ASPPH logo


Member Research & Reports

Member Research & Reports

East Tennessee Researchers Find Connection between Prenatal Smoke Exposure and Adolescent Obesity

Four East Tennessee State University faculty members and a doctoral student recently authored an article addressing the independent and joint effects of prenatal maternal smoking and maternal exposure to second-hand smoke on the development of adolescent obesity. The article was published this summer in the Journal of Pediatrics and Child Health. Drs. Liang Wang, Hadii Mamudu, Arsham Alamian and James Anderson – all faculty within ETSU’s College of Public Health – and Mr. Billy Brooks, a doctoral student in public health, conducted the longitudinal study that resulted in the article.


[Photo: Dr. Liang Wang]

Using data from 1991-2007 from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development, the researchers examined children ages 12-15 whose mothers had smoked while pregnant and/or had been exposed to second-hand smoke during pregnancy. “Through this study, we realized there is an increased risk of obesity when both prenatal maternal smoking and exposure to second-hand smoke are present,” said Dr. Wang, lead author for the project. “If you are in both smoking environments, it is worse.”

Results of the study showed that obesity was more prevalent among adolescents whose mothers smoked or had second-hand smoke exposure than adolescents whose mothers did not smoke or have such exposure. The odds for obesity more than doubled among adolescents when there had been exposure to both types of smoking compared to those without any exposure.

Additional factors determined to be associated with increased odds of obesity were maternal obesity, not breastfeeding and longer screen viewing hours per day. Dr. Wang focuses much of his research on obesity, particularly in youth. “This age period is very significant,” Dr. Wang said. “If you become obese as an adolescent, it is likely that you will remain obese as an adult. So we want to focus on early ages to prevent it in the first place.” That, Dr. Wang noted, is a big challenge.

“Obesity is very complex. We need a lot of expertise in a lot of areas and we need to work together to address this,” he said. “We need more scientific ways to work on this problem, especially in Tennessee and the Appalachian region as a whole.” Dr. Wang hopes the findings of this particular study will help, in part, to solve the obesity epidemic.

“This study links obesity and smoking,” he explained. “The findings suggest that adolescent obesity could possibly be curtailed with the development and promotion of smoking cessation programs for families during the year before birth.” Dr. Wang conducts obesity research in both the United States and internationally. He has authored nearly 40 publications since 2011 and is working closely with Dr. Youfa Wang, an internationally known expert and leader in the childhood obesity, to conduct more obesity studies.