Early-life Tobacco Smoke/Nicotine Exposure and Offspring Health

Maternal smoking and nicotine exposure during pregnancy are still considered to be significant global health crises as many decades ago, especially with the emergence of extensive electronic cigarette usage. The detrimental long-term repercussions in the offspring of mothers who smoke during pregnancy are not only concerning in regard to its effects on the lung, such as asthma, chronic lung disease, and increased risk for allergies and infections, but also of great concern are its effects on many other developing organs. For example, there is increased predisposition to metabolic disorders such as obesity and diabetes, heart damage, hypertension, altered internal oxygen sensing, infertility, and malignancies. Convincing evidence shows that the hazardous effects of perinatal tobacco smoke exposure on the development of lung and many other organs, including the transgenerational transmission of asthma, are nicotine mediated; additionally, many other mechanisms such as the reactive oxygen species-mediated damage, altered stress, and metabolic and epigenetic responses contribute. Not only the direct exposure via prenatal and postnatal maternal smoking is a risk, but also exposure to secondhand and thirdhand smoke is a concern, which could be equally or even more dangerous than firsthand smoke exposure. Finally, some of the effects following early-life exposure are not confined only to the exposed offspring but can also be transmitted transgenerationally.