OBJECTIVE: Maternal smoking across pregnancy and childhood is associated with adverse mental
health outcomes in offspring. Few studies have prospectively examined this using administrative
data. This study investigated whether maternal smoking from prepregnancy through the child’s
early adolescence (age 13 years) was associated with mental health diagnoses in the offspring (ages
18-23 years), identified via medical service use.
METHODS: Data came from 2082 mother-child dyads in the Québec Longitudinal Study of Child
Development (born in 1997-1998) linked to administrative health databases. Maternal smoking was
reported when children were aged 5 months and 1.5, 2.5, 3.5, 5, 7, 10, and 13 years. Trajectories were
identified using latent class growth analysis. Offspring mental health diagnoses (mood disorders,
anxiety disorders, psychotic disorders, and Attention-Deficit/Hyperactivity Disorder [ADHD]) were
extracted from administrative databases between ages 18 and 23 years. Poisson regression models
were adjusted for key sociodemographic and perinatal confounders.
RESULTS: Three smoking trajectories were identified: no smoking (77.3%), moderate sustained
smoking (~11 cigarettes/day; 15.1%), and high sustained smoking (~19 cigarettes/day; 7.4%).
Offspring of mothers in the high sustained smoking group had a higher risk of mood (risk ratio
[RR], 1.83; 95% CI, 1.28–2.60), anxiety (RR, 1.55; 95% CI, 1.16–2.05), and psychotic (RR, 3.33; 95%
CI, 1.43–7.78) diagnoses compared with the offspring of nonsmoking mothers. No associations were
observed for moderate sustained smoking or ADHD diagnoses.
CONCLUSION: High sustained maternal smoking from prepregnancy through child’s early
adolescence was associated with increased likelihood of mood, anxiety, and psychotic diagnoses in
offspring during young adulthood. Maternal smoking may inform youth mental health screening
Olivier Legault, Ophélie Collet, Pablo Martinez, Gillis-Delmas Tchouangue-Dinkou, Emile Diamant, Jiacheng Chen, Laurie Charest, Marie-Claude Geoffroy, Massimiliano Orri, Nicholas Chadi, Sylvana M. Côté; Association of Prepregnancy to Early Adolescence Maternal Smoking With Young Adult Mental Health. Pediatrics Open Science June 2026; 2 (2): 1–11. https://doi.org/10.1542/pedsos.2025-001060
