Children and smoking: the family circle

Children's and adults' smoking can form a 'family circle'. Young women and their male partners who are less well-educated and less affluent are most likely to smoke during the woman's pregnancy. The harmful effects on the fetus, including low birth weight and increased risk of respiratory diseases, are carried forward into childhood. The frequent minor ailments can cause absence from school, falling behind with school work and perhaps under-achievement. Children of mothers who smoked during pregnancy are likely to have smaller stature which can also affect self-esteem. Passive smoking in the home exacerbates these effects and adds others. The child, therefore, can become disenchanted with school and reject its norms and is then at increased risk of becoming a smoker. These young smokers are most likely to leave school early, to start families early and to smoke during pregnancy, thus continuing the 'family circle' or 'cycle of deprivation'. Practical action is needed.