoyed me a should say that I smoke cigars ar. are the major targets of the anti