Friday, 26 July 2013

On maternal smoking during pregnancy, from the Daily Mail and Pfizer

Rarely does one get to the nub of an issue so quickly. This research was reported in the Daily Mail under the heading 'Does smoking make you a bad parent?' two days ago, focussing on parenting behaviour. It was reported yesterday under the heading 'Mothers who smoke during pregnancy are more likely to have children with "bad behaviour or ADHD"', in the same paper, this time drawing a link between behaviour problems and maternal smoking. Both carry the paragraph:
The research was carried out by pharmaceutical company Pfizer as part of their Don't Go Cold Turkey Campaign and asked 6,271 smokers about how they funded smoking in tougher economic times.
In these tough economic times, indigent smokers are under scrutiny as a potential cash cow for Pfizer – which wants to sell a smoking cessation remedy. That is really all these appalling stories are about. Trying to persuade people not to give up smoking without help from pharmaceutical companies – it really is that cynical.

Time was when most parents in the UK smoked – the baby boom years of the fifties and sixties, before smoking was recognised as a major public health issue. There are still people around who remember those days. 

This study and associated surveys are in especially bad taste, as they seek to give the impression that only smoking parents ever deprive their children in order to fund treats for themselves. In the usual fashion of anti-smoking studies, the standards are rigorously unscientific, and no control is provided. (As for those stealing from their children's money boxes I suspect that many who admitted to doing this were in the grip of a stronger addiction than tobacco, but the survey wasn't about strong drugs.)

We should also not forget that behavioural problems have a huge number of factors to explain them –  an exponential increase in autistic spectrum disorders is just one of these. The most important factor is that they are a subjective issue – behaviour is a problem if it affects others and they perceive it to be a problem. Consider this paragraph, from the second report:
“Our findings suggest an association between pregnancy smoking and child conduct problems that is unlikely to be fully explained by postnatal environmental factors (i.e., parenting practices) even when the postnatal passive genotype-environment correlation has been removed.” The authors conclude, “The causal explanation for the association between smoking in pregnancy and offspring conduct problems is not known but may include genetic factors and other prenatal environmental hazards, including smoking itself.”
Trying to work out in such precise terms the factors for 'conduct problems' is a curious intellectual feat, precisely because conduct problems, like heart attacks and lung disease, are multi-factorial. The very word 'problem' has to be enormously problematic when making a scientific evaluation, because of its subjectivity. Behavioural problems might be any one of a number of issues of varying seriousness. They might exist only in the eyes of  monumentally selfish parents not prepared to give their children the time of day, or appear in an autistic child, without the power of speech, in physical pain and unable to explain his frustration – or a combination of anything in between.

That the study is clearly geared to promoting smoking cessation medications could not be clearer (as quoted above in the Daily Mail article: the press release also refers to 'funding disclosures' but I haven't been able to reach the study itself). It clearly fails to ask other pertinent questions, such as whether an austerity programme is really the best answer to our economic situation, with people experiencing unemployment and other cuts in the family budget. Or whether such high tobacco taxes can be avoided – because surely so much stress on families will make it harder for parents to make the decision to stop smoking until some of the chronic uncertainty in their lives is resolved.

But no, the pressure on smokers is set up specifically to the advantage of a pharmaceutical giant, and dressed up as public health in the interests of smokers and their children.

1 comment:

Anonymous said...

Children with ADHD may smoke to treat their attention problems:
ADHD is hereditary.
So... it's the wrong way round!